Common Types of Medical Identity Theft

Identity theft prevention tips.
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You may know to be on the lookout for identity theft as you use your credit card. However, you might not realize that there’s a new fraud game in town known as medical identity theft. Essentially, this means that thieves are stealing people’s personal information to make claims against their health policies. Then after filing fraudulent claims, they pocket the cash and, in some cases, may even be getting medical services.

All the bad guys have to do is get access to some of your personal information, such as your Social Security number, and the rest is easy. What’s even more frightening is that they can get this information on the black market from the same employees that work at medical facilities (that’s called insider fraud). Some of them also hack into medical databases.

Scams to Watch out For

There are a couple of scams these thieves like to pull:

Invoicing for fraudulent treatment: Once the thieves have your information, they bill your health plan for fake treatment. The very people who you are relying on to help you, like doctors, might even be in on the action.

Buying up drugs: Medical identity thieves might also be using your information to buy up illegal drugs. They then sell these drugs or use them to feed their own addictions. 

Get free treatment: Another scam is that medical ID thieves might use your information to get free treatment because they don’t have their own policies.

Cost of Medical ID Theft

These scams can literally cost you thousands of dollars, but there is much more to it than that:

Loss of health coverage: You could lose your health coverage because of these scams. These thieves can max out your limits and then you could be in big trouble if you actually have a medical emergency.

Ruin credit history: These thieves often build up large bills at hospitals in your name and then disappear without a trace. This, of course, eventually goes to collections and you might not even realize it until creditors start contacting you.

False records: These treatments can also appear in your medical records and this could be extremely dangerous or even deadly, as medical personnel rely on this information to prescribe medicine and to give treatments.

High premiums: It’s also possible that your premiums could rise because of these scams.

How to Fight Back

There are some things you can do to fight against these scams:

Look closely at EOBs: Always take a good, hard look at your Explanation of Benefits (EOB) that you get from your health insurance company. If you see treatments on them that you didn’t get, immediately notify your insurer.

Get a list of benefits: Each year, ask your insurer for a list of all benefits paid out through your policy.

Check medical records: If you think you might be a victim of medical identity theft, check your medical records for anything suspicious.

Protect your credit: You should review your credit history with the three major credit monitoring agencies: Experian, Equifax, and TransUnion. An identity theft protection service can help you spot unexpected activity. If you see anything strange, immediately ask for a fraud alert and a credit freeze on your credit report. With a fraud alert, creditors may contact you to confirm your identity anytime they get a request for a new line of credit. If you put on a credit freeze, it means that only you, with your personal identification number, can access your credit and temporarily unfreeze to allow for credit checks.​

Correct any inaccuracies: If there are errors on your medical records, immediately get them corrected. Also, remember that any medical provider might have the same information, so contact every hospital, doctor, lab, and the insurance company you use to make sure their information is correct, too. Keep in mind that correcting this information might be difficult. Though it is a law that a patient is allowed to correct medical records, that only applies if the record was created by a medical provider, like your doctor. If those records are then sent to a hospital, the hospital is under no obligation to change them. However, you can add a note to your record that you disagree with the information there.

File a report with the police: You should notify the police if you feel that you are a victim of medical identity theft.

File a report with the government: You should also file a complaint about the incident with the Federal Trade Commission. You can do this on the FTC website or by calling 1-877-438-4338.