Better Business: How to avoid being a victim of medical identity theft

Better Business: How to avoid being a victim of medical identity theft

A Colorado man was upset when he received a hospital bill for $44,000 for surgery. The problem wasn’t the amount — it was that he’d never had surgery. An investigation determined that an ex-con had checked into the hospital and gotten an operation using the man’s Social Security number. He was a victim of medical identity theft.

The article on that relayed this story says that most cases of medical identity theft involve organized crime rings, often aided by corrupt health care workers and practitioners, who file false claims with insurance companies. It quotes the executive director of the World Privacy Forum as saying that the crooks may even set up fake clinics or buy real ones as a cover.

The World Privacy Forum has an interactive map on its website that shows one year of medical identity cases by locale as reported to the Federal Trade Commission. Florida, California, New York, Arizona, and Texas are the hardest hit states. It shows seven cases in the Memphis area.

One report estimated that 1.5 million people have been the victims of medical identity theft. The FTC says you may be a victim 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; orYou’re denied insurance because your medical records show a condition you don’t have.

Read any Explanation of Benefits (EOB) statement or Medicare Summary Notice you receive to be sure that the claims match care that you received. If there are any discrepancies in the name of the provider, date of service, or any other information, report the problem to your health care provider.

Obtain the free copy of your credit report that you’re entitled to annually to be sure the information is accurate. Look for medical collection items that may not be legitimate.

If you’ve been the victim of medical identity theft, ask for copies of your medical or insurance records from any health care provider or health plan that may be involved. The Health Insurance Portability and Accountability Act (HIPPA) governs your rights to this information and the provider’s obligations to respond to a request for it. You may have to complete a form and pay a fee. You can visit the website of the U.S. Department of Health and Human Services, Office for Civil Rights at to get more information about your rights under HIPPA.

The hassle of having to get your medical records straightened out is bad enough, but becoming the victim of medical identity theft can have even more serious consequences. If a thief uses your identity to get care, a record is created that could contain incorrect information about your blood type, inaccurate information about drug or alcohol abuse, or a diagnosis of an illness that you don’t have.

The FTC and Better Business Bureau recommend that you verify who you’re dealing with before sharing any information. Safeguard your medical and insurance records and shred them when you don’t need them anymore. Destroy the labels on prescription bottles and packages before throwing them out.

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