Protect Yourself Against Medical ID Theft

Earlier this month, the Wall Street Journal published an unnerving story about what can happen to your sense of security, not to mention your actual financial security, when someone steals your medical information.

“How Identity Theft Sticks YouWith Hospital Bills” (behind The Journal’s paywall) makes clear that medical identity theft is a fast-growing crime thanks to the proliferation of electronic medical records. Most people are aware of data being hacked at insurance companies and health-care facilities. When someone has your health records, insurance information and Social Security number, he or she can use it to get medical care, surgery, prescriptions and medical equipment while pretending to be you.

A sidebar accompanying The Journal story provides some background and offers tips to avoid being the star of that horror story.

Medical ID Theft Is Different From Financial ID Theft
If your stolen credit card numbers are used and you report it early, you’re not responsible for most of the illegal charges. But medical ID theft victims can be required to cover costs for health services they never received. “Sometimes,” according to The Journal, “the health plan or health-care provider absorbs the losses, and sometimes they push the consumer to pay. [One survey] found 65% of victims reported they spent an average of $13,500 to restore their credit, pay their health-care provider and correct inaccuracies in their health records.”

Sometimes, It’s an Inside Job

Some health-care providers use patients’ personal data to bill insurers or public agencies such as Medicare for services they never provided. Such fraud costs millions every year and wreaks havoc with the patients whose records were used to commit it.

Some Medical ID Theft Is Tied to Organized Crime

An assistant U.S. attorney who specializes in organized crime drug enforcement told The Journal that criminal organizations including gangs have turned to medical ID theft to obtain prescription drugs that can be sold on the street.

What to do:

  • Keep Tabs on Your Personal Information
    Because major data breaches involving insurers are increasing, consumers must know what to do if such a breach becomes medical identity theft.

    First, be careful about giving out any personal information over the phone or online; don’t carry your Social Security or insurance card in your wallet; keep them in a safe place. Second, review all statements from insurers (they’re known as explanation of benefits, or EOBs) to ensure you actually received the services listed and charged. Contact your carrier if there are entries you question. Third, review your credit reports regularly to detect unpaid medical bills in your name. Each of the three major credit reporting agencies must provide an annual accounting for free, so get one every four months.

  • Review Your Medical Records
    By law patients have the right to access their medical files and receive copies, although there may be a charge and you must complete an authorization form. If someone else’s medical information is included in your files, alert the doctor, hospital or other medical provider as well as your insurance company.
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