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Medical Identity Theft

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The risks of identity theft are high and getting even higher. Now these risks have invaded our health insurance and medical care systems. On September 25, 2006, the Los Angeles Times reported on problems associated with medical identity fraud. According to the LA Times,

Although the most typical of the millions of identity theft cases in the U.S. each year involve credit cards, a 2003 federal report estimated that at least 200,000 instances involved medical identity fraud. Experts believe that the rising cost of healthcare is driving more identity theft, and that many people are unaware they have become victims unless they receive a hospital bill or query from their insurer.

Apparently we will continue to see an increase in the number of victims of health insurance fraud as a forseeable consequence of increasing health care costs and rising insurance premiums. So next time you receive medical care, your health insurance company should send to you a document known as an explanation of benefits. Review it thoroughly for accuracy and do not be afraid to dispute or request information about unknown charges.

As the LA Times article described, privacy problems arise if you suspect that somebody else used your identity to fraudulently obtain medical care:

The bitter twist on medical identity theft is that once a person tells a keeper of records that someone else’s data might be intermingled, the file becomes even harder to obtain. Why? Because it includes another person’s medical history, which many hospitals argue can’t be turned over without consent.

Even when patients do see their records, they have no automatic right to fix errors they find.

The LA Times advises patients as follows:

To guard against identity theft, patients should:

• Ask to see their medical files from each provider on a regular basis;

• Scan medical and insurance bills for services, medicine and equipment they didn’t receive;

• Demand an annual list from their health insurance company of benefits that have been provided.

If medical records have been compromised:

• Ask the healthcare providers to delete the incorrect information and contact everyone they have shared that information with, as required by the health insurance act;

• Ask the providers for a list of those recipients, and follow up with them;

• Clean up records with the health insurer and make sure the provider has not passed along improper benefit reports to insurance databases;

• Scrutinize credit reports for unpaid medical bills;

• File a police report;

• Contact the Federal Trade Commission and state health and insurance departments.

So now we must guard against identity theft in every day business transactions, when we use our computers, when we use our credit cards, and even when we go to the doctor.