Medical identity theft occurs when someone uses an individual’s name or other parts of the individual’s identity – such as insurance information or Social Security Number – without the victim’s knowledge or consent to obtain medical services or goods.

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Medical identity theft can also occur when someone uses the person’s identity to obtain money by falsifying claims for medical services and falsifying health records to support those claims. The essence of the crime is the use of a medical identity by a criminal and the lack of knowledge by the victim.

 

Identity theft of medical records can be especially difficult to fix. Larry Ponemon, chairman of the Ponemon Institute, said he expected the number of identity thefts from health care providers to keep rising. Consumers who have suffered medical identity theft need help and support to fix their records.

“Things will get worse before they get better,” he said. “We see hacking as a daily event. It just seems that the ability to protect this information is not easy.” As the protections become more sophisticated, “the hackers get smarter,” he said.

If you think you may be a victim of medical identity theft,  review the following quick tips for detecting and correcting medical identity theft:

How To Detect Medical Identity Theft

— Always read your medical and insurance statements.

— Signs of medical identity theft can 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 plan saying you reached your benefit limit; a denial of insurance because your medical records show a condition you don’t have.

How To Correct Medical Identity Theft

— Get copies of your medical records.

— Contact each doctor, clinic, hospital, pharmacy, laboratory, health plan and location where a thief may have used your information. If a provider denies your request for your records, you have a right to appeal.

— Ask each of your health plans and medical providers for a copy of the “accounting of disclosures” for your medical records. The accounting is a record of who got copies of your records from the provider.

— Write to your health plan and medical providers and explain which information is not accurate. Send copies of the documents that support your position. Ask the provider to correct or delete each error. Keep the original documents.

Where to get more information for medical identity theft help:

— The Federal Trade Commission: ftc.gov or call the identity theft hotline: 1-877-ID-THEFT (1-877-438-4338), TTY 1-866-653-4261. See also, FTC Identity Theft Resource Center.

– FTC Bureau of Consumer Protection – Medical Identity Theft: FAQs for Health Care Providers and Health Plans.

— World Privacy Forum: worldprivacyforum.org; email [email protected]; or call 1-760-712-4281

— Identity Theft Resource Center: idtheftcenter.org or call 1-888-400-5530

Sources: Federal Trade Commission; World Privacy Forum; Identity Theft Resource Center

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