Medical identity theft: Fastest growing fraud can be deadly
byJan 2nd 2010 3:00PM
When someone uses your identity, incorrect information gets into your medical files. When you seek care you can end up with the wrong medical history, wrong blood type, wrong allergies and other errors that could end up being deadly for you.
In many cases the ID thieves steal your personal information to make money by filing fraudulent claims against your own health policy. Medical ID thieves often get your personal information, such as your health-insurance number and Social Security number, from employees at medical facilities. The information is then resold on the black market. Another way they get the information is to hack into medical databases. For example, at one medical clinic in Weston, Florida, a front desk clerk downloaded information of more than 1,100 Medicare patients and gave it to a cousin who made $2.8 million in false Medicare claims.
Many times you'll never know you are a victim of Medical ID theft, which can cost you thousands of dollars, unless you check your medical records closely. In most case you won't even know of the fraud until after the damage has been done.
As many as 500,000 Americans have been victims of medical identify theft, according to the World Privacy Forum. Medical identity theft is growing rapidly . The Federal Trade Commission received almost 19,500 reports of medical ID theft between January 1992 to April 2006. About one every four reports were received in 2006.
There are a number of ways Medical ID thieves steal your identity:
- Bill your health plan for fake or inflated treatment claims. Often these crooks are doctors or other medical personnel who know how the insurance billing system works. Organized theft rings also are involved. Using stolen information they buy on the black market, they set up fake clinics to file bogus claims.
- Use your identity to buy prescription drugs. They then sell these prescriptions or use them to feed their own addictions. For example, dishonest pharmacists might bill your policy for narcotics or nurses may call in prescriptions in a patient's name but pick it up themselves.
- Get free treatment. Medical ID thieves who don't have their own health coverage can use your identity to get free medical treatment based on your policy. They sign into a hospital or clinic using your identity and your policy receives the bills.
These fraudulent claims can even max out your health policy benefits and leave you with no coverage in a medical emergency. Or you could be denied treatment or an expensive operation because your coverage has been maxed out. In addition the inaccurate information in your records from this theft could include the wrong blood type or medicine to which you're allergic. You life can actually be put on the line if you're given the wrong medication or blood type in an emergency.
Long term these false medical claims could result in your being denied health insurance in the future or increase your health insurance claims dramatically.
How can you fight back?
- Check your explanation of benefits each time you get them from your insurer. Be sure they include the doctors you have actually seen and the treatments you have actually received. If you don't recognize something on the bill, call your insurer immediately.
- Get a yearly statement from your insurer listing all benefits paid out under your policy for the past year. Some insurers give you access to this information online. Check it regularly for any irregularities. The sooner you catch a medical identity thief the better it will be for you. You'll also have less of a mess to clean up.
- If you think you might be a victim of medical ID fraud, get a copy of your records from your doctor, hospital, pharmacy and laboratory so you'll have the proof you'll need about your actual medical identity and can use it to prove the fraud. You must clean up those fraudulent records to be sure you aren't treated inappropriately, especially in an emergency situation where information about the medical thief may be used to treat you with the wrong blood or drugs.
- Check your credit reports with the three major credit reporting agencies -- TransUnion, Equifax and Experian. You can do that for free once each year at annualcreditreport.com. Look for billings from medical doctors, clinics or other medical facilities that you did not use. Report the fraud to the credit reporting agencies and ask that a fraud alert be put on your credit file.
- Correct any false medical reports immediately. Check with your physician, local hospitals, medical labs and any other medical facility you frequent to be sure they don't have the inaccurate information.
File a police report immediately to notify law enforcement a crime may have been committed. Also send the report to your insurer, medical providers and all credit bureaus. You should also file a medical identify theft complaint with the Federal Trade Commission (FTC) or call the FTC's toll free hotline at 1-877-IDTHEFT (438-4338).
Medical identity theft can cost you your life. Don't allow friends without insurance to use your insurance card. Be sure to act quickly to clean up any sign of identity theft.
Lita Epstein has written more than 25 books including "The Complete Idiot's Guide to Improving Your Credit Score."