Monday, March 09, 2015

We get it. Now stop doing that.

In the course of working in Medical Administration for over 15 years, I am always amazed at what people will do to circumvent the policies of seeing a doctor. One of the basic policies is to present an  insurance card to confirm identity (the presentation of a valid photo ID, at time of service). So I was a bit perplexed when not once, but twice in the past few months, I had patients who presented a photocopy of their Medicare Card with their billing number (which is their social security number) blacked out. Each time I gave the “card” back to the patient and said I could not accept a photo copy, I needed the original card with all the information visible. You see, the only way I can get my doctor paid is to bill Medicare for your service and I need that number to bill. Then I ran across this article and it became clear:

Why you shouldn't give your doctor your Social Security number”.

According to the article, doctors do not need your social security number to bill. That is correct; however, we do need your social security number if you choose not to pay your bill and we have to turn you over to collections. You see, when you go to a doctor, we are becoming a creditor, and we are accepting your word that you will pay us whatever your insurance company says you will pay after we've billed them. Surprisingly, many of you decide, after the fact and for a variety of reasons, not to pay us:
1) I shouldn't have to pay that much.
2) My insurance company said you billed wrong and you need to recode.
3) I thought it was free (preventive/well visits).
4) I do not believe in paying for medical care.
5) And many more that I have heard over the years.
So, if you do not want to give your doctor your social security number, then pay for your appointment in full, at the doctor’s fee schedule, and then wait for any refund after the doctor bills and receives notification from your insurance company.

The article makes suggestions about how to get out of giving your social security number, but alas, your social security number is your Medicare number, so this is suggested:

CR’s advice: If you're on Medicare, you still have to share your Social Security number with your health care providers (in the form of your Medicare card), so they can get paid by Medicare. But you can get some protection by making a copy of your original card and, after the first visit, blacking out all but the last four digits of your Social Security number. That way you won’t have to carry around your original card, with your complete Social Security number, at all times.”

Okay so why is this so wrong? Simple: because of identity theft and the ability to change insurances during the open enrollment each year (and sometimes more often), the physician has to confirm each time you visit that you do, in fact, have insurance, and that insurance is, in fact, yours. This is done by confirming your Insurance Number and Name with outside entities that assure your doctor that, yes, the insurance is active and you are you. Thus, you can never bring in a photocopy, as each visit is its own self contained event which must be verified. So with all due respect to Consumer Reports: this advice is wrong, so please stop doing it.
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