Protecting Information: Its a Top Priority

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Medical Identity Theft (MIT)

• Taking someones identity
• To receive care
• To make false claims for money
• And in the process
• Adding false information to a persons medical
  record

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Impact on an Individual

• Possible Consequences of MIT
• Wrong information in the record can lead to
• 1. Future denials of insurance coverage
• 2. False claims that count toward a lifetime
  maximum
• 3. False diagnoses
• 4. Unsafe or deadly care

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Impact on the Care Provider

• The care provider relies on the health record for
  the truth of the patients condition and status.
  
• The ability to provide the correct treatment to
  the correct patient depends upon the accuracy of
  the health record.

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Impact on the Care Provider

• When the record is on paper, separating the true
  from the false information can be difficult, but
  in the electronic record, it is even more
  complicated.

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Precautions for Individuals

• What can individuals do? There are several steps
  an individual can take
• Share personal and health insurance information
  only with trusted providers.
• Review the Explanation of Benefits that come from
  insurers to monitor care that is billed in your
  name.

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Precautions for Individuals

• Request a yearly summary from the insurer of all
  the benefits paid for that year.
• Maintain copies of your healthcare records (see
  www.MyPHR.com for further help).

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Precautions for Individuals

• 5. Check your personal credit history for
  medical liens
• 6. Question telephone marketers or anyone
  offering free service (such as immunizations,
  free samples or other activities, and in the
  process, ask for your insurance card).

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Precautions for Individuals

• Request a yearly accounting of disclosures from
  your healthcare providers.
• When you find errors in your record, request that
  they be removed and your record amended.

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Preventative Measuresfor Healthcare Providers

• Establish patient verification processes that
  include some kind of photo identification. Make
  sure the process is as thorough as possible.

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Prevention Measuresfor Healthcare Providers

• 2. Minimize the use of social security numbers
  and, if at all possible, eliminate using it and
  displaying it altogether.

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Preventative Measures for Healthcare Providers

• Store individually identifiable health
  information in a secure manner and ensure that
  administrative, technical, and physical
  safeguards are in place.

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Prevention Measures for Healthcare Providers

• 4. Implement and comply with procedures for
  the appropriate disposal and destruction of any
  media used to collect and store individually
  identifiable health information.

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Red Flag Rules

• The Federal Trade Commission has established a
  deadline for compliance with a new rule mandating
  programs to guard against identity theft.
• Organizations that can be considered creditors
  must comply with this rule.

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Red Flag Rules

• What Are the Red Flag Rules?
• A written program that identifies and detects the
  warning signs of identity theft and also
  describes appropriate responses to prevent and
  mitigate the crime.

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Red Flag Rules

• Red Flags fall into five categories
• Alerts, notifications, or warnings from a
  consumer reporting agency
• Suspicious documents
• Suspicious personally identifying information,
  such as a suspicious address
• Unusual use of or suspicious activity
  relating to a covered account and
• Notices from customers, victims of identity
  theft, law enforcement authorities, or other
  businesses about possible identity theft in
  connection with covered accounts.

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Questions?
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References Used

• World Privacy Forum www.worldprivacyforum.org
• AHIMA Practice Brief Mitigating Medical Identity
  Theft, found online at www.ahima.org.
• Red Flag Rules, found online atwww.ftc.gov
• www.MyPHR.com