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New Rice policy aims to reduce risk of patient misidentification, identity theft

Elizabeth Cruze, a records management clerk at Rice Memorial Hospital in Willmar, sorts through a stack of patient medical files. Tribune photo by Anne Polta

WILLMAR -- While the patient was in Rice Memorial Hospital's emergency room, nurses happened to overhear family members discussing what name to use.

It was an immediate tip-off: Here was a patient who might be using a fake ID.

Hospital officials and staff can count on at least a few cases each year of patients using a false name, an identity stolen from someone else, or someone else's insurance card.

When it's a matter of patient care, it can be a serious issue, said Stephanie Brown, manager of the business office at Rice.

"There's a lot at stake when it comes to identity theft," she said. "Medical errors could occur. It's not just their credit or stealing someone else's insurance benefits."

Hospital officials hope to reduce the risk and cut down on the incidence of identity theft and patient misidentification with a new policy adopted earlier this month. Hospitals across Minnesota and the U.S. are taking similar steps to comply with the Federal Trade Commission's identity theft prevention rules.

"It's a very broad policy. It's very detailed," Brown said. "It's designed to protect patients' credit, their health information and patient safety from misidentification."

Most of the time, when a patient shows up at Rice Hospital with a fake ID, it's an ID that has been purchased for obtaining employment, she said.

Less often, a patient will present a stolen insurance card. There've also been cases, although not locally, of hospital or clinic employees stealing patients' Social Security numbers and then selling them.

And sometimes, Brown said, the wrong file accidentally gets pulled for a patient who has a similar name to someone else. "You have to be careful," she said.

Someone whose insurance card is stolen might wind up owing thousands of dollars for care that was actually provided to someone else. By the time the case is untangled, the hospital might be unable to collect its money from the real patient.

The main concern, however, is for patient safety and for ensuring medical charts are matched with the right person, Brown said.

Last year someone came to the hospital using an ID that belonged to someone else who lives in the Willmar area, and their medical files, containing critical information about health history, allergies and so on, became mingled, she said.

The hospital is still working on straightening it out, she said. "There'll be a pretty involved process to make sure the charts are accurate. There'll be alerts on the chart. There'll be alerts on the account."

Similar problems can result when patients use a different fake ID each time they come to the hospital, ending up with their medical information scattered across multiple charts.

Rice's new policy outlines procedures for confirming the patient's identity when he or she is admitted.

Staff have already begun scanning in IDs so the information can be stored and retrieved later, Brown said. "This is mainly driver's licenses. That's our first line of defense," she said.

The policy also outlines what steps to take if a patient is accidentally misidentified or is suspected of using a false ID.

This is important for hospital staff, said Dale Hustedt, associate administrator for facility and human resources.

"It allows us to identify how we're going to do the investigation and look further and how we're going to deal with it," he said. "There are questions about where does identity theft begin and HIPAA privacy rights end."

"I think it's so helpful for all the staff," Brown agreed.

Identity issues can be uncovered in various ways, she said. Sometimes, as in last year's case in the emergency room, patients and families drop clues in their conversation. Other times, it's caught during the registration process or when new parents fill out a birth certificate.

"There's a lot of different ways we find that out," Brown said. "We hope that through the whole process, somebody will catch it. There are a lot of different stopping points along the way."

Hospital officials said patients won't be refused care if they don't have the proper ID or if their identification is in question. Billing also will be delayed until any questions are cleared up.

"We don't want to make the patient feel uncomfortable," Brown said. "We want to make sure we have the correct medical chart so the right care can be provided and we can bill the correct payer. We want to do a full investigation before we address it."

Anne Polta

Anne Polta covers health care, business/economic development and general assignment. Her HealthBeat blog can be found at Follow her on Twitter at @AnnePolta.

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