Medical Identity Theft

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When you head to the doctor for your annual checkup, it's not just your medical history you should be concerned about. You also want to ensure that your records are up to date regarding your health insurance and billing details.

Unfortunately, the large amounts of personal information contained in your medical records can leave you vulnerable to identity theft and in need of identity protection.

If an identity thief uses your name or health insurance number in order to receive medical care, the thief's health history will get confused with yours. This can cause problems with your medical treatment, health insurance, payment records, and even your credit report. Plus, an identity thief with access to your medical records can gain access to a whole host of personal information, and the identity theft might spread to other aspects of your financial life.

It is crucial that you keep track of your health records for identity theft protection. It's just as important for identity theft recovery to act fast if you've learned that someone has used your information to see a doctor, obtain prescription drugs, or file an insurance claim.

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What is medical identity theft?

If someone uses your personal information to seek medical services, medical identity theft has been committed. 

Unlike other types of identity theft, the offender does not necessarily need your Social Security number—access to your name, date of birth, and address could be enough to commit the crime. 
 
Because a hospital has to treat emergency patients quickly, inaccurate medical and insurance information can make its way to the billing department before identity theft is detected.
 
If your medical identity is stolen, you may be in danger when you seek your own medical treatment. Your medical records may have been changed to reflect a thief's health conditions and history. 
 
 

How do you know if your medical identity has been stolen?

The first sign of medical identity theft may come in a bill for medical services you did not receive or in a phone call or letter from a debt collector inquiring about a medical debt that's not yours. 
 
Other signs include an unfamiliar medical collection notice on your credit report or mistakes in your medical record. If you are told that you have reached your benefit limit on your health insurance plan or you are denied health insurance because of a condition you don't have, you could also be a victim. 
 

What should you do if you are a victim of medical identity theft?

Medical privacy standards like the Health Insurance Portability and Accountability Act (HIPAA) might initially prevent you from accessing medical records if the providers are trying to protect the rights of the identity thief. You have a right to access your records, though, and you can appeal if they are not provided. You will probably need to provide proof of your identity and documentation of identity theft. 

  • Obtain copies of your medical records and search for any mistakes. Contact every health care provider where your personal information was used—doctor's offices, hospitals, pharmacies, and so on.
  • Determine which information the thief used to access medical treatment, such as your Social Security or health insurance numbers.
  • Send all information documenting the identity theft to the medical billing departments and collection agencies involved.
  • Request a copy of the "accounting of disclosures" from your health plan and medical providers. This will show where copies of your medical records have been sent. Contact the parties that have received your erroneous records.
  • Send a request, in writing, to your medical and insurance providers to correct your medical record. You will need to prove that your medical record contains invalid items.
  • Report your case to the Federal Trade Commission, which manages all types of identity theft.
  • File a police report with the department that has jurisdiction in your case.
  • Think about applying a fraud alert or credit freeze to your credit files with the three credit reporting agencies.
  • Record all communication you have during the troubleshooting process, and file copies of all letters received and sent.
  • Send all documents by certified mail with a return receipt.

 

How can you avoid becoming a victim of medical identity theft?

  • Regularly ask your health insurance provider for a record of the benefits that have been paid in your name.
  • Only disclose your personal information to legitimate sources. Be aware that identity thieves can impersonate medical personnel, including doctors, pharmacists, and insurance professionals.
  • Request your medical and insurance providers assign you a unique personal identification number, and do not use your Social Security number on your records.
  • Don't reveal medical or insurance information by phone or email unless you made the first contact.
  • File paper and electronic copies of your records in a secure location, and shred any outdated medical documents, including old prescription labels.
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