Medical Identity Theft

By Carol Church

I recently received a mysterious medical appointment reminder for an appointment I do not have from a provider I have never seen. When I called to inquire about the situation, I was told that somehow my phone number had been accidentally transposed onto the file of another patient. Although this seems to have just been a clerical error, the situation worried me, because it made me feel concerned about the possibility of medical identity theft.

These days, almost everyone is probably familiar with the general idea of identity theft. However, most of us may be more likely to think of having a Social Security card number or credit card number stolen than to consider the concern of medical ID theft.

Who is Affected?

Photospin/Erwin Wodicka

Unfortunately, however, this is a serious problem affecting millions of Americans every year. And the aftermath can be just as devastating (or more so) than other types of identity theft. Victims of medical identity theft can end up on the hook for thousands of dollars of medical bills and may be denied coverage and services. Medical identity theft can even put your own health at risk, as when someone else’s health concerns, allergies, conditions, etc. become intertwined with yours and falsely appear on your medical records. Some medical identity theft victims have even been erroneously accused of crimes when criminals used their information to obtain painkillers.

Sadly, veterans and service members are at elevated risk of all types of identity theft, including medical identity theft. This is for two reasons: first, their personal information is in many, many systems and frequently requested; second, unscrupulous people know that military medical benefits are highly valuable and wish to obtain access. For this reason, service members and those who work with them need to be informed about this lesser-known problem.

What are the signs of medical identity theft?

All of the following may be warning signs of medical identity theft:

  • Receiving medical bills for procedures or office visits you do not recognize or that you did not authorize
  • Seeing charges, procedures, or visits on your EOBs (Explanation of Benefits) materials from your insurance company that are unfamiliar
  • Being told you have reached a cap or lifetime limit when you are not anywhere close to this
  • Receiving notices from creditors or being denied credit for medical bills you do not recognize
  • Confusing information in your health records that seems to not be yours (for instance, about conditions you do not have or procedures you never underwent)

What should someone do if they suspect or believe they are a victim?

  • If you suspect that you have been a victim of medical identity theft, the first step is to find the instances. Request your medical records from every provider that you know or think may have been involved. You have a right to these records, but unfortunately, there may be a fee.
  • If you find mistakes, correct these with the providers. You may need to file a report with the police to help this process along.
  • Alert your health insurer to the fraud.
  • Medical identity theft victims may be the victims of other types of identity theft as well, so if you have identified this type of ID theft, it’s time to check other accounts, including credit cards, bank accounts, and your credit report.
  • File a complaint at www.ftccomplaintassistant.gov or by phone at 1-877-ID-THEFT (1-877-438-4338). Visit www.ftc.gov/idtheft for additional information.

How can medical identity theft be prevented?

  • Guard all sensitive military IDs, Social Security numbers, Medicare and Medicaid numbers, Tricare and insurance cards, etc. Securely store or shred papers containing these numbers.
  • Always contact your insurance company and/or health care providers about unfamiliar charges, bills, or procedures. (Remember, however, that bills can be confusing and human error can occur. Not all mysterious charges are fraudulent.)
  • Never “share” medical identities with someone, even if they are in dire need. And be careful about who has access to your personal records, even within your family. According to one study, the majority of medical identity thieves are someone who knew the victim.

Medical identity theft is yet another type of crime that we need to be aware of in today’s changing world. Staying alert to the risk of this type of fraud is key.

References and resources:

Andrews, M. The rise of medical identity theft. Retrieved from http://www.consumerreports.org/medical-identity-theft/medical-identity-theft/

Federal Trade Commission. (2011). Medical Identity Theft: FAQs for Health Care Providers and Health Plans. Retrieved from https://www.ftc.gov/tips-advice/business-center/guidance/medical-identity-theft-faqs-health-care-providers-health-plans

Office of Inspector General. Medical ID Theft / Fraud Information. Retrieved from https://oig.hhs.gov/fraud/medical-id-theft/

University of Texas at Austin Center for Identity. Medical Identity Theft Targeting Veterans and Active Service Personnel: What You Need to Know. Retrieved from https://identity.utexas.edu/veterans-and-active-service-personnel/medical-identity-theft-targeting-veterans-and-active-service-personnel-what-you-need-to-know

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