Identity theft is nothing new. The law states that identity theft is when “someone unlawfully obtains another’s personal information and uses it to commit theft or fraud.” Law enforcement has been chasing down suspects using fake IDs and check forgers for decades. However, as technology has improved so have the techniques of identity thefts.
The fastest growing form of identity theft is medical identity theft. This involves someone stealing an identity and using it to get medical care, prescription drugs, file insurance claims, or receive other care. There are some signs to look for if you believe you have been the victim of medical identity theft.
You should always check your explanation of benefits (EOB) statement to make sure the claims match the medical treatment you received. If you discover any discrepancies between the treatment you received and your statement, you should contact your insurance company and report it immediately. Some other signs include:
• A bill for medical services you didn’t received.
• A call from a debt collector about a bill you don’t owe (we’ll return to this point later)
• Medical collections on your credit report that you don’t recognize.
• Notice from your health plan saying you’ve reached your benefit limit.
• Your insurance shows a condition you don’t have.
If you suspect you have been the victim of medical identity theft, you need to obtain a copy of your medical records. This may require you to pay for copies. However, if you can limit the time frame to when the fraud occurred you should only ask for that period of time.
What do you do after obtaining the records? First you need to contact your medical provider and insurance company to ask for corrections. Be sure to include any and all evidence to support your claim. When sending in documents, be sure to highlight and/or circle the items in question. If you are mailing your records, be sure to send them in a way that you can get a delivery confirmation.
Your insurance provider should be able to take the disputed claims off your record. However, if they refuse, make sure you get a statement that you filed the dispute on your records. If your insurance company or health provider accepts your dispute, they should notify anyone else that might have gotten the wrong information. During this time, you should always keep a record of everything you gathered and any conversations you have with your insurance company and medical providers.
If your provider refuses to send you a copy of your medical records, it may be a mistaken issue about violating the identity theif’s privacy, and the U.S. Department of Health and Human Services Office for Civil Rights allows you to file a complaint (www.hhs.gov/ocr/office/index.html). Please note that all states have varying laws regarding this, and you should always seek legal advice if it becomes necessary.
If you do not monitor your credit report, you should order a copy at this point. Check to see if the medical accounts in question are still on your report (it could take about a month for the account to be removed). If you have to file a complaint with the credit bureau, the investigation can take 30-45 days, but going through the credit reporting agencies provides some legal protection if the company in question refuses to remove the accounts.
If you believe you have been the victim of medical identity theft, do not wait. Immediately begin collecting records and making phone calls. Do not be afraid to contact the credit reporting agencies and file a dispute. The most important thing you can do is be pro-active and maintain all records of your visits to medical providers.