There seem to be at least four reasons why patients are being asked for the social security numbers:
1. The FTC's Red Flags Rule
In an effort to curb identity theft, the Federal Trade Commission in 2007 unveiled what they called the Red Flags Rule." The Red Flags Rule requires all creditors to collect social security numbers and other pieces of personal information to prove the borrower is who he or she says they are. If a borrower does not not have the required documentation, that raises a red flag.
Originally, doctors and other healthcare entities were included in the lists of creditors who were required to collect all that personal information, because medical identity theft, including health insurance information, is growing exponentially. But those providers fought the rule, focusing on the fact that they do not consider themselves to be creditors as a credit card or mortgage company might be.
Enforcement of the Red Flags Rule was to begin in 2009. However, in 2010 it was decided by Congress that healthcare providers would be exempt from the Red Flags Rules.
However, many doctors, hospitals and other health care entities in the interim had begun to collect SSNs in preparation for enforcement of the Red Flags Rule, before it was withdrawn. And some may still be requesting them today, knowing that if they have trouble getting paid by a patient, they may use that SSN to collect what is owed to them.
2. Healthcare Payers Use Social Security Numbers
Doctors find it increasingly difficult to collect the money owed to them from all payers - health insurers, Medicare, Medicaid and others. The universal identifier among Americans is, of course, the social security number. Having that universal identifier may make it easier for the doctor to collect what is owed from your payer.
If you use any government healthcare payment system, then your social security number is already being used. Medicare, Medicaid, the VA and TriCare require social security numbers, and that number is used for each reimbursement request.
Not all non-government insurers use the SSN, but some do. Because each doctor works with dozens of payers, they don't always know from the moment a patient checks in whether or not they will need your SSN to collect from your payer. Therefore, some offices simply ask everyone to provide it.
3. When a Patient Dies
As difficult as it is for a doctor or other health care entity to collect from a living patient with (or without) insurance, it may be even more difficult to collect from one who has died.
If the doctor has the patient's social security number, it may be easier to collect money owed. For older patients on Medicare, the doctor may already have the SSN on file. For younger, possibly terminal patients, requesting an SSN may be the normal course of business.
4. Social Security Numbers and Immigration
In the United States, the existence of large numbers of undocumented immigrants is becoming a larger and larger issue. While not specifically included or mentioned in the Red Flags Rule, any patient arriving at a doctor's office without credible documentation could be identified as being undocumented.
What If You Don't Want to Disclose Your Social Security Number to Your Doctor?
Many patients question whether the points listed above will really benefit them at all. Some may believe that putting protections in place to keep their identity from being stolen is a good idea. Others believe that providing their SSNs in a doctor's office actually exposes it even further to a group of new people who could potentially steal their identities. Still others worry that tying their health care to their social security number may be more about Big Brother and less about protecting them.
Until doctors are required to collect this information (if they are ever required to collect SSNs) there seems to be no law or reason for them to force patients to turn over their social security numbers if those patients use only private insurance. Doing so may benefit the doctor when it comes time to collect on a debt, but doesn't seem to have much benefit for patients.
If you don't want to turn over your social security number to office personnel that ask for it, or write it on the form they give you, then here are a few ways you may be able to wrangle your way out of that requirement:
- Offer to pay cash for the service.
- Offer to provide a portion of your SSN - perhaps the last four digits.
- Offer to provide another piece of identifying information such as a driver's license or a document that has your blood type listed.
- Ask for the office manager and find out what their intent is for collecting the SSN. If they tell you they are required by some entity to collect it, then ask what entity expects that. If they tell you it's the FTC or the federal government, then tell them you know about the Red Flags Rule and that it will not be enforced until December 31, 2010.
- Understand that you may be at risk of being rejected as a patient if you simply refuse a doctor's office staff member who is adamant. In that case, you may be better off looking for a new doctor anyway.