Safeguarding Your Health Information From Medical Fraud

by | Sep 16, 2024

Health insurance is intended to ensure individuals and families have access to essential treatments, preventive services, and emergency care. However, it has increasingly become a target for scammers seeking financial gain.

Earlier this year, Change Healthcare experienced a cyber-attack that affected thousands of healthcare providers, insurers, and policyholders across the country. Reports indicate that nearly half of all U.S. medical claims might be at risk. To illustrate, if you find yourself in a waiting room with nine others, there is a possibility that five of you could become victims of medical identity theft within the year. The consequences of this fraud are extensive, impacting numerous individuals and their healthcare access. Once your medical information is exposed online, identity thieves can exploit it to submit false claims, purchase costly prescriptions, and more, all charged to your account.

The most distressing aspect is how some individuals discover they have been affected. Some face tax or mortgage fraud, while others visit a doctor only to receive a rejection letter from their insurer, stating their benefits are exhausted due to multiple procedures they never had. This happens because someone else used their medical ID for personal treatments.

It’s not just individuals who are at risk. Deceptive organizations can misuse your medical information for fraudulent billing schemes. They submit false claims for services you never requested or received, collecting payments while leaving you with the bill. Recently, 193 defendants, including medical professionals, were charged for their involvement in healthcare fraud schemes that resulted in $2.75 billion in false billings to federal programs. Medical fraud is a real threat.

How to Recognize If You’re a Victim

Here are 10 signs that your medical ID may have been stolen and is currently being used by cybercriminals:

  1. Unexpected Medical Bills: Receiving bills for medical services you didn’t receive is a major red flag.
  2. Collection Notices: Being contacted by debt collectors for unpaid medical bills that aren’t yours.
  3. Errors In Medical Records: Finding inaccuracies in your medical records, such as treatments you never had, incorrect diagnoses or unfamiliar medical histories.
  4. Insurance Issues: Your health insurance claims are denied because your benefits have been maxed out or you’re told you’ve reached your coverage limit, despite not using the services.
  5. Notification From Your Insurance Provider: Receiving alerts from your health insurance provider about claims or services you don’t recognize.
  6. Unknown Accounts: Discovering new health insurance accounts or medical records under your name that you didn’t create.
  7. Discrepancies In Your Explanation Of Benefits (EOB): Your EOB statements from your insurer list medical services you didn’t receive.
  8. Being Denied Insurance: Having difficulty obtaining life or health insurance because medical conditions that you don’t have are listed in your records.
  9. Calls From Medical Providers: Receiving calls from doctors or medical facilities about appointments or follow-ups for treatments you never had.
  10. Unfamiliar Prescriptions: Notices about prescriptions being filled in your name that you did not authorize or receive.

How to Prevent Medical ID Fraud

Don’t become the next medical ID theft victim. Here are a few steps you can take to protect yourself:

  • Check For Health Care Breaches: Use a searchable database, like this one, to find out if your health care information has been compromised.

  • Secure Your Records: Store paper copies of medical records in a safe or lockbox to prevent unauthorized access. If your health care organization’s system is compromised and records are lost, altered or unable to be accessed, you will be glad you did this.

  • Shred Documents: Shred any documents with personal information before disposing of them.

  • Monitor Your Medical Records: Regularly request and review your medical records from your health care providers and look for unfamiliar treatments, diagnoses or other discrepancies.

  • Review Insurance Bills: Carefully review explanation of benefits (EOB) statements from your insurance provider for any services you did not receive and question unfamiliar or unclear charges. Contact your insurer immediately if you see any charges or services that you don’t recognize. Afterward, report any billing errors to the credit bureaus at IdentityTheft.gov.

  • Dispose Of Prescription Labels: Remove labels from empty prescription bottles before discarding them! These labels can contain information that, believe it or not, can be used to steal your identity.

  • Monitor Your Credit: At AnnualCreditReport.com, you are able to get three free reports a year to keep an eye on any suspicious activity.

Healthcare will always be a target for hackers, and attacks on medical facilities will continue. It’s crucial to take proactive steps to protect yourself. Schedule a call with our team to assess your risk and ensure your information is secure.

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