Alert! Access areas at high risk for fraud
Alert! Access areas at high risk for fraud
Protect patient information
Could a patient standing in front of you be using another patient's ID and insurance to obtain care? Is someone stealing a patient's information to obtain credit fraudulently? These areas are the primary risk in registration areas, according to Dan Schulte, executive vice president of revenue cycle solutions at The Outsource Group in St. Louis, MO.
Schulte recommends that patient access leaders take these steps:
Store all patient-identifying information under lock and key in a secure office, and not in bins or trays.
"Registration forms with demographic information or insurance information should be signed and then secured," says Schulte.
The best practice is to eliminate the permanent paper record by scanning and then destroying paper forms, he advises, or using digital solutions entirely, including digital signature devices.
Immediately move any document with protected health information (PHI) away from any area easily accessed by the public.
If a registrar is interviewing a patient at the counter or in a booth, he or she should enter data with the computer screen situated so the public cannot see it, print on a printer away from public access, and immediately obtain any printed forms for immediate signature and proper disposition, says Schulte.
Manage all financial information in a private office.
Payments, credit card information exchange, receipts, charity care applications, pay arrangements, and promissory notes are not for public domain, warns Schulte.
"These transactions have the highest threat of identity theft," he says. "Complete these tasks in a more private area."
Ensure that policies and processes are clearly understood regarding Red Flag Rules and other identity-related issues.
"These should be as important to patient access as the Fraudulent Claims Act is to the billing group in the business office," says Schulte.
Each group needs to develop a "visible culture of compliance," in which identifying problems, fixing them, and preventing future problems is an everyday occurrence, he says.
"This will take a commitment from top to bottom in the organization," he says. "It will require resources to educate, monitor, support, and counsel every employee on a regular basis."
Identify every patient being registered with a legitimate ID card.
"Unless the patient is a clearly defined emergency or urgent care patient, the patient's ID should be clearly established before treatment begins," says Schulte.
Sources
For more information on preventing fraud in registration areas, contact:
Na Toshia Joseph, Manager, Patient Access Services/Quality and Process Improvement, St. Luke's Episcopal Hospital, Houston, TX. Phone: (832) 355-7935. Email: [email protected].
Dan Schulte, The Outsource Group, St. Louis, MO. Phone: (314) 692-6500. Email: [email protected].
Could a patient standing in front of you be using another patient's ID and insurance to obtain care? Is someone stealing a patient's information to obtain credit fraudulently? These areas are the primary risk in registration areas, according to Dan Schulte, executive vice president of revenue cycle solutions at The Outsource Group in St. Louis, MO.Subscribe Now for Access
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