Establishing Identity of ED Patients

[Jolie]

What is the procedure in your ED for verifying the identity of patients? Do you photocopy or scan a photo ID, take a digital photo for the medical record, or use some other method?

Has your department detected individuals misrepresenting their identity to obtain care under someone else's insurance?

[Jolie, BSN]

I'm asking as an employer, not a caregiver.

I have been made aware that a former employee allowed someone else to access "emergency" care using his insurance coverage (a plan we pay in full.) I reported this to the insurance company, and have been amazed at the claims representative's lack of knowledge regarding ED practices.

She insists that the ED would not have seen a patient without first proving identity. I know better, but my hands are tied. Due to privacy laws, I am prohibited from seeing the medical records and must rely on this individual to investigate for me. It's a frustrating, cumbersome process.

This type of fraud hurts us all.

[Penelope_Pitstop, BSN, RN]

I'm asking as an employer, not a caregiver.

I have been made aware that a former employee allowed someone else to access "emergency" care using his insurance coverage (a plan we pay in full.) I reported this to the insurance company, and have been amazed at the claims representative's lack of knowledge regarding ED practices.

She insists that the ED would not have seen a patient without first proving identity. I know better, but my hands are tied. Due to privacy laws, I am prohibited from seeing the medical records and must rely on this individual to investigate for me. It's a frustrating, cumbersome process.

This type of fraud hurts us all.

Our ED has cameras all through the waiting room and and entrance. I wonder if that could assist you (or her)?

[smoup]

I work in ER registration and we are responsible for registering the patient when they first come in. We ask for photo ID. If they don't have any, name and birthday. If they are found in the system we ask them to verify another piece of information, last four of SSN, address, phone, middle initial, etc. Normally not a big deal. We also scan photo ID's each time a patient visits so we can compare them from one visit to another if need be.

We had had people using other people's name/ins though I am not sure how it was found out. We were given photocopies of what the person looked like and told to report to security if seen again.