What is Medical Identity Theft and How Does it Happen?

If it were bad enough that criminals were out to steal your identity for financial reasons, there’s another kind of identity theft that is undercover sweeping the nation: medical identity theft. This is where criminals steal healthcare-related information and documentation and largely use it to obtain healthcare services. The result is that those who fall victim to medical identity theft may get slapped with medical bills that aren’t theirs and even misdiagnosis, improper treatments and even the denial of healthcare services that you would otherwise be eligible for. 

Definition of Medical Identity Theft  

Medical identity theft involves the misuse of insurance coverage information, where one individual’s data is used to obtain or pay for healthcare services for another individual. This form of identity theft is not limited to hackers using social engineering tactics to acquire personal information from medical providers and patients. 

Healthcare organizations can also be vulnerable to data breaches, whether through the theft of physical devices like laptops and flash drives or employees’ unauthorized access and leaking of private data. These incidents highlight the need for robust security measures in the healthcare sector to prevent medical identity theft, as motivations for such crimes can range from financial gain to personal agendas.

How Medical Identity Theft Works 

Medical identity theft is a sophisticated crime that operates in various ways to exploit individuals’ healthcare information and insurance coverage. It can involve the physical theft of healthcare documents, social engineering tactics that involve deceiving individuals into disclosing personal information willingly (phishing) or even healthcare professionals misusing patient info. But it most commonly occurs when hackers target healthcare providers or insurance firms to gain unauthorized access to databases containing sensitive patient information. 

With this info, a hacker can get access to social security numbers, health insurance details, and other personal data. In return, victims may face unexpected medical bills for services they never received, discover false information in their medical records, or experience denied insurance claims due to suspicious activities associated with their identities. It can also lead to misdiagnosis, incorrect treatments, or dangerous drug interactions, posing serious risks to the victims’ health and well-being.

How to Identify Medical Identity Theft 

Identifying medical identity theft can be challenging since it often goes unnoticed until the victim experiences financial or medical consequences. To help detect and identify potential medical identity theft cases, people can watch for a few cautionary indicators and warning signs.

• Review Explanation of Benefits (EOB) Statements
• Monitor Medical Bills and Statements
• Request and Review Medical Records
• Check Your Credit Reports
• Pay Attention to Collection Notices or Calls
• Stay Alert for Data Breaches
• Monitor Your Health Insurance Statements
• Be Wary of Unsolicited Medical Offers

You must act immediately if you discover or suspect possible medical identity theft. Contact your healthcare providers, insurance companies, and law enforcement authorities to report the fraud and seek guidance on resolving the situation. They can assist in launching investigations, correcting medical records, disputing fraudulent charges, and implementing additional security measures to protect your identity moving forward.

How to Safeguard Your Identity From Criminals  

Protecting against medical identity theft is essential to safeguard your health information and prevent potential financial and health-related consequences. You can take the following preventative steps to lessen your chance of falling victim to medical identity theft:

1. Safeguard Personal Information
2. Be Cautious Online
3. Protect Physical Documents
4. Use Strong and Unique Passwords
5. Be Wary of Suspicious Communications
6. Monitor Your Accounts Regularly
7. Educate Yourself and Stay Informed
8. Use Secure Wi-Fi Networks
9. Enable Two-Factor Authentication
10. Regularly Update Software and Security Measures

You may dramatically lower your risk of becoming a victim of medical identity theft by putting these safety measures into place and being watchful. Regular monitoring, strong security practices, and timely reporting of suspicious activity are key to protecting your health information and maintaining control over your medical identity.

What to Do If Your Identity Has Been Compromised

Discovering that you are a victim of medical identity theft can be distressing. But taking immediate action is important to mitigate the potential harm and restore your identity. Here’s what do do if you find yourself faced with medical identity theft:

• Contact Your Healthcare Provider: Contact your healthcare provider immediately about medical identity theft. Please provide them with details and evidence, and request the removal or correction of any fraudulent information in your medical records.
• Report to Your Health Insurance Company: Inform your health insurance company about the identity theft. Provide a detailed explanation of the fraudulent activities, including incorrect charges or services. They will investigate, resolve the issue, and prevent future unauthorized claims.
• File a Police Report: A police report with all relevant information and evidence about medical identity theft. It helps establish a paper trail and is crucial for disputing fraudulent charges and protecting your rights.
• Freeze or Monitor Your Credit Reports: Freeze or monitor your credit reports with major credit reporting bureaus (Experian, Equifax, TransUnion) to stop fraudulent accounts, request a fraud alert or credit freeze. Keep an eye out for unusual activities, and report any bogus accounts. Learn more about how to freeze your credit. 
• Review and Correct Your Medical Records: Review your medical records for inaccuracies caused by identity theft. Contact each healthcare provider involved to correct or remove fraudulent information. Provide supporting documents like the police report or insurance statement if necessary.
• Maintain Detailed Records: Detailed records of all communication regarding the medical identity theft incident, including dates, times, and people involved. This documentation will be valuable when disputing charges, resolving insurance matters, and collaborating with law enforcement.
• Dispute Unauthorized Charges: Fraudulent Dispute charges on medical bills or insurance statements with the billing department or insurance company. Provide supporting documents and follow up until resolved.
• Consider Identity Theft Protection Services: Consider identity theft protection services for assistance with medical identity theft. These services offer ongoing personal information monitoring, help resolve identity theft issues, and provide support during recovery.
• Stay Vigilant and Monitor: Stay vigilant and monitor your medical bills, insurance statements, credit reports, and accounts for recurring fraud. Report suspicious incidents promptly for ongoing protection against medical identity theft.
• Seek Legal Assistance if Necessary: Seek legal assistance if you encounter challenges or difficulties in resolving medical identity theft. Consult an attorney specializing in identity theft or consumer protection for tailored guidance and legal advice.

Learn more about how to report medical identity theft and the next steps you should take to recover your identity.

Bottom Line 

Medical identity theft is a serious concern in the digital age, with hackers and insiders threatening the security of our health information. However, staying informed, safeguarding personal information, and being vigilant can reduce the risk of becoming a victim. It’s important to periodically verify your medical records, monitor your credit reports, and report any unusual activity immediately. 

Healthcare organizations also play a crucial role in implementing strong cybersecurity measures and prioritizing protecting patient data. Together, through awareness and proactive measures, we can combat medical identity theft and ensure the privacy and security of our health data and financial well-being.

Frequently Asked Questions (FAQs)