• Table Of Contents

• Introduction
• How and Why Medical Identity Theft Occurs
• Warning Signs You May Be a Medical Identity Theft Victim
• Ways to Prevent Medical Identity Theft
• What to Do if You Are a Victim of Medical Identity Theft
• Helpful Online Resources
• References

Introduction

Medical identity theft is an alarming and growing trend in the United States, but unlike with traditional identity fraud – you may not be aware it has even occurred. Approximately 1.4 million people in the United States have been victims of medical identity theft, according to a survey conducted by the Ponemon Institute and sponsored by credit reporting firm Experian. [1]

What exactly is medical identity theft? Quite simply, thieves steal personal information like health insurance identification and social security numbers and make money by filing fraudulent claims against health insurance policies. In some cases, the personal information is resold on the black market. [2] This type of identity theft not only affects one’s insurance benefits, but can also prevent an individual from attaining health insurance in the future. Additionally, victims’ finances and credit are severely strained, which could result in being turned down for bank loans on a car or house, or losing a job after an employer researches one’s credit history. [2]

Even more unimaginable, however, is the reality that medical identity theft can be life-threatening. When impersonators alter a victim’s medical history (including blood type, diseases, medications, or allergies) emergencies turn out to be much more complicated than they should be. [3] In this article, we will explain exactly how and why medical identity theft happens and what you can do to fight back.

How and Why Medical Identity Theft Occurs

Identities and insurance information are sometimes stolen to help those without health insurance get expensive medical procedures, but that’s not always the case or the incentive. In fact, medical identity thieves often work within the medical industry and include doctors, nurses, and even medical clerks. In some cases, medical industry personnel are attempting to increase their income by filing false claims. In other instances, medical records and billing codes are stolen by organized crime rings that go so far as to set up fake medical clinics offering free health screenings to lure in patients, only to steal their insurance information, falsely bill them, and disappear before they realize what has happened. [3]

Other cases of medical identity theft involve prescription medications. Personal information is stolen to buy drugs like narcotics and then the medications are either used by addicts or sold on the black market. [2]

Warning Signs You May Be a Medical Identity Theft Victim

“We have definitely seen an increase in medical identity theft over the last year,” Jennifer Trussell, director of investigations for the U.S. Department of Health and Human Services told ABC News in 2010.  [4]

The shocking news usually arrives in the form of a medical bill or an Explanation of Benefits (EOB) notification for procedures or doctor’s visits that look foreign to the insured. Sometimes, a red flag might actually pop up at the doctor’s office or pharmacy when victims are told they don’t have proper authorization or that coverage has been denied.

“I was not only humiliated, I was having to advocate and plead with these providers to rebill my insurance and help me. Frustrated with having to rebill, they wouldn’t and my medical bills skyrocketed,” recalls Alexis Moore, a medical identity theft victim who says it took 2+ years and between $10,000-20,000 to clear up the confusion. [5]

In 2003, Brandon Sharp, a manager at an oil and gas company in Houston, Texas discovered that his identity had been stolen when he requested a copy of his credit report just before applying for a mortgage for his first home. Imagine his surprise when he learned he owed exorbitant amounts of money in emergency medical bills. [6]

“There was even a $19,000 bill for a Life Flight air ambulance service in some remote location I’d never heard of,” said Sharp. “I had emergency room bills from places like Bowling Green, Kansas, where I’ve never even visited. I’m still cleaning up the mess.” [6]

Below is a list of warning signs that may indicate your identity has been stolen for medical purposes:

1. Your health insurance identification card has suddenly gone missing or is stolen.
2. You receive a suspicious medical bill from a doctor or hospital.
3. You receive an Explanation of Benefits (EOB) from your health insurance company for services you didn’t receive.
4. You are contacted by a debt collector about unfamiliar medical debt. [7]
5. You are told you have received the limit on your benefits or you are denied health insurance because of a condition you do not actually have. [7]
6. Your doctor or pharmacist has inaccurate information about you.
7. Your credit score changes or you notice a medical collection notice on your credit report. [8]

Ways to Prevent Medical Identity Theft

Avoiding the nightmare of identity theft all together is your best defense. Since medical identity theft happens several different ways, there are many easy ways to help prevent medical theft from happening to you, including the following:

