Verification of Identity

Op10.03-24 Verification of Identity

Applies to the Administrative Requirements of the Health Insurance Portability and Accountability Act of 1996. 45 CFR Section 164.514(h)

Policy

The Health Plan verifies the identity of the individual requesting Protected Health Information prior to releasing the information to either the participant or their authorized personal representative.

Procedure

The individual requesting their own protected health information is required to provide any two of the following pieces of information:

• Social Security Number of the participant,
• University BearPass Card of the participant,
• Date of Birth of the participant.

The individual’s identity is verified when the information provided is identical to the information contained in the Personnel database.

In addition to the above participant verification process, the personal representative must provide one of the following forms of identification to verify his/her own identity:

• Driver’s License,
• Social Security card,
• Birth Certificate, or

If the information can be confirmed from the Personnel database, the personal representative’s Social Security Number or University BearPass Card and date of birth.

If the identity of the participant or personal representative cannot be verified or is insufficient, Protected Health Information shall not be released and the individual will be informed as to the basis of the denial.

If the individual has authoritative alternate forms of identification, he/she may make written request to the Privacy Official to review the information or documentation to determine whether it may be accepted as alternative proof of identification.

If the Employee Benefit Plan has a reasonable belief that the identity of the individual is false, the Employee Benefit Plan may elect to treat the proffered identification as insufficient and deny release of the Protected Health Information.

Effective Date: April 14, 2003