How should you verify a possible match that comes up during your monthly compliance monitoring? This is a question that we often get phone calls and support tickets about here at Valenz.

First off, a matching, or close matching, name alone is not enough to determine whether the person you are searching for and the possible match that appeared are the same individual. Claiming a searched party is a confirmed match on name alone could expose your organization to FCRA claims and further issues.

Further verification is an important step in the compliance monitoring process as it allows you to be sure of whether a possible match is a full match with verifiable information like date of birth and Social Security Number.

How to Verify a Possible Match

When a possible match does appear during a search, they can sometimes be verified with information that you already have available or can easily retrieve if needed. If you are presented with a possible match during your monthly compliance monitoring, following these steps can ensure that you’re verifying them the correct way:

• Check for verifiable information in the record details. For example, does the possible result give a DOB for the sanctioned/excluded individual? If not, does it give a middle name? If yes to either of those, and the information does not match that of the searched party, that is a good indication that there is not a positive match.
• If further information is not given in the record details, find which agency the possible result is coming from. Within EPStaffCheck specifically, this information can be found in column K of the QuickSearchResults.csv file for batch reports, or in the record details section on the very right of the screen for single searches. Once you find the sanctioning/excluding agency, try to locate the possible result within the original source to see if more information is given that could allow you to verify. Original sources for sanction/exclusion lists can be found in the Help section of EPStaffCheck.
• If no additional information is available after looking up the possible result on the original source, then you will want to determine which method of further verification mentioned below is required for the specific agency the result is coming from.

Verifying a Possible Match with Limited Information

Unfortunately, sometimes there isn’t much information other than a name given for a possible result. When this happens, further verification is required to make a determination. The ways to go about further verifying a possible match often depends on where the sanction/exclusion is coming from, as certain sanction/exclusion agencies have different methods of verification available. The good news is that while there are many different sanction/exclusion agencies, their verification processes usually fall into one of the following categories:

• Agencies like the OIG, New York OMIG, Texas OIG, Maine HHS, and Louisiana Medicaid have online verification tools you can use to verify a possible match within seconds if you have your searched party’s SSN available.
• Most agencies will have an email contact and/or a hotline where you can inquire about a possible match that is coming from their sanction/exclusion list. The email contact can usually be found on the same webpage that houses their sanction/exclusion list, though it can sometimes be on the list itself. You can also find contact information for specific agencies in the Help section of EPStaffCheck within the About the Databases folder.

Simplify Your Monthly Compliance Monitoring

If you have additional questions, please check out our other blogs in which we cover topics like What is a Compliance Program? and Why is OIG Compliance Monitoring Required? Additionally, if you would like to explore how Valenz and EPStaffCheck can help your compliance monitoring program visit our website for additional information.