Medical identity theft occurs when somebody uses your information to obtain medical treatment without your knowledge or consent. Unlike traditional identity theft that requires a social security number, this can be as simple as using your name, date of birth, and address. The dangerous thing about medical identity theft is that a hospital has to take in any emergency patients and often little attention is paid to whether the information they receive about that patient is accurate when it goes to the billing department.
Medical identity theft comes in two stages. The first is the billing stage. The billing department for any hospital, doctors office, pharmacy, or emergency room will use the information they have on the patient to try to bill them or their insurance provider. Once a victim is notified that their information has been used for medical treatment, they must work with the billing department of the hospital as well as any other groups such as Medicare or their insurance provider to prove that they were not the ones who received treatment. This is made easy by sending a copy of a driver's license for photo comparison to the patient. The one thing about this process is that it can take many months for the different departments and companies to recognize that identity theft has occurred.
The second stage is the medical history stage. Whatever treatment the identity thief acquired under the victim's information will now be placed on the victim's medical record. Most hospitals are now electronically networked and a patient's information can be accessed and updated from any part of the country. A thief can get prescription drugs, treatment for diseases, surgeries, etc. and it would all show up on the victim's medical record. This can make it hard for a victim to get the prescription drugs they needs, proper diagnosis of illness, or proper treatment in an emergency situation.
If you discover that you may be the victim of medical identity theft, file a police report with your local police department using the information you have gathered on the fraud. Talk to the billing department of the medical facility as well as any insurance or government agencies that may be involved. Write to the hospital/doctor about viewing your medical history using the form LF 130A. And ask any physicians involved to amend your medical records to reflect that you were not the one who was treated.
For more information please see our Fact Sheet FS 130 on Medical Identity Theft.
"Medical Identity Theft: The Basics" was written by Kat Rocha. Kat is a Victim Advisor at the ITRC. We welcome you to post/reprint the above article, as written, giving credit to and linking back to the original post.