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Avoiding Medical Identity Theft



Medical identity theft occurs when someone uses your personal health information without your knowledge or consent to obtain, or receive payment for, medical treatment, services, or goods. It often results in erroneous entries being placed in existing medical records, and can involve the creation of fictitious medical records in the victim’s name leaving a trail of falsified information in medical records that can plague your medical and financial life for years, or even put your health at risk.
  • Monitor your health records closely and address any errors quickly
  • Share personal and health insurance information only with trusted providers
  • Monitor the explanation of benefits received from insurers and obtain an annual summary of all the benefits paid
  • Contact the insurer or provider about charges for care that was not received, even when there is no money owed
  • Maintain copies of your healthcare records
  • Beware of “free” medical services or treatments as some of these entities use the lure of “free” services to obtain names and insurance information for use in fraudulent claim submissions
  • Protect health insurance information. Safeguard your insurance cards, explanation of benefits, and health plan correspondence in the same way you would safeguard your credit cards.
  • Monitor your credit reports with the nationwide credit reporting companies – Equifax, Experian, and TransUnion – to identify reports of medical debts

Awareness is critical for timely detection of and thorough response to a medical identity theft incident. You may use the Medical Identity Theft Response Checklist to help keep your health records safe!

You may be the first to learn about an incident of identity theft involving your health information. Should this happen, we encourage you to use the Medical Identity Theft Response Checklist mentioned above which includes a variety of actions that must be taken to help protect yourself and your health information. Some of the many action items include:
  • Contact the health information manager or privacy officer at the provider organization or antifraud hotline at the health plan where the medical identity theft appears to have occurred
  • Request an accounting of disclosures from the relevant healthcare providers or health plans
  • Write down the date, name, and contact information of everyone contacted as well as the content of the conversation
  • Make copies of any letters or email sent or received regarding the identity theft
  • File complaints with the state attorney general, the state insurance department, the Identity Theft Data Clearinghouse, and the Department of Health and Human Services
A checklist is provided to help you prevent, detect, and/or respond to a possible incident.