How Health Care Organizations Use the Death Master File

Written by Researchbite | Updated on: February 18, 2023

How Health Care Organizations Use the Death Master File

It is necessary for many compliances and H.R. professionals in the healthcare industry to verify provider data concerning several government databases and registries. Let us understand how they do it.

Introduction

Verification against the Death Master File of the Social Security Administration is a typical hurdle for most of these searches (DMF). The Office of the Inspector General took "809 criminal actions against people or groups committing crimes against recipients of HHS programs and the programs themselves" in addition to 695 civil proceedings in 2019, according to the Department of Health and Human Services (HHS). These misappropriated payments from Medicare, Medicaid, and other HHS programs total around $5.9 billion in total. Using a deceased person's Social Security number (SSN) to get benefits or other types of identity theft. Checking against the Death Master File (DMF), which is made publicly available so that a range of public and private organizations can use it to authenticate identities, is one of the tools available to the government for early fraud detection and prevention.

What Exactly Is A Death Master File?

The SSA developed the SSA DMF as a public-use file in response to FOIA requests from the general public requesting information on the vital status. For those whose Social Security numbers indicate they are deceased, the DMF includes their last known ZIP code, first, middle, and last names, dates of birth, and dates of death. The SSA collects death data from many different sources, but most come from the deceased's family, funeral homes, banks, and other government agencies. These fatalities are noted in the numerical identification (NUDIMENT) file as soon as they are received. To enable the termination of benefits for Social Security beneficiaries, in the past, death had to be confirmed through the SSA field offices by having someone in the beneficiary's home, a representative payee, a nursing home, a doctor, or a hospital agree that the person was dead and vouch for the date of death.

A search of the U.S. Social Security Death Index can provide the name, Social Security Number (SSN), birth date, and death date of a deceased person who passed away in 1936. More than 83 million records of SSN-holding people's deaths may be found in the DMF. According to the Freedom of Information Act, death data are deemed public, and in their current format, searches can be done for information going as far back as 1962. Weekly and monthly updates are made to the SSDI. In addition, government, financial, investigative, credit reporting, and healthcare organizations can obtain the latest version from the National Technical Information Service (NTIS) Department of Commerce.

The Social Security Administration maintains the Death Master Files. Improving the prevention, identification, and recovery of erroneous payments resulting from SSN misuse is one of the main goals of the Social Security Office of the Inspector General. Due to the OIG's audit work, suggestions have been made to improve the DMF's capability to identify possible Social Security fraud and overpayments. For instance, an OIG examination in 2016 discovered that the DMF had not included some personally identifying information, preventing the proper fatalities recording. The audit also showed that 69,863 SSNs associated with $3.9 billion in revenue during five years had name/SSN combinations that did not match SSA records. To stop future SSNs from being misused, the OIG suggested that the SSA create a system to integrate the missing data. The finest source of death data is still the publicly accessible DMF, even though it does not yet provide a complete record of all deaths in the U.S. Financial institutions, state and federal agencies, postal authorities, relatives of the deceased, healthcare providers, and funeral homes are just a few of the sources of data. The timeliness of the information that is accessible may suffer from a reporting lag. A Social Security Index search cannot be used to conclusively verify that a person is alive since The Social can not guarantee 100% correctness of the DMF data.

Information Found in the Death Master File

For each decedent, the file contains the following details, if they are known to the SSA:

  • Name
  • Date of Birth (DOB)
  • The Social Security Number (SSN)
  • Date of Death

The Social Security Administration can not guarantee the complete correctness of the data and does not have a death record for every person. Therefore, reviewers of the Death Master File shouldn't infer that a specific person's absence indicates that they are still alive.

