On Power Your Practice, we spend so much time discussing what doctors can do to prevent medical fraud that we never really focus on what your patients should be doing to protect their health information.
Today, we rectify this with a tutorial you can give patients so they can better protect their private medical information.
What is Medical Identity Theft?
Medical identity theft usually occurs in one of two ways. The first type involves ill-intentioned or phony providers using patient information to bill a third-party payer for treatment the patient doesn’t need.
The second type entails thieves using another person’s medical information to obtain medical service and medications. Thieves may steal a social security number, health system ID, driver’s license, or health insurance policy number as well as other personal information in order to pose as someone else.
Consequences of Medical Identity Theft
There are two harmful consequences posed by medical identity theft. For one, if a patient’s medical record is corrupted by a shady provider it could lead to mistreatment, misdiagnosis, a delay in care, or even being prescribed the wrong medication from honest physicians — an error with potentially fatal consequences.
“It’s an insidious crime and the consequences can be deadly,” said Robin Slade with the Medical Identity Fraud Alliance (MIFA). “This fraud causes your medical records to get contaminated by the perpetrator’s medical information, so it could literally kill you.”
Second are the financial effects. Unlike credit cards and banks that usually reimburse victims for the money lost due to theft, medical identify theft usually ends up costing the victim a significant amount of money.
According to a recent Ponemon Institute survey on patient privacy issues, 36% of identity theft victims are forced to pay money out of pocket to resolve the crime. Actually, victims spent more than $12 billion last year dealing with the effects of their compromised medical or insurance records.
Even more alarming, medical identity theft rose almost 20% in the last year according to the Ponemon survey.
Thankfully, patients aren’t powerless in the struggle to combat medical identity theft. There are many approaches they can take to prevent falling victim to this possibly fatal crime.
So What Can Patients Do?
The first thing patients need to do is ask for a copy of their medical records right away. That way, if something is changed later without their consent, the patient can prove their identity and medical history. We recommend doing this at least once a year.
They should also treat insurance identity information as if it were a credit card number. Be cautious when providing personal or insurance information, dealing with a new healthcare providers and when being offered free medical services. Fraudsters often use this as a way to obtain patient health information.
Advise patients not to let insurance explanation-of-benefit statements sit in a pile of unopened mail. Review them thoroughly for any unfamiliar procedures, doctor names, or service dates. If anything looks suspicious, call the insurance provider.
Always report lost or stolen health insurance identification cards. Insurance carriers should always be notified of misplaced, lost, or stolen cards to prevent unauthorized use.
Finally, never sign a blank insurance form from an unknown medical provider. Many fraudulent providers will use this form later to falsely bill insurance or Medicare.
Keep in mind medical identity theft can happen to anyone. Always be observant of how other providers handle patient medical information. If patients remain proactive rather than reactive in the fight to battle medical identity theft, they should be better prepared to prevent an incident from occurring.
