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The Ill Effects of Medical ID Theft
Could identity thieves be using your personal and health insurance information to get medical treatment, prescription drugs or have surgery? Could dishonest people working in a medical setting be using your information to submit false bills to insurance companies? Medical ID theft is a twist on traditional identity theft, which happens when someone steals your personal information. Like traditional identity theft, medical ID theft can affect your finances; but it also can take a toll on your health.

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Family Practice Center

Administrative Office
3040 N. Susquehanna Trail
P.O. Box 129
Shamokin Dam, PA 17876
Phone: 570-743-1703

Billing Questions:
P: 570-837-2123

Detecting Medical Identity Theft
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
  • you're denied insurance because your medical records show a condition you don’t have

Medical ID theft may change your medical and health insurance records. Every time a thief uses your identity to get care, a record is created with the imposters medical information that could be mistaken for your medical information.For example, 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.

Pay Attention To Your Medical Bills
Paying close attention to your medical, insurance & financial records can help you spot discrepancies and possible fraud.

Read the Explanation of Benefits (EOB) statement that your health plan sends you after treatment. If you are a Medicare beneficiary, read the Medicare Summary Notice. Make sure the claims paid match the care you received. Look for the name of the provider, the date of service, and the service provided. If there’s a discrepancy, contact your health plan to report the problem.

Order a copy of your credit reports, and review them carefully. Credit reports are full of information about you, including what accounts you have and whether you pay your bills in a timely way. The law requires each of three major nationwide credit reporting companies – Equifax, Experian and TransUnion – to give you a free copy of your credit report each year if you ask for it. Visit www.AnnualCreditReport.com or call 1-877-322-8228 to order your free credit reports each year, or complete the Annual Credit Report Request Form and mail it to: Annual Credit Report Request Service, P.O. Box 105281, Atlanta, GA 30348-5281. You can download the form at www.ftc.gov/freereports.

Once you have your reports, look for inquiries from companies you didn’t contact, accounts you didn’t open, and debts on your accounts that you can’t explain. Check that your Social Security number, your address(es), name or initials, and your employers are listed correctly. If you find inaccurate or fraudulent information, get it fixed or removed. Visit www.ftc.gov/idtheft to learn how.

Ask for a copy of your medical records. If you believe you’ve already been a victim of medical identity theft, review your medical and health insurance records regularly. The thief may have used your name to see a doctor, get prescription drugs with your health ID number, file claims with your insurance provider, or done other things that leave a trail in your medical records. Try to review your health records for inaccuracies before you seek additional medical care. The Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule gives you the right to copies of your records that are maintained by health plans and medical providers covered by that law. Health care providers and health plans generally are required to give you your files within 30 days after you ask for them. Unlike credit reports, there is no central source for your medical records. You need to contact each provider you do business with – including doctors, clinics, hospitals, pharmacies, laboratories and health plans – that is relevant to your experience. For example, if a thief got a prescription in your name, you may want the record from the pharmacy that filled the prescription and the health care provider who wrote the prescription. Or if you’ve been using the same hospital for 20 years and you think that the identity theft is recent, you may want to limit your request to records of the last few years or months.

An ounce of prevention...

While there’s no fool-proof way to avoid medical identity theft, you can take a few steps to minimize your risk.

Verify a source before sharing information.
Don’t give out personal or medical information on the phone or through the mail unless you’ve initiated the contact and you’re sure you know who you’re dealing with. Be wary of offers of “free” health services or products from providers who require you to give them your health plan ID number. Medical identity thieves may pose as employees of insurance companies, doctors’ offices, clinics, pharmacies & even government agencies to get people to reveal their personal information. Then they use it to commit fraud, like submitting false claims for Medicare reimbursement.

Safeguard your medical and health insurance information.
If you keep copies of your medical or health insurance records, make sure they’re secure, whether on paper in a desk drawer or in a file online. Be on guard when you use the internet, especially to access accounts or records related to your medical care or insurance. If you are asked to share sensitive personal information like your social security number, insurance account information or any details of your health or medical conditions on the internet, ask why it’s needed, how it will be kept safe, and whether it will be shared. Look for website privacy policies and read them: They should specify how site operators maintain the accuracy of the personal information they collect, as well as how they secure it, who has access to it, how they will use the information you provide, and whether they will share it with third parties. If you decide to share your information online, look for indicators that the site is secure, like a lock icon on the browser’s status bar or a URL that begins “https:” (the “s” is for secure). Remember that email is not secure.

Treat your trash carefully.
To thwart a medical identity thief who may pick through your trash or recycling bins to capture your personal and medical information, shred your health insurance forms and prescription and physician statements. It’s also a good idea to destroy the labels on your prescription bottles and packages before you throw them out.

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