What is medical identity theft? In this serious and growing problem, someone else uses your personal information to obtain medical goods or services. Medical identity theft affects consumers, health care providers, and insurance organization. According to the Federal Trade Commission (FTC), medical identity theft accounts for about 3 percent of all identity theft, and the World Privacy Forum claims it’s the most difficult form of identity theft to correct.
When you are the victim of medical identity theft, incorrect information about diagnoses and treatments may appear on your medical records, potentially affecting your health care providers’ decisions about your care and treatment. Also, in addition to paying for treatment you didn’t receive, in some cases you might be denied treatment or coverage because of fraudulent medical or insurance information.
But there is some good news: HIPAA (the Health Insurance Portability and Accountability Act) regulations and the Identity Theft Protection Act, already in place, give you many of the tools you need to get errors corrected at your doctor’s office and with your insurance provider. Of course, like any crime, you’re better off preventing it from happening in the first place.
Spotting Medical Identity Theft
Among other signs, the FTC states that you may be a target of a potential medical identity theft or fraud if you are charged for medical services you didn’t receive. Keep a calendar to track your appointments, treatment dates, and any hospital admission and discharge dates. If the explanation of benefits from your insurance provider or Medicare isn’t exactly right, clear up the error as soon as possible.
Medical receipts, prescription drug information, health insurance forms, and any documents bearing your health care providers’ names might be all a clever thief needs to begin off-loading other medical claims to you. If you don’t need to keep medical documents, shred or burn them, and peel off labels from your prescription medications before recycling the containers.
Legal Protection to Combat Medical Identity Theft
The Identity Theft Protection Act of 2005 requires any commercial, charitable, educational, or non-profit organization that acquires or uses sensitive personal data to provide significant administrative, technical, and physical safeguards to prevent that data from being mishandled.
The same act that allows consumers to place a freeze on their credit reports also requires any covered entity to investigate suspected misappropriation of personal medical data and to do everything possible to correct resulting inaccurate medical information and billing problems.
Tips to Prevent Medical Identity Theft
Take your photo ID to all doctor appointments. Bring an ID along with your insurance information and any other documents, such as a Medicare card, so you can provide it. An FTC law known as the “red flags rule” encourages doctors and other health care providers to require proof of identity before providing services. You can write “See ID” on the signature line of your Medicare card, just as you can on a credit card, so your health care provider will be prompted to verify your identity. Also, when you’re asked to sign any paper at your doctor’s office, review the document first and be sure any erroneous information is corrected immediately.
Don’t divulge medical or insurance information too freely. Sometimes you’re smart to be suspicious, especially of someone contacting you by phone. If you get a caller asking you to take a health care survey and requesting your health care provider’s name or your insurance information, hang up, and then call to alert your insurance provider. Also, be suspicious of health care providers and equipment suppliers who use telemarketing or door-to-door sales tactics, put the wrong diagnosis on a claim “so Medicare will pay,” or advertise free medical consultations for people with Medicare.
Report any ID card loss immediately. If you lose your Medicare card or suspect it may have been stolen, call Social Security to get a replacement. Likewise, if you lose your insurance card, let your provider know right away.
Review all of your insurance documents. Insurance information and statements of benefits can be confusing, and medical identity thieves know that many people don’t read them carefully. However, these documents are one of the first alerts that you may be a victim of medical identity theft. Read your statements and if they don’t seem right, call your insurer’s office. Before you call, verify that the phone number on the documents you have matches the one on your insurance card.
Monitor Your Privacy and Your Health
Most people realize that maintaining good health — managing weight and keeping the body strong and mind active — means making an effort every day. Avoiding medical identity theft doesn’t require daily vigilance, but in order to avoid problems, you should perform regular “check-ups” to be sure no one is posing as you. Be sure to monitor your insurance provider’s regular statements. Although you can also request a complete copy of your medical records from your health care provider, it can be expensive — ask about the cost before you formally request it.
