Can You Protect Your Medical Records?

When you are a victim of identity theft, one of the smartest things you can do to thwart the thief from doing more damage is to place a fraud alert or a credit freeze on your credit reports. An alert will warn creditors to look more closely before extending credit, while a freeze will prevent your credit report from being accessed without a PIN number you supply.

But what happens if you are a victim of medical identity theft? Can you freeze your medical information?

Medical identity theft — where someone uses another person’s identifying information to receive medical treatment, or uses another person’s medical insurance to help pay for medical services or equipment — is a growing problem. An estimated 1.84 million Americans are victims of this crime at an estimated cost of $12.3 billion, according to the Ponemon Institute’s 2013 Survey on Medical Identity Theft.

Credit.com blog reader Jennifer recently shared her family’s experience:

My sister-in-law had a medical procedure done using my … mother-in-law’s [who has dementia] info for the payment! She has not paid and now [they] are calling my business number looking for my husband. He [has] POA (power of attorney) but we did not sign and knew nothing about this! Does he have to pay this??

Medical ID theft is perhaps the most dangerous kind of identity theft.

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Imagine what might happen now that Jennifer’s sister-in-law’s medical records are mixed up with her mother’s. Their medications, blood types, and medical history can lead to inaccurate and even life-threatening medical mistakes in the future. “There can be medical complications that could harm your own health,” says Sally Hurme, project advisor with education and outreach for AARP.

Unfortunately, medical ID theft is often an inside job. In the Ponemon survey, 30% of respondents “knowingly shared personal identification or medical credentials.” And, as in Jennifer’s mother-in-law’s case, 28% said a “family member took personal identification or medical credentials without consent.”

What Now?

Unfortunately there is no simple way to “lock down” your medical information to prevent future theft. “Medical identity theft procedures and remediation is not as far along as it is with credit fraud,” says Hurme.

In fact, it is possible for a person to get certain types of care without ever showing a current, valid photo ID. “In the medical world it’s help the customer before you verify the customer,” says Brett Montgomery, a fraud resolution manager for Identity Theft 911. He says emergency rooms in particular must help someone who seeks medical attention.

If you do become a victim of this type of fraud, there are a number of steps you’ll want to take:

1. Review your Explanation of Benefits statements carefully.

These are the statements that your insurers send you, detailing claims that have been submitted to them. If you see charges for services you didn’t receive, or from providers you don’t recognize, contact your insurance company for help.

2. Report fraud.

Get in touch with your health insurance plan, whether it is Medicare (call 1-800-Medicare) or a private insurer. “Your health insurance company is going to have a fraud department,” says Hurme. “They want to hear from you if you think there has been a fraudulent claim against your health insurance company.”

It’s also a good idea to file a police report. In fact, you may have to have one in order to get your name removed from fraudulent bills, says Montgomery. Of course, that’s a tough thing to do when you know it’s a family member who has committed this crime. But without one, you may find yourself fighting with collection agencies and providers who insist the bill is valid.

3. Review your medical files.

This can be easier said than done, because there is no central source for checking your medical files, like there is with free annual credit reports.

If you have health insurance — including Medicare or Medicaid — then your Explanation of Benefits can help you identify any provider who has submitted claims. You can then ask those providers for a copy of “your” medical records. If you don’t have insurance, though, it will be more difficult to track down the places where your information has been used. You may want to at least contact your local hospitals, explain that you have been a victim of this crime and ask them whether they have a medical file for you on record.

4. Check your credit reports.

Unpaid medical bills are usually turned over to collection agencies. This can be a warning sign of medical ID theft. Collection accounts on credit reports are “one of the most common ways people find out that their information was used by someone else to obtain medical goods or services,” says Susan Henson, senior director, public relations for Experian.

If you do find collection accounts for bills that don’t belong to you listed on one or more of your credit reports, you’ll need to dispute them.

While you are at it, monitor your credit scores so you will be alerted to any significant changes. If a collection account shows up on your credit, for example, your credit scores will likely drop significantly and you’ll need to investigate further. You can get a free credit score updated every 14 days at Credit.com.

And whatever you do, don’t allow someone else to use your personal information or insurance cards to obtain or pay for services. Doing so can literally ruin your life.

Image: Medioimages/Photodisc