Multiple dates of birth

[firework]

I've seen so many patients with more than one dates of birth. If I ask, it's always an "insurance thing". I didn't asked before and now I'm too embarrassed that I don't know. But why? Does insurance mess up people's DOB and won't admit it and fix it? Or people tell insurance different DOB on purpose to get coverage? why?

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[APN-59 rph]

I've seen so many patients with more than one dates of birth. If I ask, it's always an "insurance thing". I didn't asked before and now I'm too embarrassed that I don't know. But why? Does insurance mess up people's DOB and won't admit it and fix it? Or people tell insurance different DOB on purpose to get coverage? why?

From keypunch error to fraud....to ??......I have two Soc Sec cards..never knew why...no one does....

 

[owlegrad]

In my experience it was always that the insurance had the wrong date of birth and fixing it was more trouble than just using the wrong DOB at the pharmacy. If there was a fraudulent reason for it I never realized or figured out what it was.

 

[owlegrad]

Also this isn't really the right forum for this topic, let me move it for you.

 

[lord999]

There's actually a couple of things:

Depending on the plan, you have to put in the "planholder" not necessarily the "Insured" birthdate for processing. This used to be a bigger thing until most states' insurance commissions made it illegal to force that behavior.

Technically though for most plans, you're "supposed" to refuse a fill in those circumstances as they aren't proven to be that person. Obviously, no one does that in practice unless you get a chargeback (Aetna and Blue Cross did that), so it's usually something that corrects at the next plan year.

My favorite ones though are VA birthdates that are different from the patient's real birthdate, because the patient lied on their age to enlist in the military (this was a tacitly allowed practice before 1980 when the EDIPI number was started which cross-references SSN), you might get a person who has a military DOB of an older person but present a drivers license that is younger. We're still in the midst of correcting those since the law changed in 2010 or so, but I can't tell the difference in most people between 75 and 85 in most cases.

 

[maria1oh]

There is some old trick for medicaid if the mother has medicaid and has a newborn baby then you can use mothers medicaid card and "baby girl" or "baby boy" has to have matching dob of mother.

 

[zelman]

My employer screwed up my DOB during the hiring process. I’ve fixed it in a few systems a few times, but it randomly will revert.

 

[APN-59 rph]

There's actually a couple of things:

Depending on the plan, you have to put in the "planholder" not necessarily the "Insured" birthdate for processing. This used to be a bigger thing until most states' insurance commissions made it illegal to force that behavior.

Technically though for most plans, you're "supposed" to refuse a fill in those circumstances as they aren't proven to be that person. Obviously, no one does that in practice unless you get a chargeback (Aetna and Blue Cross did that), so it's usually something that corrects at the next plan year.

My favorite ones though are VA birthdates that are different from the patient's real birthdate, because the patient lied on their age to enlist in the military (this was a tacitly allowed practice before 1980 when the EDIPI number was started which cross-references SSN), you might get a person who has a military DOB of an older person but present a drivers license that is younger. We're still in the midst of correcting those since the law changed in 2010 or so, but I can't tell the difference in most people between 75 and 85 in most cases.

 

[owlegrad]

My employer screwed up my DOB during the hiring process. I’ve fixed it in a few systems a few times, but it randomly will revert.

Me too! At both of my last jobs. Seems like it would be a simple thing to get right or to fix but in both cases I will randomly find a system that still has it wrong.

My dental insurance was two days off and they never fixed it after multiple attempts so I just have to remember when I go to the dentist I am two days older. In another system I am a full 10 years younger (yes please!).

 

[ChalupaBatman86]

People also change their dates of birth to pass criminal background checks for jobs or to fool PMP databases.

 

[firework]

If insurance refuses to fix their mistakes, how are we gonna tell if it’s waste fraud and abuse?