Health Care and Medical ID Theft

Have you ever been victimized by identity theft, or had someone steal your wallet or purse with all your credit cards and other vital information? Has anyone ever tried to open up new accounts using your name or social security number? Even worse, have you ever had to challenge billing from a health care provider because someone received medical treatment using your name? Medical ID theft has skyrocketed over the past few years, and it only continues to get worse as internet hackers and those expert in ID theft rachet up the thievery. Although the incidents of medical ID theft are increasing, some of it can be blamed on cases where insurance company employees leave their office with a laptop that gets stolen from their vehicle. In that case, the negligence on the part of the company, and representative, is a big part of the overall problem. And the media loves to blast this type of story all over the national news.

How would you know if your personal, health, or health insurance information has been compromised? According to the Federal Trade Commission (FTC), the nation’s consumer protection agency, you may be a victim of medical identity theft if:
--You get a bill for medical services you didn’t receive;
--A debt collector contacts you about medical debt you don’t owe;
--You order a copy of your credit report and see medical collection notices you don’t recognize;
--You try to make a legitimate insurance claim and your health plan says you’ve reached your limit on benefits; or
--You are denied insurance because your medical records show a condition you don’t have.

Medical identity theft, according to the FTC, may change your medical and health insurance records: Every time a thief uses your identity to get care, a record is created with the imposter’s medical information that could be mistaken for your medical information – say, a different blood type, an inaccurate history of drug or alcohol abuse, test results that aren’t yours, or a diagnosis of an illness, allergy or condition you don’t have. Any of these could lead to improper treatment, which in turn, could lead to injury, illness or worse. And according to WalletPop.com, while you're probably well aware of identity theft and its impact on your credit, you may not be aware of a type of identify theft that can be even more harmful to you personally. You may not only end up with bills incurred by the person who steals your identity, but the crime can even prove fatal.

When someone uses your identity, incorrect information gets into your medical files, according to WalletPop.com. 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. 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 rapidly growing.

According to WalletPop.com, 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.

More info can be found on this website: http://www.walletpop.com/blog/2010/01/02/medical-identity-theft-fastest-growing-fraud-can-be-deadly/.

And, according to ABCNews.com, if your medical identity is stolen, your medical records may be altered and may show incorrect information. This may prevent your obtaining proper medical care and insurance benefits, according to the FTC. Here's what you can do to prevent medical identity theft:
1. Keep a close eye on information in your credit report. Identify any medical debts on the report and make sure they are yours.
2. It's a good idea to monitor any explanation of benefits that may be sent to you by insurers. If anything appears to be incorrect, contact the insurer or provider for a full explanation. If you get a statement that's not yours, don't ignore it simply because it may say you don't owe any money. 3. Request and review all the benefits that have been paid in your name by insurance plans to which you belong. You should do this at least once a year, and much more often if you think there may be a problem.

The fallout of medical ID fraud is that the victim is forced to sort out what happened with doctors, hospitals, insurance companies, credit agencies and sometimes even lenders that may have granted a loan for medical reasons. According to a survey provided through a report on NetworkWorld.com, 29% of victims of medical ID theft discovered the problem a year after the incident, and 21% said it took two or more years to learn about it. The average cost of sorting out the mess was $20,160, which might include making out-of-pocket payments to a health plan provider to restore coverage. Nearly half of the victims (48%) lost coverage due to medical ID theft. Roughly 75% found resolution difficult, and only about 25% said there were no consequences due to the theft. Among the victims surveyed, 46% did not report the incident to law enforcement or other legal authorities, according to the report, and 33% said the medical ID theft occurred because a family member used their medical ID for goods and services without their knowledge. Other medical ID thefts were attributed to a lost wallet with insurance card in it, and a data breach that exposed patient information. The study was done by The Ponemon Institute.

According to InsuranceFraud.org, you pay a high price for medical ID theft. Medical ID theft can cause serious and long-lasting damage. Recovering can take years. Here are some of the issues you deal with in the recovery:
--Ruined credit: Thieves often ring up large hospital bills in your name, then disappear without paying. This can ruin your credit. Straightening out inaccurate credit records can take months or even years of time-consuming headaches. Meanwhile, you could be hounded by bill collectors, turned down for loans or mortgages, and forced to pay higher lending costs. You also could lose jobs; some employers check a candidate’s credit history.
--Loss of health coverage: Fraudulent insurance claims can max out your health-policy limits. This can leave you with no coverage when you have a medical emergency, or need an expensive operation or other treatment.
--Inaccurate records: Medical ID theft can threaten your health or even life. A thief’s treatment history can end up on your medical records. This could include the wrong blood type, or medicine to which you’re allergic. Your life thus could be on the line if you receive the wrong treatment based on the thief’s treatment. Your records also could be falsely saddled with damaging—and inaccurate—diagnoses such as mental illness. This could follow you throughout your life.
--Legal troubles: A pregnant woman stole the medical identity of a mother, and delivered a baby who tested positive for illegal drugs. Social workers tried to take away the real mother’s four children, falsely thinking she was the addict. She had to hire a lawyer to keep her family.
Higher health premiums. False claims against a health insurance policy can raise your health premiums—costing you yet more money.

Correcting records can be hard, according to InsuranceFraud.org. In general, federal law lets patients correct medical records created only by the medical provider or insurer that now maintains your information. A hospital or insurer that later receives your information doesn’t have to correct its records—even when they’re wrong. But… you do have the right to have your records state that you disagree with the information, and why. Be sure your complaint is entered into your records.

According to FTC.gov, if you are a victim of medical identity theft, here are several steps to take immediately:
--Keep detailed records of your conversations and copies of your correspondence.
--File a complaint with the Federal Trade Commission online at https://www.ftccomplaintassistant.gov or by phone at 1-877-ID-THEFT (438-4338); TTY: 1-866-653-4261.
--File a report with your local police, and send copies of the report to your health plan’s fraud department, your health care provider(s), and the three nationwide credit reporting companies. Information on how to file a police report is at www.ftc.gov/idtheft/consumers/defend.html.
--Exercise your right under HIPAA to correct errors in your medical and billing records. Write to your health plan or provider detailing the information that seems inaccurate. Include copies (keep the originals) of any document that supports your position. In addition to providing your complete name and address, your letter should identify each item in your record that you dispute, state the facts and your reasons for disputing the information, and request that each error be corrected or deleted. You may want to enclose a copy of your medical record with the items in question circled. Send your letter by certified mail, and ask for a “return receipt,” so you can document what the plan or provider received. Keep copies of your dispute letter and enclosures.
--Visit this site for more information by the FTC on medical ID theft: http://www.ftc.gov/bcp/edu/pubs/consumer/idtheft/idt10.shtm.

Protecting your identity is a must for everyone, especially when dealing with medical records and any health care related case. If you are a victim of fraud or theft on any of these types of issues, follow the guidelines that are available to all consumers. Additionally, you may wish to buy an ID theft protection plan. There are many products on the market that will help you prevent ID theft, but medical ID theft is a specialized threat. In the interim, you can check out plans online with reputable companies, like LifeLock, Careington, ID Experts, and others. Also, you can purchase a plan that includes access to ID theft prevention and recovery, in addition to financial counseling and legal advice through Careington (www.careington.com) in a plan the company markets under the brand name CareShield for just a few dollars per month for membership.

With the availability of millions of medical records, sooner or later you may be a victim. It makes sense to protect yourself and your family as much as possible by being smart about your health care and your credit. Following simple precautions may help keep you healthy and safe.

Until next time. Let me know what you think.