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How To Defend Yourself From Medical Identity Theft

As detailed in Medical Identity Theft Overview, there are a myriad of ways criminals can invade your medical records. Before going through means of defending yourself, we will mention some additional ways of being victimized:

• While most of us are familiar with identity theft for financial robbery, another frequent problem involves illegal immigrants gaining fraudulent Social Security numbers and other identity (ID) information to obtain medical services. As reported in How Identity Thieves Steal Your Money, the Pew Hispanic Center estimates that illegal immigrants comprise one in every 20 workers with fraudulent Social Security numbers and other ID documents.

• In an example case of this problem, an information technology professional in California had to endure nearly 10 years of being harassed by collection agencies for thousands of dollars in medical bills from a hospital her had never visited. This case underscores another reason why Americans need to be vigilant of their private information.

• In October 2006, the Government Accountability Office issued a warning reporting they had discovered a potentially disastrous security problem concerning medical information of Americans registered in Medicare and Medicaid. Describing the problem as ‘security controls over key information that are missing,’ they warned that personal data might be “modified, disclosed or deleted” to impact millions of Americans.

How to Defend Yourself

This information can be found in detail on worldprivacyforum.org/medicalidentitytheft.html
(a non-profit organization):

• Always review statements sent by health insurers entitled Explanation of Benefits. Look for charges for medical services, office visits or medical equipment you did not receive.

• Request an annual statement of benefits without waiting for insurance company to do so.

• To protect against criminals who use phony mailing addresses and phone numbers, check with your insurance company to verify your information periodically.

• By the authority of the Health Insurance Portability and Accountability Act (HIPAA), you are entitled to receive a copy of your medical records by each health insurance company you use. Also ask for a listing of privacy practices that will explain all procedures and fees necessary for acquiring data.

• Also by the authority of the Health Insurance Portability and Accountability Act (HIPAA), you are entitled to an accounting of disclosures that is another method of protection. This record details any information disclosed, when and why it was given and the recipient. If incorrect information created and distributed to others, this will help you track down the parties. (The federal rule does not require information on when records are revealed for treatment, payment, or many other purposes.)

• Ask about costs for copies of medical records before you order them – x-rays can be costly.

• If your appeal for records is not met, the institution’s "notice of privacy practices" will spell out the appeal procedure you need to follow.

• If you still are turned away or are dissatisfied in obtaining your records, you may file a complaint with the Office of Civil Rights at the federal Department of Health and Human Services http://www.hhs.gov/ocr/ or 1-800-368-1019.

• Correcting health records can be complicated. Errors in a doctor’s file, or laboratory results may have been transferred to an insurance company. You’ll probably need to make separate submissions at each data source. Also inquire with each record keeper if corrections were made in your records properly – don’t rely on others!

• If you were a victim of medical ID theft, it’s a good idea to file a police report. The addition of police reports may assist your information requests.

• Do not tolerate a medical data source allowing incorrect information to remain in your file with only an attachment as to why the information is incorrect. That wrong diagnosis, blood type, etc. could come back to haunt you later on. A lawyer may facilitate the process of gathering and correcting information from medical institutions. Threat of legal action works wonders.

• Monitor your credit report to spot for collection notices from medical entities.

• Any fraudulent debt incurred might be tough to prove as such if the criminal used your Social Security Number and insurance information. If you have correct medical files on hand, it will lend great credibility to your claim to compare with the phony charges. A copy of your medical records will be quite valuable, if they are ever tampered with in the future.

Resources

• To keep copies of many health records in one place, go to the American Health Information Management Association at http://www.myphr.com/

• Additional information on your rights covered by the Fair Credit Billing Act can be found at the Federal Trade Commission (FTC) website at: http://www.ftc.gov/bcp/conline/pubs/credit/fcb.htm.

• If you have been a victim of Medicare/Medicaid fraud, call 1-800-HHS-TIPS (1-800-447-8477).

• File a medical ID theft complaint with the FTC at:  <http://www.consumer.gov/idtheft/>. Or by phone at FTC Identity Theft Toll-Free Hotline at 1-877-IDTHEFT (438-4338).

• If you are experiencing a health care record keeper refusing to let you obtain your medical records, you may file a complaint with the Office of Civil Rights at Health and Human Services at <http://www.hhs.gov/ocr/privacyhowtofile.htm> or 1-800-368-1019.

• Visit the Blue Cross/Blue Shield page of superb tips for preventing fraud problems at: http://www.bcbs.com/antifraud/

• Find additional information about your health privacy rights at the Health Privacy Project: http://www.healthprivacy.org/.

• Georgetown University Center’s website on state laws concerning acquiring and correcting medical information is at: http://hpi.georgetown.edu/privacy/records.html

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Source: Consumer Info & Action National Health Care Anti-Fraud Association (www.nhcaa.org)

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