1. Always show your photo ID. If you have a signature area on your health insurance card, write “See ID” so your medical provider will always ask for it when you visit. [9]
2. Maintain a medical calendar. Keep records of all your appointments and hospital visits and make sure they match with what is stated on your EOB documents. [9]
3. Shred medical documents. Crooks would love to get their hands on receipts or forms with health insurance information or prescription drug coverage data, so discard these carefully by shredding them. [9]
4. Report ID card loss right away. Alert your health insurance provider immediately if your card has been lost or stolen.  [9]
5. Monitor health insurance statements. Either check your statements online if available or request annual statements from your insurance provider to ensure their information about you is accurate. [2]
6. Monitor your credit. Take advantage of the free credit report you are entitled to each year from all three major credit reporting agencies – TransUnion, Equifax and Experian.  Report unauthorized activity appearing on your credit report immediately.
7. Beware of phishing scams. Avoid medical providers who offer free medical consultations and use questionable telemarketing or advertising techniques. [9]
8. Keep medical information private. Don’t readily disclose your medical and insurance information to anybody who asks for it. Remember, scam artists do their best to sound legitimate.
9. Avoid accessing medical websites from unprotected computers. If you are accessing the Internet from a public computer or are using a Wi-Fi connection that is not secure, steer clear of your doctor’s website or your insurance company’s website which may have your medical information stored.

What to Do if You Are a Victim of Medical Identity Theft

If you think you may be a victim of medical identity theft, take action as quickly as possible to clear up matters with your health insurance company, medical providers, debt collectors, and the credit bureaus.

Here are a few vital steps to take:

1. Request an investigation. Contact your health insurance provider and tell them you are a potential medical identity fraud victim. [10]
2. Get copies of your medical records. Be sure to ask all of the medical professionals you see for copies. [2]
3. Correct false medical reports. Make sure your doctor, hospital, and labs all have accurate information about you. Under federal law, you have the right to have your records changed to remove incorrect information. [5]
4. File a police report. Notify your local law enforcement agency immediately that a crime has been committed. Keep copies of the report to send to your health insurance company, medical providers, and all credit bureaus with whom you may need to dispute claims.
5. Freeze your credit report. Alert the three major credit bureaus about the crime [5]
6. Set up fraud alerts. You only have to contact one of the three major credit bureaus to set this up; the one you call is required to notify the other bureaus. [11]
7. File a complaint with the FTC. Visit their site or call the FTC at 1-877-IDTHEFT (438-4338); TTY: 1-866-653-4261. Be sure to fill out an Identity Theft Affidavit. [10]

https://www.myid.com/checkout/paymentmodule”>Protect Your Identity Now

Helpful Online Resources

Better Business Bureau
Federal Trade Commission
National Association of Attorneys General
Electronic Privacy Information Center
Connect Safely
Privacy Rights Clearinghouse
Privacy.org
Electronic Frontier Foundation
Center for Digital Democracy
World Privacy Form
Center on Medical Record Rights and Privacy
U.S. Department of Health and Human Services

References

1. Mills, Elinor. (2010, March 3). “Study: Medical identity theft is costly for victims.” Cnet.com. Retrieved on March 13, 2011.
2. Epstein, Lita. (2010, January 2). “Medical identity theft: Fastest growing fraud can be deadly.” Walletpop.com. Retrieved on March 13, 2011.
3. “Diagnosis: Identity Theft.” (2007, January 8). Businessweek.com. Retrieved on March 13, 2011.
4. Golodryga, Bianna and Netter, Sarah. (2010, March 9). “Medical Identity Theft: How to Protect Yourself.” ABCNews.com. Retrieved on March 13, 2011.
5. Nance-Nash, Sheryl. (2010, October 17). “How to Protect Yourself From Medical Identity Theft.” Dailyfinance.com. Retrieved on March 13, 2011.
6. Konrad, Walecia. (2009, June 12). “Medical Problems Could Include Identity Theft.” NYTimes.com. Retrieved on March 13, 2011.
7. “Red Flag or Not: What You Should Do to Respond to Identity Theft.” (2011, March). Gastro.org. Retrieved on March 13, 2011.
8. Adams, Laura. (2010, September 14). “Are You Safe from a New Kind of Identity Theft?” Moneygirl.com. Retrieved on March 13, 2011.
9. Stresing, Diane. (2010, November 9). “How to Protect Yourself From Medical Identity Theft.” Everydayhealth.com. Retrieved on March 13, 2011.
10. Anderson, Gwynneth. (2011, February 28). “Medical Identity Theft—Are You the Next Victim?” Investinganswers.com. Retrieved on March 13, 2011.
11. “Facts for Consumers: Medical Identity Theft.” (2010, January).  FTC.gov. Retrieved on March 13, 2011.