Identity Validation Is Necessary Before Disclosing PHI
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) maintains policies and procedures, which must be followed by all employees to ensure the safeguard of our members’ Protected Health Information (PHI). These policies and procedures address all applicable privacy laws and regulations, and are intended to comply with current state and federal law, as well as the accreditation standards of the National Committee for Quality Assurance.
We protect the personally identifiable information about each of our members, and disclose only information legally appropriate. Before disclosing any information about a particular member, we must first validate the appropriateness of sharing their PHI with a given requestor.
When contacting Blue Cross NC involves disclosure of a member’s PHI, such as in situations of eligibility and benefit verifications and/or obtaining prior authorizations, the following information will typically be requested from you to help confirm identities and the acceptability of our exchanging information:
- Your name as the caller, and
- Your name as the provider or the provider who you represent, and
- Your health care organization’s National Provider Identifier or Tax Identification number, as well as
- The member’s identification number, date-of-birth and address
We appreciate your help in our combined effort to ensure our members and your patients have their PHI respected and protected.