Several months ago, an AmeriHealth member received three bills from three separate hospitals for emergency room visits. He was shocked since he has never been in a hospital let alone three separate visits during a two-week span. This was not a mistake or a billing error by the hospital — his health insurance card had been stolen. An investigation by the AmeriHealth Corporate and Financial Investigation Department (CFID) showed that a man was using his identity. The perpetrator is currently being charged with identity theft and insurance fraud.

Protecting patient medical information

AmeriHealth recognizes the problems that specifically target medical identity theft, and we take every measure to investigate and mitigate harm to our members. However, as a provider in our network, here are some ways that you can help protect patient medical information:

• When a patient checks in for an appointment, the provider office staff should request the member's medical identification card along with another form of identification, such as a driver's license or verification of date of birth.
• Providers should closely review their Provider Explanation of Benefits, Provider Remittance, or Statement of Remittance* to ensure charges on the statement correlate with services provided to their patients.
• Providers should protect a medical insurance card as if it is the member's Social Security card by returning it promptly to the patient and refraining from leaving the card or copies of the card in common areas (i.e., copy room or near the check-in desk).

*For members who have been migrated to the new platform, providers will no longer receive a Statement of Remittance. Professional providers will receive a Provider Explanation of Benefits, and facility providers will receive a Provider Remittance.