Updated: 9/29/2010 9:00 AM ET|
Thieves are stealing health care
Medical identity theft is a growing problem, and recovering from the theft can be difficult. Here's what to watch for and how to protect yourself.
I've written about how annoying it is to get asked for identification when using a credit card.
But that's nothing compared with what can happen when you try to get health care in some areas.
At a recent mammogram appointment in Los Angeles, I was asked for my driver's license when I checked in at the front desk and again when I met with the intake clerk who took my health insurance information. The woman who guided me back to the exam room didn't demand my driver's license, but she did ask me to rattle off my date of birth.
The reason they were so interested in making sure I was who I said I was? Health care identity theft, which is on the rise.
Sierra Morgan of Modesto, Calif., certainly wishes someone had asked for ID when a thief pretending to be her charged a $12,000 liposuction procedure to the health care credit account Morgan had opened to pay for braces for her teeth.
Morgan didn't learn about the crime until she logged in to the account to pay the bill and saw the charge.
"I was like, 'What do I do?'" recounted Morgan, 31. "I was freaking out."
Morgan did have the satisfaction of seeing her doppelgänger arrested. Morgan worked with the clinic manager, who set up another appointment for the thief to get additional services. When the thief showed up, the clinic called the police, and she was hauled off to jail.
Other victims have been dunned for medical procedures, including childbirths, dental work, methadone treatments and even breast implants they hadn't received, said Linda Foley, the director of the Identity Theft Resource Center in San Diego.
The crime can take many forms, including:
- Large-scale theft of identities by computer hackers or others who might, for example, sell the information or use it to bill insurers for treatments at phony clinics.
- Crimes of opportunity, such as when a thief gets your wallet and uses or sells your health insurance information.
- Crimes by friends, family or others you know who have access to your information.
One woman discovered she had become a victim when she went to a new dentist and was asked to pay an overdue bill, Foley said. After some questioning, the woman realized her mother had stolen her dental coverage to get treatment.
Recovering from health care identity theft can be tough. The bills, collection calls and damaged credit are all hassle enough, but an even bigger concern is that the thief's medical records could get commingled with your own, causing future problems.
"That can cause a misdiagnosis or delay a diagnosis," Foley said. "What if it's something that prevents you from getting life insurance?"
Health care fraud cases were just a fraction of identity theft reported in 2009, with 275,000 cases reported, compared with 11 million total victims of all identity theft, according to Javelin Strategy & Research, which tracks these crimes.
But the number of cases doubled from the previous year. Identity theft experts expect the problem will continue to get worse.
Some medical providers are already responding, as mine did, by checking identities and even taking pictures of those who seek treatment, so they can be compared in case health care fraud allegations are made. Some providers insist all patients be checked, even if they're well-known to the staff.
"My pharmacist says: 'Hi, Linda. How are you? May I see your ID?'" Foley said, laughing. It's absurd, she acknowledges, but she believes it's also necessary to curb the problem. "People are getting hurt."
Recovering from medical identity theft can be particularly tricky because federal privacy laws restrict health care providers from sharing records with "unauthorized" parties. If it's determined the person getting treatment in your records really isn't you, health care providers may balk at providing you with those records.
"It's a crazy, mixed-up world," Foley said. "The thief has privacy rights, too."
The move toward electronic medical records could lead to more identity theft by making large-scale thefts of health information easier if providers don't use proper safeguards, some identity theft experts warn.
But it could also make it easier for providers to segregate a thief's information from your own while linking it to your original file, Foley said. That would allow providers to follow federal privacy laws while still maintaining the integrity of your files.
Preventing health care identity theft is all but impossible, because much of your vital information is already in big databases that are outside your control. But you can guard your health insurance card carefully and take steps to contain the damage if you're victimized. The Identity Theft Resource Center and the World Privacy Forum recommend that you:
- Scrutinize every "explanation of benefits" form. Health insurers send these out after every claim. Check all of yours for office visits, services or equipment deliveries you don't recognize.
- Ask your insurer for a complete list of benefits annually. If a thief has changed the billing address on your account, you may never see the individual EOB forms. A complete list of claims submitted and paid each year can help you spot problems.
- Ask for copies of your records from medical providers. The World Privacy Forum recommends making this request after every visit, so you can check for fraud and reconstruct your records afterward if you're ever victimized. The forum has more information here on what to do if your records are withheld.
- If you're victimized, contact the health care provider's billing department first. Explain that you're a victim of identity theft and that the charges aren't yours. If the billing department is reluctant to help, you may need to appeal to the health care provider directly. Try to find out if the thief used your health insurance information and/or Social Security number. If so, contact, your health insurer and consider putting a fraud alert or a freeze on your credit bureau files.
- File a police report. You were the victim of a crime, and filing a police report is often essential in helping you clear your name.
- Disseminate the information. Send copies of the police report, an affidavit of fraud (.pdf file) and any additional supporting documents to your provider's medical billing department, and to collection agencies and your insurer, if they are involved.
- Keep the evidence. Hang on to copies of all your paperwork and ask the provider to provide a "letter of clearance" acknowledging you were the victim of identity theft. This paperwork can help short-circuit problems that could crop up later if, for example, the phony bills arise as collection accounts.
Liz Weston is the Web's most-read personal-finance writer. She is the author of several books, most recently "The 10 Commandments of Money: Survive and Thrive in the New Economy" (find it on Bing). Weston's award-winning columns appear every Monday and Thursday, exclusively on MSN Money. Join the conversation and send in your financial questions on Liz Weston's Facebook fan page.
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