How to Detect Medical Identity Theft

Posted on behalf of Rizk Law on Aug 15, 2013 in Consumer Alerts

A thief may use your name or health insurance numbers to see a doctor or get prescription drugs or other health care. If the thief’s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be effected.

Read your medical statements, health insurance Explanation of Benefits (EOB) statements, and/or Medicare Summary Notices regularly and completely. Check the name of the provider, the date of service and the service provided. Does it match the care that you received? If you see a mistake, contact your health plan and report the problem.

Other signs of medical theft include:

  • A bill for medical services you didn’t receive
  • A call from a debt collector about a medical debt you don’t owe
  • Medical collection notices on your credit report you don’t recognize
  • A notice from your health plan saying you have reached your benefit limit
  • A denial of insurance because your medical records show a condition you don’t have

Correcting Errors in Your Medical Records

If you know a thief used your medical information, you need to do the following:

  • Get copies of your records.
  • Contact each doctor, clinic, hospital, pharmacy, laboratory, health plan, and location where a thief may have used your information, and ask for the records the provider must provide your records within 30 days of your written request).
  • Keep copies of your postal and email correspondence and a record of your phone calls, conversations and activities with health plan and medical providers.
  • Ask each of your health plans and medical providers for a copy of the Accounting of Disclosures for your medical records (the record of who got copies of your records from the provider).
  • Write to your health plan and medical providers and explain which information is not accurate, sending copies of the documents that support your position, asking the provider to correct or delete each error, and keeping the original documents.
  • Send all correspondence by certified mail and ask for a “return receipt,” which gives you a record of what the plan or provider received, and keep copies of the letters and documents you sent.

A health plan or medical provider that has made mistakes in your files must change the information. It should also inform labs, other health care providers and anyone else that might have gotten wrong information. If a health plan or medical provider won’t make the changes you request, ask it to include a statement of your dispute in your record.