Medical Identity Theft

Medical identity theft happens when someone uses your name and insurance information to receive medical care, prescription drugs, or submit fraudulent insurance claims. It's harder to detect than financial identity theft and can have serious consequences — including dangerous errors in your medical record.

Why Medical Identity Theft Is Especially Dangerous

Financial identity theft ruins your credit. Medical identity theft can do that and more:

• The thief's medical history (blood type, allergies, diagnoses, medications) is merged with yours in your medical record
• Healthcare decisions made on your behalf could be based on false medical history
• Your health insurance benefits may be exhausted
• You receive bills for services you never received
• Your credit is damaged by collections for those bills

How to Detect Medical Identity Theft

• Receiving an Explanation of Benefits (EOB) from your insurer for care you didn't receive
• Bills from providers you never visited
• Collections accounts from medical providers on your credit report for unknown services
• Your insurance company notifying you of unusual claims
• Discovering unfamiliar entries in your medical records when you request them

Your Right to Access and Amend Your Medical Records

Under HIPAA, you have the right to access your medical records from any provider, and the right to request correction of errors. Request your records from any provider where fraudulent care was received and from your health insurer. If the record contains fraudulent information, submit a written amendment request.

If the provider denies your correction request, you have the right to add a statement of disagreement to your record under HIPAA.

Steps to Take After Medical Identity Theft

1. File an FTC Identity Theft Report at IdentityTheft.gov
2. File a complaint with HHS Office for Civil Rights (for HIPAA violations) at ocrportal.hhs.gov
3. Contact your health insurer's fraud department immediately
4. Contact the medical providers where fraudulent services were rendered
5. Request and review your medical records from those providers
6. Submit correction requests for false medical history
7. Dispute any medical collection accounts that appear on your credit report

Protecting Yourself Going Forward

Don't share your insurance card or Medicare/Medicaid number except at the point of care. Be suspicious of anyone who contacts you offering free medical services in exchange for your insurance information. Review your EOBs carefully every month — your insurer's app makes this easy.

See also: Identity Theft Response | Filing Your FTC Report