Medical Identity Theft - A Rising Fraud with Adverse Effects

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Medical identity theft is among the most devastating and dangerous of identity-related crimes perpetrated against consumers. It occurs when someone misrepresents who they are in order to obtain health-related services. When someone steals your medical identity your Personal Health Information (PHI) can become contaminated with the thief's medical information. This can lead to misdiagnosis and potentially put your life at risk.

What if you're given the wrong blood because your records indicate another person's blood-type? What if you receive a drug you are severely allergic to because the records are incorrect? What if your appendicitis goes undiagnosed because your medical records state your appendix has already been removed?

Life-threatening issues notwithstanding, when confronted with this crime you can face burdensome costs and enormous amounts of time attempting to recover and correct your PHI. It is most often discovered when bills arrive for healthcare-related service you didn't receive. Getting your medical records purged and corrected can be a nightmare. According to a 2010 Ponemon Institute Survey, the average cost a consumer faces in attempting to resolve a medical identity theft incident is more than $20,000, and 48% of the consumers surveyed actually lost their health insurance coverage. Therefore, it's important for you to know you have the right to review your medical records for accuracy and request an amendment of your PHI.

New laws and regulations are changing the way healthcare providers keep records, including providing monetary incentives to electronify data (HITECH Act) and protect that data or risk fines and penalties (HIPAA Security Rule). However, electronifying PHI data will still present an increased risk of exposure by data breach, and could make it easier for rogue employees working for organized crime rings to steal your information to sell on the black market, or use your name and insurance information to make fraudulent insurance claims. It is also too soon to know whether electronification of your PHI will make identifying errors easier, or whether it will add to the complexity and difficulty of correcting your information should medical identity theft occur.

There are steps you can take to lessen your exposure to medical identity theft. As always, the first line of defense starts with you...

  • Leave your insurance card in a safe (and preferably locked) place, and don't carry it with you unless you need it.
  • Monitor any explanation of benefits received from your insurance company, or ask for an annual list of payments made on your behalf for medical care. If you find an incorrect item, even if no money is owed, contact your insurance company immediately.
  • Safeguard any insurance-related paperwork, much like you would your credit card statements. 
  • Review your credit reports annually.  You have a right to an annual free credit report from each of the credit bureaus. Be sure your reports are free of any medical liens.
  • Be cautious providing your personal and insurance information when offered "free" medical services. Often fraudsters use this as a way to obtain your PHI.
As part of our ongoing support for America's Fraud Fighting Community today's post is written by fellow anti-fraud fighter: Robin Slade, President & CEO of The Foundation for Payments Fraud Abatement & Activism (FPF2A) a non-profit corporation founded in 2010 by financial fraud prevention professionals who share a desire to make a positive contribution to the public good and founded 
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1 Comment

It has always been my fear that someone would steal my identity. What more if someone would tamper my medical records. That would definitely be a nightmare for anyone. Highly skilled hackers would be able to get into anything they want to so I am afraid that no matter how much security you have, there will always be a risk.

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