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emPower eLearning: Red Flags Rule: Protecting Patient Identity

Wednesday, May 5, 2010

Red Flags Rule: Protecting Patient Identity

Health-care identity theft causes untrue entries into existing medical records at doctor’s offices, pharmacies, hospitals, and insurance companies. These erroneous entries made to victims’ medical files may not be corrected for years or even not discovered. Medical identity theft victims may not get proper medical treatment or may find their health insurance destroyed. Health-care providers who do false billing of victims of identity theft may be required to disregard all its health-care expenses. Medical identity thieves may steal physician’s name, license number or any other account information, forge a signature or prescriptions. Health-care providers and plans may lose its prestige which in turns results in irreversible business consequences.

To prevent and detect identity theft, the “Red Flags” Rule is enforced by the Federal Trade Commission (FTC) requires all financial institutions and creditors including physician offices, to develop and implement written identity theft prevention program  for detection, prevention and mitigation of identity theft in connection with the covered account. As per FTC’s rules, physicians who regularly bill their patients for services rendered are considered creditors and required to comply with the Red Flags rules. Red Flags Rule covers:

  • Insurance Claim Information
  • Credit Card Details
  • Tax Identification Numbers
  • Background checks for employees and service providers
Formerly, health-care industry was tagged as technology laggard as no electronic system maintained for health records. The ultimate objective of Health Care entities is to become highly efficient providers of quality patient care, equip system to maintain electronic health records and information and securely control critical aspects of patient safety care. Complete compliance to Red Flags Rule by health-care sector is necessary to protect the patient identity and protects the organization from penalties and criminal convictions arising due to any lapse.

Red Flags rule ensures privacy of patient health information.

Jason Gaya

Read more on, Red Flags rule at, www.empowerbpo.com

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