Are you among the 56 percent of Americans who do not check their medical records? That’s a mistake that can cost you. Medical identity fraud is on the rise, having claimed 1.8 million victims in 2013, an increase of 19 percent over the previous year, according to a recent survey from the Ponemon Institute.
When someone steals your medical information in order to get goods or services, it can lead to errors in your medical records that could compromise your own care. It also can create financial problems, if you are charged for services or medications you didn’t receive.
Robin Slade, development coordinator for the Medical Identity Fraud Alliance, says medical information is more valuable to fraudsters than even a Social Security number. The ability to capture that data has increased as medical information has gone digital.
“I see such a correlation between what health care is going through now and what the financial industry was going through with the advent of e-commerce,” Slade says.
Many victims find out about medical identity theft when they see mistakes in their health or insurance records, or get invoices from health providers or collection letters for unpaid services they never received. It’s important to know how to prevent medical identity theft and what to do if it happens to you.
If your insurance card is lost or stolen, the first step is to contact your insurer and follow the company protocols to protect yourself from identity theft.
Never give your account information by phone during unsolicited calls, Slade says. Hang up and call the number on the back of your insurance card to follow up.
Also consider removing your medical insurance card from your wallet. Make a copy of it and black out all but the last four numbers, Slade says. Give your full insurance information to an emergency contact and keep his or her contact information in your wallet.
Be sure to review the Explanation of Benefits sent by your insurer. Verify dates for doctor visits or treatments, Slade says. Make sure the information makes sense to you. Another safety measure may be to have EOBs sent via email, says Slade.
Each year, obtain a "benefits request" from your insurer for a list of all benefits and services paid in your name. Also be sure to scan your credit report annually (you can get it free once a year at annualcreditreport.com) for any medical liens.
If you discover that you have been a victim of medical identity theft, experts say the first step is reporting the crime to the police and contacting your health insurer to let them know what has happened.
Then, request copies of your medical records from any health provider where you or the thief has received care based on your findings. You do not have to give the provider a reason for your request. According to the Federal Trade Commission, you may have to pay for the information in some cases, but federal law gives you the right to know what is in your file and your request cannot be denied. If a provider denies your request, you can appeal through the patient representative listed in the provider’s Notice of Privacy Practices.
Ask each of the health providers for a copy of the “accounting of disclosures” for your medical records. You are entitled to one free copy every 12 months. This will give you information about who has copies of erroneous records and whom you need to contact to correct them.
Finally, submit a request in writing to your health plan and medical providers asking them to correct or delete inaccuracies. Include an explanation of the mistakes and copies of documents that support your position with the errors highlighted. Send the request by certified mail and get a return receipt. Keep all original documents and copies of any correspondence in your files.
