Healthy Apple II

Identity theft is usually associated with financial transaction. However, identity thieves are now stealing identities in order to defraud individuals through the healthcare care system. The Federal Trade Commission (FTC) has said that medical identity theft happens when a person steals another person’s name or insurance information in order to get access to medical care, prescriptions, or other medical services. This also happens when the thieves use another person’s identity to present false claims to an insurance company. This is a very serious offense and it can ruin the financial reputation of the victim. If the thief uses your identity to make fake medical claims or access treatment, your finances will be affected including your credit report. It is important that you carefully scrutinize your bills when looking for signs of medical identity theft.

Healthy Apple II

How do the thieves operate?

The thieves send out bills to your insurance company for treatment that was never performed. It is a sad statistic, but research shows that most of the culprits in these schemes are doctors and other medical employees who are familiar with insurance schemes. Sometimes the doctor just sends information to theft rings on the black market. These rings then set up fake clinics and make claims for payment on phony patients (using your information).

Secondly, the thieves can use the stolen ID to buy addictive drugs to sell on the street. Several crooked pharmacists have been arrested for making claims for drugs that they have not dispensed.

Thirdly, the thieves can use the stolen ID to access medical treatment. This is perpetrated by those who cannot afford private health coverage.

How does this affect you?

The most adverse effect will be on your credit. The thieves may ring up a huge medical bill at an expensive hospital and then leave without paying. The hospital will send debt collectors to your home to ask you to pay. This has the effect of ruining your credit, and it may take years for this to be rectified. The rolling effect is that you will not be able to access credit mechanisms such as mortgages. It could also cost you your job, since employers check past credit history.

Secondly, you will not get access to medical coverage since the false claims will reach the limit of your medical cover. Thirdly, when you do get ill, and the doctor has to check your medical history, the record will reflect the false entries made by the thieves. This could lead to the doctor giving you the wrong treatment, and this could even be fatal. Legal issues do come up, too. A woman almost lost her children after her identity was used by a drug addict. When the hospital reported this, and the police came visiting, her children were given to a social service. It took the intervention of lawyers for the issue to be resolved.

What can one do?

Keep a keen eye on your medical bills. You should get explanation of benefits (EOB) from your insurance provider, and go though it carefully and identify false entries. Some medical insurance providers post these online so you can access them as frequently as you want. You should also do an annual checking on the list of benefits for which you are being billed any benefits provided may have been given to another person. If you find any false claims use your hospital and doctor records to set the matter straight. It is important that you fight against medical identity theft, and report any suspicious transactions to investigators.