Customer Service and Database Problem

Customer Service and Database Problem Confronting Independence Blue Cross

Initial and Problem

The problem with identity theft is rife throughout modern organizations that deal with confidential information. For the employees at a health care organization such as Independence Blue Cross (ICB), which deals with huge amounts of confidential employee data on a daily basis, this question of confidential yet verifiable and accurate data of employee insurance records of particular concern. Several weeks ago, Independence Blue Cross converted their Personal Choice insurance system for its employees to a new computer system, switching from using the employee's Social Security Numbers (SSNs) and internal Certification Numbers to a new identification number for every patient.

The conversion was to facilitate the change over and increase security by refreshing the old system and minimizing the necessary use of SSNs. But apparently, due to a miscommunication, IBC's pharmacy benefit manager dropped all employee Social Security numbers from their system, mere replacing them with the new ID number, without keeping the SSNs on file. Therefore, while everyone still appeared in the pharmacy system, the employee's insurance records could not be assessed using the SSN. Thus, these employees experienced problems with insurance related transactions, and were informed that their policies no longer existed. When this became clear, employees were told they would be reimbursed for any out of pocket expenses they were forced to pay after a period of no less than two months.

Statement of Desired Goal or Outcome

The desired goal of the computer change over was to employ a new and more effective computer database system and continue to use a safe way of verifying patient and employee identities, without compromising the confidentiality of employees. Now, the desired goal is to continue to reach this verification goal, but in a way that satisfies the now-suspicious and injured parties.

Research Evidence and Hard Data

According to the Department of Health and Human Services, when faced with a similar problem of confidentiality and confusion regarding patient records of Medicaid and Medicare patients, patients themselves were required to apply for a new identification number, rather than relying upon an immediate and involuntary systems conversion. This change over would be slower, but would have produced the system-wide gap in knowledge that afflicted IBS.

Outcomes

Although the new system may theoretically be better, the mischance suggests that a more secure and slower process of conversion in the future will necessary to prevent further occurrences of such unfortunate and inconvenient events. Also, it is critical that the concerned customers who had to pay out of pocket expenses are assuaged of their fears that this may reoccur.

Solutions