ID fraud reported at hospital

Officials at South Coast Medical Center are still trying to figure out how a woman was admitted under a 72-hour psychiatric hold using another woman’s identity — and insurance card.

The hospital found out about the fraud in late June after the victim was contacted for a follow-up to a three-day stay related to substance abuse and suicidal thoughts, said Andrea Kofl, chief operating officer and chief nursing officer at the hospital.

The woman who was contacted in the follow-up call had no idea what the hospital employee was talking about, Laguna Beach Police Sgt. Jason Kravetz said.

Hospital officials were shocked to learn the patient and the woman whose insurance was billed for the $13,000 hospital stay were not the same.

“It took us back,” Kofl said. “It’s another twist in identity fraud.”

Kofl said it is the first known incident of insurance identity theft in the Adventist Health chain of 18 hospitals.

Kofl said she suspects the patient, known as “Jane Doe,” came to the hospital for the purpose of seeking drugs.

“The patient came in seeking detox, but she had suicidal ideation and was held on a 5150, three-day hold, then released with a follow-up appointment, which she never kept,” Kofl said.

The hospital had no way of knowing the woman was using another person’s insurance card, Kofl said.

“The patient had a valid insurance card and the address matched what was in the system,” she said. “It’s very unusual.”

Kofl said the hospital is reviewing procedures to try to avoid such incidents in the future.

The woman whose insurance card was stolen isn’t the only victim, she said.

“The hospital was defrauded, because now the bill won’t be paid,” Kofl said.

CINDY FRAZIER is city editor of the Coastline Pilot. She can be contacted at (949) 494-2087 or cindy.frazier@latimes.com.