Provider personnel will follow the following procedures in order to detect the red flags indicated above, which indicate the possibility of identity theft.
(A) The process of confirming a patient's identity should never delay the delivery of urgently or emergently needed medical care. When a patient's condition permits collection of demographic information and documentation, medical transport crews shall request, in addition to an insurance card, a driver's license or other form of government issued photographic personal identification. If the patient lacks such photographic identification, medical transport personnel shall:
(1) Request other form of identification, such as a credit card; and/or
(2) Ask a family member or other person at the scene who knows the patient to verify the patient's identity.
(B) Billing personnel, in the course of creating and processing claims, and verifying patient information, shall be alert for the existence of any of the red flags listed in § 36.03 above.
(C) Before providing information regarding an account, or making any change to an address or other information associated with an account, the requester shall be required to provide the social security number, full name, date of birth and address of the patient. If the requester makes the request in person, a driver's license or other government issued photographic identification shall be requested.
(D) In the event medical transport personnel or billing personnel encounter a red flag, the existence of the red flag shall be brought to the prompt attention of the individual's supervisor or the Program Compliance Officer so that it can be investigated and addressed, as appropriate, in accordance with the procedures set forth in § 36.05 below.
(Ord. 2416, passed 7-13-2010)