There are two variations of this file that the Social Security Administration makes available:

Public DMF

  • Records of deaths from NUMIDENT
  • Given to the NTIS of the U.S. Department of Commerce
  • Sold to the general public (banks, credit companies, etc.)
  • Excludes information on state deaths

Full DMF

  • Death certificates from NUMIDENT
  • Contains death statistics obtained from states
  • Only shared with specific state and federal authorities
  • Shared in line with Social Security Act Section 205(r)

 Use Of The Death Master File By Organisations

Federal authorities, genealogists, medical researchers, and other organizations can utilize the DMF as one of the numerous databases to confirm deaths, stop fraud, or carry out other crucial research. For instance, a bank or lending organization may verify the DMF to make sure the SSN supplied wasn't associated with a deceased individual. One of the most apparent reasons is stopping benefit checks from the SSA, the Veterans Administration, and the Office of Personnel Management. The DMF is primarily used in the healthcare industry for initial credentialing and continuing practitioner screening to catch identity fraud. Despite its flaws, the DMF remains a crucial data source for the credentialing procedure. These records are a small part of the overall image of a practitioner's record, credentials, and experience.

Industries that primarily reference this file are:

  • Financial firms
  • Credit companies
  • Healthcare organizations
  • Security firms
  • Government agencies
  • Genealogists
  • Insurance companies

Health Care Uses For The Master Death File

Numerous businesses and institutions utilize the DMF data. The database is a crucial resource for possible identity fraud and medical research; nevertheless, for healthcare insurers and institutions:

  • For their investigations and to gather data on deaths, hospitals, and medical researchers keep track of former patients.
  • Healthcare compliance and fraud specialists confirm provider identification and authentication of provider data concerning state and federal government databases and registries.
  • Credentialing offices rule out identity fraud as part of the initial and continuous screening of provider licensing. Unfortunately, an all-too-common fraud strategy involves prescribing medications, items, and services using a deceased provider's credentials.
  • As part of the background screening procedure, H.R. departments verify prospective workers' identities before hiring to ensure that excluded persons or businesses are not using fictitious or stolen SSNs to acquire employment.
  • Identifying unethical insurance billing methods, such as services provided by a deceased provider or services provided to a deceased member.

Master Death File with Limited Access (LADMF)

  • Only Numident death records, not state death records, are included in the LADMF.
  • Certified subscribers (such as state/federal agencies who do not satisfy the requirements for access to the complete DMF file, banks, credit businesses, and healthcare institutions) are given access to this public file by the NTIS.
  • The main goal of the public file is to locate and stop the exploitation of a deceased person's name for fraudulent activities like faking a job application or engaging in financial fraud.
  • The NTIS certification form contains the certification requirements.
  • Certified subscribers must link their usage of the list to an authorized reason, such as identifying and preventing fraud or a specific business goal.

Federal and state entities can retrieve these files that the SSA has generated. However, to get either the "complete file" or the "public file," they must agree with the administration to share data.

  • The whole file is only shared with specific Federal and State entities following section 205(r) of the Social Security Act. It contains all death records pulled from the administration's NUMIDENT database, including death data received from the States.
  • Public file contains death records taken from the NUMIDENT database of the government, but it excludes death information from the United States. This version is given to the National Technical Information Service (NTIS) of the U.S. Department of Commerce, which sells the data to the general public, including banks and credit reporting organizations (CRAs).

Conclusion

Even with the decreased number of deaths recorded, the public Death Master File is still the most accurate and dependable means to screen for death records despite its complicated history and the difficulties with its data sources. The public file will contain progressively fewer new death reports as state data grow as a percentage of the SSA's death data, making it less helpful as a fraud-fighting or identity-verification tool or for monitoring research participants. Many public members are unaware of the impact of the removal of 4.2 million death data from the DMF in 2011, despite the knowledge of certain specialists. As a result, clients who come to us to inquire about the status of death could be perplexed if the death they are looking for is no longer included in the DMF. Services like Streamline Verify may share only data from the public Death Master File; if the SSA has deleted a file, it will no longer be found in any searches.

References

  • https://www.ahajournals.org/doi/pdf/10.1161/circoutcomes.112.968826
  • https://www.providertrust.com/blog/ssa-death-master-file-guide/

         

Tags


Written by
Researchbite
ResearchBite is a platform committed to availing the scientific knowledge and information at your fingertips.

Check out other articles written by Researchbite .