Last updated April 2024
Last updated April 2024
The most insidious of all identity theft crimes is medical identity theft. This type of crime is a double-edge sword, not only is a victim left to recover their credit reports but also their medical histories and health insurance records as well. Like financial identity theft, victims may discover this crime through a phone call from a collection agency, a letter denying them coverage because of a medical condition they do not possess or a bill for medical services they never received. The end result is another individual’s health issues are now part of their medical record and can impede their ability to obtain health insurance, personal or home loans and affect the diagnosis and treatment decisions made by their physicians causing illness, allergic reactions, even death.
According to a study by Javelin Strategy & Research, a consulting firm for the financial service industry, states that of the 11 million identity theft cases reported only 275, 000 were medical theft. While that number seems low, the report also stated that the number of cases have doubled from 2018 to 2019 and were expected to rise.
The good news is that medical identity theft can be caught early with the use of a few preventative steps.
First always review any “Explanation of Benefits” statement from your health insurer. Check it for claims that show services or medical equipment you never received or charges for office visits you never made.
Also verify the name of the provider, the service date and the service type. If you find a suspicious claim or entry, contact your health plan to report the problem. A suspicious claim or entry doesn’t necessarily have to be associated with a charge to be of concern; always inquire if you feel your statement looks incorrect or inaccurate.
Secondly, just as you request your annual credit reports from the three credit reporting agencies, you should be proactively reviewing a list of benefits from your health insurer on a yearly basis. Let’s just say for example, that a thief has changed your address and you haven’t seen your monthly “Explanation of Benefits” in awhile. This request to your insurer can assist you in catching any bogus claims made against your account, if for some reason your EOB statements become lost in the mail.
Since its always better to be proactive then reactive, you should be requesting a copy of your current medical records from your health care provider at least once a year whether you’ve been a victim of medical identity theft or not. There may be a fee to acquire your records, and under the Health Insurance Portability and Accountability Act (HIPAA), they have 30 days to comply. Since there is no central source when it comes to medical records, it is best to contact each provider, whether it’s a pharmacist, doctor, clinic or hospital. If you do find something questionable in your medical records, it’s far easier to reconstruct a few months of erroneous information than 2 years worth.
Lastly, always review your credit reports. With medical identity theft, victims come across collection notices to labs, doctors, or other medical services. Victims have been able to prove their innocence by comparing their own medical histories with those of the perpetrator’s. Details such as existing or non-existing conditions, blood types, even age can be used to dispute and prove that the debt does not belong to you.
Medical identity theft can tarnish both your credit and your medical records, and at the very worst lead to dangerous outcomes when medical emergencies occur. If you should find yourself a victim of this crime, see The Road to Recovery from Medical Identity Theft for more information.
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