But well-informed patients can help drive down those costs. Here are six ways to protect your PHI, said Connie Schweyen, managing principal of healthcare at Verizon, in an interview with InformationWeek Healthcare .
1. Guard Your Personal Information.
Provide insurance identification only to those who offer medical services, and don't let anyone borrow your insurance identification or Medicare card, advised Schweyen. "There's an increase in the number of people approaching Medicare individuals or others, asking to use their medical information so they can go out and purchase medical services," she said. It's an emerging, scheme, she said, that follows an old pattern. "But it's definitely occurring out there because the more vulnerable people in our population are subject to being abused in this way," she said.
[To find out which medical apps doctors and patients are turning to, see 9 Mobile Health Apps Worth A Closer Look. ]
2. Beware "Free" Medical Services.
According to Schweyen, a common fraud scheme has sales people offering medical services or equipment for free, but in exchange for an insurance or Medicare identification number. "There are a couple of different ways people are approached to do this," said Schweyen. "[People] are approaching individuals through the promise of some financial payment to them or coercion to get free services, but they're taking medical information in exchange for promising these services." Often, she continued, victims will end up being signed up for subscription services. "There are so many stories of people who have garages full of diapers or diabetic supplies, and they don't know how to stop the supplies from coming," she said. The supplies arrive free to them, but insurance or government programs are being billed. "It's fraud, waste, and abuse against the medical program it's being billed to," she said.
3. Keep Accurate Medical Records.
Even if your physician uses an electronic healthcare record, as the patient you should keep track of your medical records, said Schweyen. A patient has the option to use a personal health information service or to simply keep a written record of any medical services and medications he has received. "It's the ability to go back and verify your own personal data against what the provider may have recorded," she said. In some instances, Schweyen continued, doctors have fabricated medical record information so they can bill the insurance of a government health program. By documenting your health information as the patient, she said, "you can go in and look at something that may be fabricated," she said. "Sometimes, government investigators come along to look at providers' data, and they can compare it and interview the patient to see what they may have on hand, so [the patient] isn't wrapped up in a fraud investigation inappropriately."
4. Review Your Medical Bills.
Make sure to ask for your bill at the time of your visit, and then check your bill to make sure it compares to the insurer's description of your benefits. This ensures you aren't charged for services you didn't receive or were charged for the same services twice. "Sometimes there's an error, so it's a good thing to check, but in other instances, when you see strange information, you'll want to reach out to your health plan or a hotline to see if it's appropriate," Schweyen continued. Additionally, she said, check that the dates and services match up.
5. Destroy Medical Records Before Throwing Them In The Trash.
It's an obvious tip, but Schweyen said to make sure to shred or rip up any medical documents to stop information from getting into the wrong hands or having your identity stolen. "We get all this medical information, and it can be gone through in dumpsters or garbage cans; medical documents or other bills have identifying information on them," she said.
6. Report Possible Fraud.
"Most people don't know what to do when fraud is determined," said Schweyen. Frequently, health plans have direct fraud help lines. Medicare and Medicaid also have phone numbers established so people can report fraud. "In certain instances, if you're in a provider practice and you see fraud happening, you can be eligible for a whistleblower reward," Schweyen said. "It's always good for people to report fraud to prevent costs from going up and to protect our insurance and health programs from overspending money."
Clinical, patient engagement, and consumer apps promise to re-energize healthcare. Also in the new, all-digital Mobile Power issue of InformationWeek Healthcare: Comparative effectiveness research taps the IT toolbox to compare treatments to determine which ones are most effective. (Free registration required.)