Medical identity theft results from the fraudulent use of an
individual’s personal information, Social Security number, or
health insurance information to obtain medical goods and
services, money through insurance fraud, or insurance coverage for
treatments. This may result in a number of problems for the victim
which might include a collection account for a past due bill, medical
insurance filing errors, or distorted medical records that could affect
future medical treatment.
Medical identity theft is one of the more complicated and problematic
types of identity theft that can occur. The reasons for these
complications are mainly attributed to the lack of a central repository of
medical history and the extensive privacy laws in relation to medical
file disclosure. It is difficult to discover and the fraud may exist until
uncovered through various methods.
Discovery: Ways an individual might discover medical identity theft
Some of the ways victims discovered their personal information was
used by another person for medical purposes include:
• Receipt of an Explanation of Benefits statement from
your health insurer listing services or treatments that
were never provided.
• Receipt of a bill for services or equipment that were
• Collection account listed on a credit report that is the
result of an unpaid medical bill not related to any valid
• Denial of health insurance or notice of increase in premiums
based on a medical condition that you do not have.
• Inaccuracy found in medical record held by physician
• Alert received from a healthcare provider, law enforcement
agency, or an insurance company who has discovered
Proactive steps: Early detection of medical identity theft
These steps may help detect signs of medical identity theft early and are
instrumental in limiting the amount of damage done by an identity thief.
• Review your health insurance provider’s Explanation of Benefits
statement for any activity that is not correct.
• Obtain your “benefits request” each year from your
insurance provider. This is a listing of benefits paid in your name
by your health insurer. If you do not recognize a payment, follow up
with the insurer or provider to learn more.
• Request your medical records if you have any suspicion
of fraud. You have the right to request copies of records
from any entity covered by the Health Insurance Portability
and Accountability Act of 1996 (HIPAA) that maintains
information or is suspected to have information about you.
These organizations are subject to the HIPAA privacy rules
and have an obligation to provide you with access to your
• Request an “accounting of disclosures” from health care
providers and health insurers. This is a list of any entities
that received personally identifiable health. These reports
are available once every 12 months, free of charge.
• Consider pulling a Medical Information Bureau (MIB) report--
although you may not have one. The MIB is “a membership
corporation of insurance companies that maintains a
confidential database of individually identifiable information
significant to underwriting applications for life and health
insurance.” They will only have information on a person
if that person has applied for individually underwritten
life, health, disability income, long-term or critical illness
insurance with a member insurer in the past seven years.
Request the report by calling 1-866-692-6901.
Author: Scott Crawley Wealth Care Advisors
Identity Theft Crisis (And how to protect yourself)
Sign up today for identify theft monitoring and restoration services with the worlds leading risk consulting company. This is a special edition of the Wealthcare Advisors newsletter. Originally, our topic for the month was creating wealth for 2015. An exciting, catching, uplifting topic. Our scheduled topic has been preempted, however, by yet another attack on the "PROTECTING WEALTH" mission of Wealthcare Advisors. The latest cyber hacking attack on Anthem is now filling national headlines. Perhaps the other cyber attacks did not raise an eyebrow for you because you were not a Home Depot or Target shopper. Nor were you affected by the Sony attack in December. We now have an attack on Anthem (Blue Cross Blue Shield) that may affect up to 80 million current and FORMER customers of the second largest health insurance carrier in the country. Exposed in the hacking were names, addresses, dates of birth and social secuity numbers. THAT IS A PROBLEM! THE ANSWER TO THE PROBLEM
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