How healthcare providers can protect themselves from identity theft

Do you know where your professional information is stored – who has access and why they access it? Your college license or association registration number could be at risk unless you take steps to protect your professional information.

The Problem

As a healthcare professional, if you own a clinic, you are responsible for safeguarding the professional information of yourself and others. Or, you may be employed by one or more clinics, and need to ensure that your professional information is safeguarded in each location.

Some questions to think about:

1. Could the clinic computer be hacked and your professional information stolen?
2. What happens to your professional information if the clinic is sold?
3. What happens to your professional information when you stop working at a clinic?
4. Do you review the claims for services (receipts or electronic claims) remitted with your professional information frequently?

If your professional identity is not protected, claims may be submitted to insurers for services that did not occur. Plan maximums could be depleted without the members having benefited in any way. Insurers sometimes see collusion between clinics and plan members, where fake claims are submitted under a stolen healthcare provider identity, and the reimbursed funds shared. Or the plan member may receive another sort of inducement, such as a free item of some kind.

How To Protect Your Professional Identity

While it may be difficult to be fully protected, there are a number of steps that you can take to make sure your professional identity is safe.

Step 1: Don’t give out your license/provider number until AFTER being hired by a clinic.

Step 2: Make sure clinic staff, the owner (if not you) and your colleagues have an agreement as to the appropriate use of professional information – specifically after a service has been delivered and the invoice/claim made. In order to confirm, you should review all invoices/claims made with your license on a frequent basis to catch any problems, administrative errors and/or fraud.

Step 3: If you are a prescriber, guard your prescription pad.

Step 4: When you stop working for any clinic, have an agreement that no further invoices/claims will be made with your license after your date of departure. Contact your College and advise them that you no longer work at the location. Contact all insurers to advise them of this change by going to www.clhia.ca/antifraud and click on ‘Report It’.