Need conclusive identification of potential OIG matches? Try Sherlock Holmes.

Posted by Frank Strafford on November 18, 2014 in Exclusion Screening,

OIG exclusion verification







Despite all of the technological advances in the field of OIG exclusion verification, separating real matches from false ones is still an exercise in frustration.

Assuming you’ve got the right software, a typical OIG exclusion search is easy: You simply type in the employee’s name, date of birth and social, and you get an instantaneous list of potential matches.  Now you’ve got to figure out if those potential matches are just random people, or if your employee is actually one of them.

And that’s where the fun begins…

The easiest, most foolproof way of making that conclusive determination is by verifying the social security numbers.  Some states, such as Texas and Louisiana, have social security portals right on their verification database sites.  Unfortunately, the vast majority of states do not.

The next possibility is to try to rule out the potential match by comparing the dates of birth.  Illinois recently added dates of birth to their online database, and the decrease in problematic potential matches is dramatic.  If the state in question offers this type of online listing, ruling out potential matches should be pretty simple; the problem is that most of them do not.

Your next option is to try to verify the social or DOB by contacting the state agency directly.  Traditionally, this option includes the requisite runaround of calling in, waiting on hold, getting transferred to a different extension, waiting on hold again, getting transferred to a third and fourth extension, etc….after which you finally get the information you need.

Here at Streamline Verify, we were able to mitigate that phase of annoyance by incorporating a direct email feature into our software.  This method was so well-received that a representative of the State of Ohio actually ended up contacting us to ask how he could cut down on the huge number of social security verification request emails that he was now fielding from our clients!  We respectfully replied that the solution is simple: Build an online social security portal, or even just include DOBs on your database, and none of us will have to hassle with this stuff at all!  He took us up on the suggestion, and Ohio now lists DOBs on its website.

Finally, after having narrowed down your list of potential matches, you’re left with the most difficult ones of all: the states that don’t even possess lists of socials or DOBs themselves!  California, for example, incorporates exclusions and sanctions from a host of Medical Boards, several of which refuse to release lists of DOBs or socials to the exclusion agency.  North Carolina has temporarily taken down its database while it undergoes reconstruction, despite the fact that potential matches are still showing up in the old database; and when you contact the state agency for verification of a match, you are told that the only thing you can do is check the Federal OIG site, which generally does not include the listing that you need.

What now?!

Well, now you’re kind of stuck.  Calling the Medical Board (which originally designated this exclusion) won’t help; you’ll only be told that HIPAA laws forbid the disclosure of this type of information.  You can try to do some sleuthing by doing a license check on the State Medical License Board; occasionally, you can get a DOB that way.  Failing that…well, the next step would be to call in Sherlock Holmes.

About Frank Strafford

About Frank Strafford

Related Articles

Texas OIG Quarterly Report Highlights: Texas ...

July 12, 2021

The COVID-19 pandemic drove significant changes and expansion in care delivery practices. The federal government and the State of Texas implemented policy and treatment flexibility to ensure continued...

What Are the Effects of OIG ...

December 22, 2014

A person can end up on the OIG List of Excluded Individuals for a range of reasons and the main effect of being excluded is that individuals cannot receive payment through Medicare, Medicaid or any ot...

The Impact of FCRA and FACTA ...

August 30, 2021

Background The Fair Credit Reporting Act (FCRA) was signed into law by President Nixon in 1970 and took effect April 25, 1971. The original purpose of the FCRA was to give consumers certain rights ...

Understanding OIG Exclusions

OIG Exclusions Screening Process

Exclusion FAQS

Quick OIG Exclusion Basics

Employing Excluded Individuals

Consequences to Employing an Excluded Individual

OIG Compliance Law

Laws and Publications on OIG Compliance

More Compliance Resources

Our Culture

We build the best, so you can perform at your best.

Trusted for Good Reason

  • ✓ Guaranteed accurate
  • ✓ Certified Secure
  • ✓ Audit Proof
  • ✓ Feature-rich reporting
  • ✓ Round the clock real-time-data
  • ✓ Processing fully automated

Security First

  • ✓ Cloud hosted
  • ✓ Encrypted data
  • ✓ Real-time backups

Trusted for Accuracy

  • ✓ Physical security
  • ✓ Restricted access
  • ✓ Single sign-on
  • ✓ Password security
  • ✓ Certified secure
  • ✓ Cross checking




Average workload reduction by implementing the Streamline Verify program



Establishments trust Streamline Verify nationwide



Serving the healthcare industry’s unique compliance needs since 2011



Setting standards with hourly synchronization to primary source data