05 December 2012
Medical Identity Fraud: It’s Enough to Make You Sick

The medical service providers you use accumulate a lot of information about you, including your Social Security number, name, address, insurer, health coverage identifiers and other information that can be used by identity thieves to obtain medical services in your name.

This can create serious problems. You may be billed for co-pays for services you never received. You may be billed for expensive prescriptions you never received. And, your medical record may contain information that isn’t accurate because it’s not actually about you.

Most medical practitioners take steps to protect sensitive identification information, but when you walk into your doctor’s office you may see files on top of desks, rows of storage racks crammed with medical records and other information out in the open. A busy medical or dental practice probably focuses its attention on delivery of medical services, not on information security. Medical identity fraud may not be a top priority – even with the most careful providers of medical services.

That means you have to watch out for yourself – to protect yourself from medical identity theft and the impact it can have on the services you receive and the payments you make.

So what can you do to protect your medical identity? Take a pro-active stance.  Any discrepancies between your records and the records in the practitioner’s office should be addressed immediately.

1. Track your credit reports. If your medical information has been compromised, you may not discover the problem until the damage has been done.  Track your credit reports from the three main reporting agencies: Equifax, TransUnion and Experian. Read your reports carefully for indications that your medical identity has been compromised, and notify the practitioner of the problem as soon as it’s identified.

2. Protect your health insurance information. Maintain a file of all medical records and activity and keep this information in a secure location. Protect your health insurance card just as you protect your credit cards. Keep all correspondence from health insurance companies, and if you have questions about a billing, pick up the phone and get the matter straightened out quickly.

3. Avoid providing personal information that isn’t essential. All medical service providers use intake forms to create a profile of you, the patient. However, simply because there’s a space for your Social Security number on an intake form doesn’t mean you have to provide that information.  Provide information required by the practitioner, but ask if you can leave certain boxes empty for the protection of your information.

4. Be cautious of “free” medical care.  Know who is sponsoring the free health fair. You will probably be required to complete a form to receive a free flu shot or other medical services, but don’t provide critical information like a Social Security number in exchange for a free vaccination.  These free services are sometimes used to lure patients into providing sensitive information for illegal use.

5. Call your health insurance company even if you don’t owe any money. If you receive a statement from your insurer describing services you didn’t receive, call the insurance company as soon as possible – even if no money is owed. If you didn’t receive the treatment, who did? You may be the victim of medical identity fraud.

6. Ask medical providers how your information is protected. There are electronic records and hard copy records. How is this information protected? Does the practice conduct background checks on employees of the practice? Are electronic records protected by redundant layers of security?  Let your physician know that you want as much protection as you can get. If enough patients bring up the need for security, the practice may beef up its records-keeping procedures even more.

7. Shred medical documents. Your trash can be a treasure trove. Identity thieves often go through trash to find copies of medical bills, insurance statements or other information that can be used to commit medical fraud.  Shred your medical statements after they’ve been recorded. Same with insurance statements that include your account number, name, address and other information an identity thief can use to duplicate your identity. Treat medical documents as carefully as you do bank statements and credit card statements. The information these medical documents contain can be used against you.

8. Ask your medical provider for a copy of your medical records. Review them carefully to determine if treatments and conditions you don’t have are listed. This is a clear indication that you’ve been the victim of medical identity theft.

9. If you are the victim of medical identity fraud, notify everyone. File a complaint with the Federal Trade Commission (FTC) at www.ftccomplaintassistant.gov describing how you’ve been victimized. File a police report with the local police department and with the police department in the city where the practitioner maintains offices.  And, of course, notify the practitioner and your health coverage provider.

10. When victimized, ask credit reporting agencies to place a credit freeze on your account. Sometimes called a security freeze, the three main credit reporting agencies are now on alert for suspect activity associated with your account. In effect, a credit freeze locks down all of your accounts because medical identification fraud can also lead to other types of identity fraud – like retail fraud.

Doctors, dentists, physical therapists and other medical practitioners do require personal information to secure payments from you and your health care provider, but the best protection you have against medical identity fraud is a vigilant, pro-active approach to protecting medical information.  A heightened awareness of the problem on your part is the best cure.


The information provided is presented for general informational purposes only and does not constitute tax, legal or business advice.


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