- In This Article
- Medical identity theft may deplete your benefits
- Notify your insurer if your medical insurance card is ever lost or stolen
- Review all bills and statements you receive from hospitals, doctors and your insurance
Everyone has the right to medical care. Unfortunately, some criminals think they have a right to use your medical insurance to receive care and services without paying a dime. The growth of this crime, known as medical identity theft, is alarming.
A recent study by the Ponemon Institute that ProtectMyID™ sponsored estimates that nearly 1.5 million people in the United States have been victims of the crime. The consequences are serious. Medical identity theft is difficult to detect and resolve, and the typical victim, according to the study, faces approximately $20,000 in fraudulent insurance bills.
Victims deal with more than just financial troubles, however. Medical identity theft frequently results in erroneous information being added to a person's medical record or even the creation of an entirely fictitious medical record in the victim's name.
When the victim seeks care, he or she could end up with the wrong medical history, wrong blood type, wrong allergies and other false information that could lead to serious problems. Victims may also find that their health insurance benefits have been exhausted due to a long period of misuse.What Is Medical Identity Theft?
- One of the most common forms of this crime is using someone else's insurance card to receive medical services.
- Identity thieves may also use the person's stolen identity to obtain money by falsifying claims for medical services and falsifying medical records to support those claims.
- In addition to credit cards being opened in a victim's name, perpetrators can also run up large hospital bills that can go to collections.
- Thieves can also steal a doctor's name and medical license number to forge their signature and falsify patient records and prescriptions.
- Unlike purely financial forms of identity theft, medical identity thieves may also harm victims by creating false entries in a person's health records at hospitals, doctors' offices, pharmacies and insurance companies.
What Signs Indicate Medical Identity Theft?
- Receiving a bill for medical services from a hospital or physician that you've never visited.
- These bills may be in someone else's name.
- A collection agency calls or sends a letter regarding overdue payment on a medical account that does not belong to you.
- Your insurer sends a letter confirming a change of address when you did not request one.
- Medical insurance is denied because an imposter used your benefits.
- You receive notification from a hospital or doctor when a criminal has broken into their computer and stolen patient identities.
Victims of medical identity theft are often at a disadvantage due to the long detection times. According to the Ponemon Institute, 31 percent of study participants found out they were victims one year after the incident occurred. Twenty-one percent say it took two or more years to learn about the theft. If you notice any indication that you've become a victim, take action immediately.For proactive protection, take the following steps:
- Request a copy of your prescription or medical claims history by calling your appropriate insurance provider.
- Review your claims history for inaccurate information, such as hospitals or doctors you've never visited or prescriptions you've never filled.
- If you find false information, contact your provider at once.
- Review all bills and notices, such as an Explanation of Benefits (EOB) you receive regarding medical services.
- If a criminal has used your benefits with his or her name, these bills or notices may list someone else's name with your address.
- Most insurance plans, including Medicare and Medicaid, will send you an Explanation of Benefits after each service received.
- Make sure you are the one who received the services listed.
- Request an accounting of disclosures of protected health information from your providers, such as hospitals and doctors.
- This will help you know with which organizations or other providers your doctors have shared your personal information and medical records.
- If you're unsure why your information was shared with another organization, be sure to question the disclosure.
Also, if your wallet is ever lost or stolen, be sure to notify your medical insurer(s). A lost or stolen insurance card could be the beginning of medical identity theft.
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