Financial Education

Medical Identity Theft

April 23, 2018 | Return to Financial Education

By now, you are most likely aware of the term “ID Theft”, or “Identification Theft” that refers to fraudsters obtaining your personal and financial information for illegal purposes – mainly to steal your money.  Are you aware of Medical Identity Theft?  Medical ID Theft can be just as damaging.

Medical identity theft occurs when a thief uses your name or health insurance numbers to see a doctor, get prescription drugs, file claims with your health insurance provider, or get other care.  If the thief’s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected.

If you see signs of medical identity theft, order copies of your medical records and check for mistakes.  You have the right to see your records and have any mistakes corrected.  Be sure to read your medical and insurance statements regularly and completely.  They can show warning signs of identity theft.  Read the Explanation of Benefits (EOB) statement or Medicare Summary Notice that your health plan sends after treatment.  Check the name of the provider, the date of service, and the service provided.  Do the claims match the care you received?  If you see a mistake, contact your health care plan provider and report the problem.

Other signs of medical identity theft include a bill for medical services you didn’t receive, a call from a debt collector about a medical debt you don’t owe, medical collection notices on your credit report that you don’t recognize, a notice from your health care plan provider saying you reached your benefit limit, and a denial of insurance because your medical records show a condition you don’t have.

If you know a thief has used your medical information, get copies of your records.  Federal law gives you the right to know what’s in your medical files.  Check them for errors.  Contact each doctor, clinic, hospital, pharmacy, laboratory, health plan, and location where a thief may have used your information.  You may need to pay for copies of your records.  If you know when the thief used your information, ask for records from just that time.  Keep copies of your postal and email correspondence and a record of your phone calls, conversations, and activities with your health care plan provider and medical providers.

To ask for corrections to your medical records, write to your health care plan provider and medical providers and explain which information is not accurate.  Send copies of the documents that support your position.  You can include a copy of your medical record and circle the disputed items.  Ask the provider to correct or delete each error.  Keep the original documents.  Send your letter by certified mail and ask for a return receipt.

Some ways to protect your medical records include being wary if someone offers you free health services or products, but requires you to provide your health plan ID number.  Medical identity thieves may pretend to work for an insurance company, doctors’ offices, clinic, or pharmacy to try to trick you into revealing sensitive information.  Don’t share medical or insurance information by phone or email unless you initiated the contact and know who you’re dealing with.  Keep paper and electronic copies of your medical and insurance records in a safe place.  Shred outdated health insurance forms, prescription and physician statements, and the labels from prescription bottles before you throw them out.  And finally, before you provide sensitive personal information to a website that asks for your Social Security number, insurance account numbers, or details about your health, find out why it’s needed, how it will be kept safe, whether it will be shared, and with whom.