Question: Our senior partner wants us to stop using Social Security numbers as patient identifiers immediately. Furthermore, he wants them removed from charts as charts are handled. We do not require patients to disclose this information if they choose not to. Medicare uses the SS# as the patient identifier, Ohio Workers’ Comp uses SS#, and our PMS system uses it as well.
We have multiple patients with the same dates of birth and, interestingly, a handful of patients with the same names AND date of birth! We will be migrating to a new PMS/EMR in several months and I had hoped to make this change at that time.
If not the SS#, what data are you using as the patient identifier?
-Business Manager
Pulmonary Medicine
Answer: This is a question that is becoming more common with the combination of the stringent HIPAA rules and the rapid changes happening in health care technology.
“A Unique Patient Identifier,” the Department of Health and Human Services explains, “is required to manage the various clinical and administrative functions relating to the delivery of care.”
Finding a unified solution is such a crucial issue that the Robert Wood Johnson Foundation’s Pioneer Portfolio recently awarded a grant to the Western Health Information Network to test how unique patient identifiers can increase control of clinical information and improve the quality of care.
Patient identifiers are essential to protect privacy, provide effective health care, and enable efficient billing. Most insurance companies are not using Social Security numbers as patient identifiers anymore for confidentiality reasons.
Some smaller insurance companies may still be transitioning, but most will stop using Social Security numbers in the near future due to privacy concerns. However, it is still important to collect the information – at least the last four digits – in the event that the patient must be sent to collections.
How to Identify Patients
The insurance companies are mainly identifying patients by name, member ID, and claim number, but primarily by claim number.
Payers like Workers’ Compensation and auto insurance companies usually identify patients by name and member ID, or the claim number for the given accident and/or injury. As the main identifier, we use claim numbers to identify payments.
Utilize patient identifier best practices to meet HIPAA’s standards by using the claim number and date of birth. Practices can also use the chart number and/or account number to identify patients internally.
This can help ensure patient confidentiality, but effectively differentiate patients with strikingly similar information.
I hope that helps!
Francis Guasp, CPC
Director of Operations
CareCloud
UPDATE: TriWest Healthcare Alliance (Tricare) released a statement that it would only use social security numbers as a patient identifier due to a system problem with Department of Defense Identification Numbers. This could affect the 2.9 million people TriWest serves with verifying eligibility, checking referral/authorization status, online claim submission, and claim status.
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