Expert advice on limiting medical identity theft

Reducing exposure to medical identity theft has become a priority for insurers as rising numbers of customers fall victim to this crime.

For advice on curbing identity theft and the healthcare fraud that often follows on its heels, FierceHealthPayer brought in two experts to speak on an identity theft webinar earlier this year: Marita Janiga, J.D., executive director of the National Special Investigations Unit and Hotline at Kaiser Permanente, and Rebecca Busch, R.N., president and CEO of Medical Business Associates, Inc.

Below you’ll find some highlights from the question and answer portion of the event, which was presented in partnership with the National Health Care Anti-Fraud Association.

FierceHealthPayer: AntiFraud: What identity theft red flags should payers share with providers? How can payers educate providers on this topic?

Rebecca Busch (right): One sign of possible identity theft for providers is when they suddenly start receiving overpayment notices that make no sense. These may be due to the actions of outsourced billing vendors. In some cases, the person who stole the identities and submitted false claims was the billing vendor, but it was the provider who was pursued for the crime.    

Marita Janiga: Tell providers not to be afraid to ask tough questions. Be probative. If something doesn’t look or seem right, providers should actively question the patient who’s giving them information or an explanation that doesn’t make sense at the point of service.    

Article source: http://www.fiercehealthpayer.com/antifraud/story/expert-advice-limiting-medical-identity-theft/2014-10-14

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