From Sheriff David A. Mahoney                           

            Phone - 884-3168

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Medical Identity Theft

We continue our discussion about Identity Theft this week by examining Medical Identity Theft.  The definition of medical identity theft is the fraudulent use of an individual’s personally identifiable information (PII), such as name, Social Security number, and/or medical insurance identity number to obtain medical goods or services, or to fraudulently bill for medical goods or services using an unlawfully obtained medical identity. Unfortunately, the definition of MIDT and the consequences that are associated with the crime are not common knowledge to the general public. Medical identity theft (MIDT) is a crime that has profound consequences for patients, insurance providers, and health care providers.  An example of this type of fraud would be a criminal using your PII to receive surgery under your name. You may detect this medical identity theft by:

  • Carefully reading any Explanation of Benefit letters you receive to make sure that all medical services listed in the letter were actually provided to you.
  • Reviewing your credit reports to see if any delinquent medical bills have been reported to the credit reporting agencies.
  • Receiving a collection letter from a collection agency claiming that you have unpaid medical bills.

What to do when you find that you have become a victim of Medical Identity Theft:

  • Request copies of your medical records from any health care provider where you feel your identity was fraudulently used.
  • Request an accounting of disclosures from your health care provider. This is a list of entities that your health care provider gave your protected health information to and may contain the same errors that exist in the original health care provider’s medical records in your name. The original health care provider must notify the other providers of the mistakes in the records they sent, but you may want to check with them yourself.
  • Contact the billing department of the medical facility or doctor requesting payment.  If you are receiving this notice from a collection agency, then contact the collection agency first.  Explain that this is a case of identity theft or mistaken identity.  If the billing department is reluctant to help, then contact the attending doctor, or the medical facility’s fraud or legal department.
  • Ask what proof they have that this person is you, when the medical service was provided, if this person used your medical insurance card or number and if they used your Social Security Number.
File a report with law enforcement, and, at your earliest opportunity, obtain a copy of the police report.  Send copies of your affidavit of fraud, the police report, any other supporting documentation proving identity theft to the medical billing department and any additional collection agencies which may be involved.  Please remember to mail this documentation certified, return receipt requested.