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Did your ED patient present without an ID or insurance card? “This can cause a series problems for the front-line registrar,” says Vanessa Gordon-Lewis, MBA, CHAM, manager of patient registration at Sarasota (FL) Memorial Health Care.
Two of the most dangerous issues: Duplicating medical records or overlaying existing ones. “When duplication or an overlay occurs, it is a major patient safety situation,” Gordon-Lewis warns. Either clinicians cannot see the patients’ medical history to know their allergies or blood type, or the history they view actually belongs to someone else.
“Not having a photo ID or insurance cards also can lead to identity theft or insurance fraud by someone presenting and providing someone else’s name and date of birth,” Gordon-Lewis notes.
Photo IDs and insurance cards routinely are scanned into the patient access department’s medical records system. “When a patient presents without one, we will look to see if we have it previously scanned and ensure that it matches the patient presenting,” Gordon-Lewis says.
The department recently invested in a biometrics identification system that reads the vein patterns in a patient’s palm.
“No two individuals feature the same vein pattern, not even twins. This makes this product more secure than other biometric tools on the market, such as fingerprint or iris scanning,” Gordon-Lewis says, adding that 222,000 patients have been added since the tool’s implementation.
When a staff member scans the patient’s palm and positively identifies him or her, the scan launches the patient medical record in the hospital’s Admission/Discharge/Transfer (A/D/T) system. This is even true for trauma patients. “Once the patient has been entered into the palm scan system on a previous visit, when they present unconscious or unresponsive, we can select an estimated age range and scan their palm,” Gordon-Lewis says. “This can help us identify a John Doe or trauma alias.” The number of duplication of medical records and overlays have decreased, she reports.
Recently, a patient who was brought to the ED by ambulance presented with another person’s identification. The A/D/T system identified the patient as a current patient who had been in the ED for a long time. “But this was not correct. EMS had just brought the patient in,” Gordon-Lewis recalls. “Because it was showing the patient as already being in a room, we were not able to register this patient until we knew his true identity.”
Registrars used the palm scanner and determined the patient’s true identity. The patient was registered, and medical care was not delayed. “Had we not had this tool, we would have discharged a patient who was currently receiving treatment when that patient should not have been discharged,” Gordon-Lewis notes. This was potentially dangerous for the previous patient. “His medical record would have been compromised, because he was actually still here,” Gordon-Lewis adds. “It could have become a major patient safety issue.”
Another recent technology implementation verifies patients’ medical insurance. If a patient presents without this information, the eligibility system searches for Medicare and Medicaid coverage based on information obtained during the registration process.
“If the patient states they have Aetna but do not have the card, we can go in and enter their demographic information and conduct a search for their eligibility,” explains Tabatha Terhune, assistant manager of patient registration.
Of course, the tool doesn’t guarantee payment of the claim. However, it often finds the patient does have insurance, even though the patient says otherwise.
“Patients present stating that they do not have insurance but they actually do,” Terhune says. “We have noticed an increase in this over the last couple of years because there is a great rise in patient deductibles.”
Registrars include this information when billing the insurance company, instead of listing the patient as self-pay.
“The patient does not have the burden of trying to clear up the bill after the fact,” Terhune says.