Slide 1 Identity Theft Prevention Program Welcome to the Identity Theft Prevention Program annual training course. Your personal identification information can be used by individuals seeking to use your identity for criminal purposes. This is identity theft. Identity theft can cause severe consequences for its victims. In this brief training, you will learn how you can help prevent, identify and respond to situations involving identity theft. 1
Slide 4 Objectives Upon completion of this course, you should be able to: Explain the purpose of the LVHN Identity Theft Program Define medical identity theft List three consequences of identity theft List precautions that individuals can take to avoid identity theft Identify the appropriate information that should be obtained to verify patient identity and four acceptable forms of identification Identify the four categories of red flags for identity theft in healthcare Upon completion of this course, you should be able to: Explain the purpose of the LVHN Identity Theft Program Define medical identity theft List three consequences of identity theft List precautions that individuals can take to avoid identity theft Identify the appropriate information that should be obtained to verify patient identity and four acceptable forms of identification Identify the four categories of red flags for identity theft in healthcare 4
Slide 5 Purpose Lehigh Valley Health Network s Identity Theft Prevention Program: Detect, prevent, decrease, and respond to identity theft Look for red flags of identity theft The Identity Theft Prevention Program can be found in the Administrative Manual on the LVHN Intranet. Click here to review the Identity Theft Prevention Program. In January 2008, the Federal Trade Commission (FTC) issued a set of regulations requiring certain organizations to develop a written program to spot the warning signs or red flags of identity theft. The purpose of the Identity Theft Prevention Program at Lehigh Valley Health Network is to detect, prevent, decrease, and respond to identity theft. LVHN s Identity Theft Prevention Program follows the guidelines issued by the FTC and the Fair and Accurate Credit Transactions (FACT) act. The Identity Theft Prevention Program looks for potential cases of identity theft by assessing patterns, practices and actions - these are the red flags of identity theft. Click the link to review the Identity Theft Prevention Program. A copy of Identity Theft Prevention Program policy document is provide in the folder. 5
Slide 6 What is Identity Theft? Identity Theft is a fraud committed or attempted using the identifying information of another person. Identity Theft can be broken down into sub categories: Financial Identity Theft Medical Identity Theft Identity Theft was the #1 consumer complaint in 2008 What is identity theft? Identity theft is a fraud committed or attempted using the identifying information of another person. Identity theft can be broken down into sub-categories: Financial Identity Theft Medical Identity Theft According to the FTC, identity theft was the number 1 consumer complaint in 2008. 6
Slide 7 Medical Identity Theft Taking someone s identity: To receive care To make false claims for money And in the process, adding false information to the person s medical record. The World Privacy Organization defines medical identity theft as theft that occurs when someone uses a person s name and sometimes other parts of their identity such as insurance information or social security number without the victim s knowledge or consent to obtain medical services or goods, or when someone uses the person s identity to obtain money by falsifying claims for medical services and falsifying medical records to support those claims. 7
Slide 8 Mr. Jones is the unknowing victim of medical identity theft. Claims have been submitted in his name for procedures that he never had. How do you think this will impact Mr. Jones? Click each of the buttons to learn about the consequences of medical identity theft. 8
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Slide 9 Avoiding Identity Theft Share personal health information only with trusted providers Review the Explanation of Benefits to monitor claims submitted in your name Request an annual summary of benefits paid from the insurer Review credit history How can you avoid becoming a victim of identity theft? Take these precautions to protect yourself: Share personal health information only with trusted providers Review the Explanation of Benefits that come from insurers to monitor claims submitted in your name Request an annual summary of benefits from the insurer Review your credit history 11
Slide 10 Steps LVHN Has Taken To help prevent identity theft, LVHN has: Established verification process Minimized use of social security numbers Created safeguards for all identifiable information Implemented procedures for disposal and destruction of health information Lehigh Valley Health Network has also taken steps to prevent identity theft. LVHN has: Established a verification process Minimized the use of social security numbers Created safeguards for all identifiable health information Implemented procedures for the disposal and destruction of health information 12
Slide 11 Why is the Program Important? The Identity Theft Prevention Program is important because it: Is required by the government Helps LVHN identify and correct potential identity theft risks Why is LVHN s Identity Theft Prevention Program important? First, the program is mandated by the government. The Federal Trade Commission (FTC) requires a written program to spot the warning signs of identity theft. The program also benefits the network. By having an Identity Theft Prevention Program, LVHN is able to quickly identify and correct any potential identity theft risks. 13
Slide 12 PROPERTIES Allow user to leave interaction: Show Next Slide Button: Completion Button Label: Anytime Don't show Next Slide A Red Flag is a pattern, practice, or specific activity that indicates the possibility of identity theft. Red flags fall into one of four categories for healthcare. Click each of the red markers to learn about the four types of red flags. Red Flag 1: Suspicious Documents The first category of red flags is suspicious documents. Examples include: Patient s identification documents appear to have been altered Expired Driver s License or Insurance Card Red Flag 2: Suspicious Identifying Information The second category of red flags in suspicious identifying information. Examples include: Driver s License picture does not match the patient 14
Patient has an insurance number but no insurance card and you cannot find active coverage Information differs from that previously provided Invalid telephone number or address Red Flag 3: Suspicious Activity to an Account The third category of red flags is unusual use of or suspicious activity to an account. Examples include: Mail is undeliverable, but the patient presents for treatment Non-payment for services when there is no history of a late payment Frequent address changes Multiple alias names Red Flag 4: Alerts from Others The fourth category of red flags in alerts from others. Other people, including law enforcement, patients, and the identity theft victim, could alert you to possible identity theft. Examples include: Family members call the patient by a different name Notification by other healthcare organizations or insurance carriers 15
Slide 13 Patient Verification Obtain appropriate demographic and insurance information from your patient: Full name Date of birth Address Social Security Number Photo ID/Driver s License Insurance Card Verify electronic insurance eligibility for all carriers To help prevent identity theft, Lehigh Valley Health Network has implemented a verification process for both new and existing patients. Obtain the appropriate demographic and insurance information from your patient. This includes: Full name Date of birth Address Social security number Photo ID/Driver s License Insurance card You should also verify electronic insurance eligibility for all carriers. 16
Slide 14 Acceptable Forms of Identification Driver s License Birth Certificate Passport Military ID Social Security Card School ID Work ID Permanent Residence Card (Green Card) Voter Registration Card Acceptable forms of identification include: Driver s License Birth Certificate Passport Military ID Social Security Card School ID Work ID Permanent Residence Card (Green Card) Voter Registration Card If you have any concerns or questions regarding a patient s identity, ask for a second form of identification to verify the patient s identity. 17
Slide 15 If You Suspect Identity Theft 1 Gather information DO NOT confront the patient 2 Provide Care NEVER turn a patient away! 3 4 Notify your supervisor/manager Notify Security (610-402-8220) and provide: Name Medical record number Account number (when applicable) 5 Complete a Patient Safety Report If you suspect identity theft, you should gather as much information as possible. But, you should not confront the patient yourself. Even if you suspect identity theft, you should provide care. Never turn a patient away! You should notify your supervisor or manager and security. When contacting security, provide the patient s name, the medical record number and the account number when applicable. Finally, you should complete a Patient Safety Report. The Patient Safety Report can be accessed through the SSO toolbar. 18