For professional medical services providers of all types, ensuring that all one's financial ducks are in a row, so to speak, is undeniably important. But there are a number of factors that can seriously impede the efficiency and proper execution of finance-related functions including collections, accounts receivable, accounts payable and more. Chief among these is fraud, and according to Georgia-based Better Business Bureau regional president and CEO Kelvin Collins, medical identity theft has become a serious problem of late for both patients and providers.
"Medical identity theft can become a major problem for patients and providers."
If patients' financial data and other identifying information is somehow compromised and stolen, it can be almost as detrimental to health care facilities as it is to patients. As such, it may be wise for care providers to learn what it would be like to outsource receivables management and collections processes to a dedicated agency equipped with the staff and resources to mitigate chances of security breaches that could lead to identity theft and fraud.
A brief examination of medical identity theft
Collins states that in some cases, a person's medical information can be compromised with as little as a name, address and date of birth, although a Social Security number is usually required. Once scammers have a way in, they can get drug prescriptions or health services for free. These tactics can also be used to fraudulently bill for Medicare or Medicaid benefits in an unsuspecting person's name.
Writing for Advance Healthcare Network, Jay Vance, a certified HIPAA professional and medical transcriptionist, noted an extreme instance of medical identity theft: A Salt Lake City woman named Anndorie Sachs had her driver's license burgled from her car, and two months later, the thief went to a hospital to give birth with Sachs's ID – and after delivery bolted with a $10,000 bill in her wake. According to Good Housekeeping, Sachs only learned of all this when the hospital called to say that her baby tested positive for methamphetamine.
The effect on patients and health care facilities
Consider this: A medical facility that provides care to a flimflam scam artist who's using another person's medical identity will send a bill for care rendered, initially being none the wiser, and then the debt will go into the collections process if it's not paid. The person whose information has been stolen ignores the bills and notices, thinking it's a mistake that will correct itself – and before the victim knows it, his or her credit report and score have been compromised by a debt he or she didn't accrue.
Not only is this individual being unfairly sought out for a fraudulent charge, but the health care provider is also adversely affected. The victim shouldn't bear the financial burden, and the chances of tracking the real culprit are greatly diminished with time. So the facility or provider doesn't get paid, and if the problem reaches a certain magnitude, all of this can negatively impact the bottom line.
Outsourcing as the solution
As serious as medical identity theft can be, it may simply be impractical for in-house financial and accounting personnel at health care facilities to look for signs of fraud in addition to their other responsibilities.
This is where outsourcing to a dedicated professional accounts receivable solutions firm can help. Providers can dedicate their financial staff to the most high-priority tasks and know that the day-to-day essential accounting processes are being handled by an agency equipped to deal with them at volume.