What To Know About Medical Identity Theft

What Is Medical Identity Theft?

Medical identity theft is when someone uses your personal information — like your name, Social Security number, health insurance account number or Medicare number — to see a doctor, get prescription drugs, buy medical devices, submit claims with your insurance provider, or get other medical care.

If the thief’s health information is mixed with yours, it could affect the medical care you’re able to get or the health insurance benefits you’re able to use. It could also hurt your credit.

How To Protect Your Medical Information From Theft

Here’s what you can do to protect your medical information.

Protect documents that contain your medical information

Keep your medical records, health insurance records, and any other documents with medical information in a safe place. These may include

• health insurance enrollment forms
• health insurance cards
• prescriptions
• prescription bottles
• billing statements from your doctor or other medical provider
• Explanation of Benefits statements from your health insurance company

An Explanation of Benefits statement tells you the doctor you visited, the date of your visit, the services the doctor provided, the cost of those services, how much your health insurance covered, and how much you’ll have to pay.

When you decide to get rid of those documents, shred them before you throw them away. If you don’t have a shredder, look for a local shred day. If it’s something that’s hard to shred — like a prescription bottle — use a marker to block out any medical and personal information.

If you get statements with medical information in the mail, take your mail out of the mailbox as soon as you can.

To limit the amount of medical information you get by mail, consider getting your medical bills or Explanation of Benefits statements online.

Ask questions before you give out your medical information

Some doctor’s offices might ask for your Social Security number to identify you. Ask if they can use a different identifier or just the last four digits of your Social Security number.

If another organization asks for information like your health insurance account number or Medicare number, or for details about your health, ask these questions first:

• Why do you need it?
• How will you protect it?
• Will you share it? If so, with whom?

Protect your medical information from scammers online and on your phone

Do not give your medical information to someone who calls, emails, or texts you unexpectedly. It could be a scammer trying to steal your information.

Instead, log in to your online medical account from a website you know is real. Or contact the company or provider using a phone number you know is real.

How To Know if Someone Is Using Your Medical Information

Besides taking steps to protect your medical information, it pays to know how to tell if someone is using your medical information. Here are some warning signs:

• You get a bill from your doctor for services you didn’t get.
• You notice errors in your Explanation of Benefits statement like services you didn’t get or prescription medications you don’t take.
• You get a call from a debt collector about a medical debt you don’t owe.
• You review your credit report and see medical debt collection notices that you don’t recognize.
• You get a notice from your health insurance company saying you reached your benefit limit.
• You are denied insurance coverage because your medical records show a pre-existing condition you don’t have.

What To Do if Someone Is Using Your Medical Information

If you think someone is using your personal information to see a doctor, get prescription drugs, buy medical devices, submit claims with your insurance provider, or get other medical care, taking these steps will help you limit the damage.

Review your medical records and report errors

 1. Get your medical records. Contact each doctor, clinic, hospital, pharmacy, laboratory, and health insurance company where the thief may have used your information. Explain the situation and ask for copies of these medical records. You may have to submit records request forms and pay fees to get copies of your records.

If the provider refuses to give you copies of the records to protect the identity thief’s privacy rights, you can appeal. Contact the person listed in your provider’s Notice of Privacy Practices, the patient representative, or the ombudsman. Explain the situation to that person and ask for your medical records.

2. Review your medical records. Look for any errors, like visits you didn’t make and services you didn’t get.

3. Report errors. Report any errors to your health care provider in writing. Include a copy of the medical record showing the incorrect information and explain why it’s incorrect. Send the letter in a way that lets you track it and confirm that someone received it, like certified mail.

Your health care provider must respond to your request within 30 days and must notify other health care providers who may have the same mistake in their records.

Review your credit reports and report medical billing errors

1. Get your credit reports. Get your free credit reports from the three credit bureaus at annualcreditreport.com or call 1-877-322-8228.

2. Review your credit reports. Look for medical billing errors, like medical debt collection notices that you don’t recognize.

3. Report errors. Report any medical billing errors to all three credit bureaus by following the “What To Do Next” steps on IdentityTheft.gov.

Create a personal recovery plan

A thief that uses your personal information to see a doctor, get prescription drugs, buy medical devices, submit claims with your insurance provider, or get other medical care may also use it in other situations. Go to IdentityTheft.gov to create a personal recovery plan.