Preventing Medical Identity Theft

Though often overlooked, medical identity theft poses significant risks to insurance companies and healthcare firms. Protecting yourself requires vigilance in safeguarding personal information and promptly addressing any errors in your medical files. Medical health information is considered sensitive information, and leakage of such sensitive data can ruin their trust and cause severe financial losses. 

However, medical identity theft can be incredibly troublesome for CISOs to resolve. As with many health issues, preventive measures are typically the most effective strategy to combat such frauds. 

In this blog, we’ll explore medical identity theft, its types, and how companies can protect themselves from it. 

What is Medical Identity Theft? 

Put simply, medical identity theft refers to the fraudulent acquisition of a person’s name, social security number, insurance documents, and other relevant details. This information can then be used to file fake insurance claims, obtain prescription drugs, or obtain other medical services. Unauthorized access to a patient’s data can lead to serious medical and financial repercussions.

Victims may receive hefty medical bills for services, drugs, or treatments they have never availed or heard of. This potentially means some severe trouble in the form of misdiagnoses, improper treatments, or refusal of insurance coverage.

Also, it is to be noted that medical theft, in contrast to financial theft, is more challenging to detect, which makes it even harder to resolve across the system. A patient’s corrupted data must be corrected across many healthcare providers and insurance companies.

Causes of Medical Identity Theft

Let’s go through a few important ways through which a person falls victim to medical theft.

Causes of medical identity theft

1. Data breaches

Healthcare providers, insurers, or other service providers that have medical data are the primary targets of hackers. A single breach can provide cybercriminals access to thousands of confidential medical records. 

2. Insider threats

Employees who have access to the medical records of patients may sell them to criminals for financial gains.

3. Loss or theft of wallets/devices

Theft or loss of physical identification cards, or devices containing sensitive information can lead to identity theft. 

4. Phishing scams

Cyber criminals can steal a person’s confidential medical records by sending them emails, calling them, or coaxing them to visit websites that prima facie seem to be coming from a genuine source.

5. Impersonation

Hackers might assume fake identities of healthcare workers thus tricking patients into parting with sensitive medical information.

6. Unsecured networks

Visiting medical portals or sharing medical records over unsecured Wi-Fi networks can also result in the theft of medical data.

7. Social engineering

Criminals engage with victims in a casual way, wherein they are enticed to give away sensitive information.  

Signs of Medical Identity Theft 

Here are some of the warning signs of medical identity theft: 

CategorySigns of Medical Identity Theft
Financial Indicators• Unexpected medical bills for services you didn’t receive.• Medical collection notices on your credit report that you don’t recognize. • Diminished credit score due to fraudulent medical debts.
Insurance Issues• Insurance claims denied due to maxed-out benefits you didn’t use.• Notifications from your insurance provider about unfamiliar claims or services.• Discovery of unknown health insurance accounts under your name.• Discrepancies in your Explanation of Benefits (EOB) statements.• Denial of insurance coverage due to conditions you don’t have.• Being told you’ve reached your benefit limit unexpectedly.
Medical Record Discrepancies• Errors in your medical records (unfamiliar treatments, diagnoses, or medical histories).• Discovery of unknown medical records under your name.• Difficulty obtaining life or health insurance due to incorrect medical conditions.
Unexpected Communications• Calls from medical providers about appointments or follow-ups for treatments you never had.• Notices about unfamiliar prescriptions filled in your name.
Data Breach Notifications• Notification that your medical provider’s records have been compromised.

How to Prevent Medical Identity Theft

Preventing medical identity theft requires continuous vigilance, monitoring, and proactive measures. Implementing these strategies can significantly reduce your risk of becoming a victim. 

Remember, protecting your medical identity is not just about safeguarding your financial well-being; it’s about ensuring the accuracy and integrity of your medical records, which can be critical in emergencies.

CategoryKey Actions
Protect Personal Information• Safeguard Social Security numbers.• Securely dispose of documents.• Use strong passwords.
Monitor Medical Records• Regularly check records for inaccuracies.• Obtain and review Explanation of Benefits (EOB).
Be Cautious with Personal Information• Avoid sharing information unnecessarily.• Recognize phishing scams.
. Secure Online Accounts• Enable two-factor authentication.• Use secure networks for online activities.
Shred Sensitive Documents• Shred physical documents.• Securely delete digital data.
Report Suspicious Activity• File police report.• Contact healthcare providers and insurers.• Place fraud alerts.• File FTC complaint.• Keep detailed records.

Consequences of Medical Identity Data Theft

Apart from the massive loss of taxpayers’ money, medical fraud can be more severe because of the delay that often comes after such incidents. The problem is people are generally unaware of identity theft unless they receive hefty bills for treatment they did not undergo or the results of tests not performed on them.

Claims and settlements are time-consuming, so patients are unaware of the theft unless insurance companies refuse to entertain their claims because they exceed the benefit limits.

More worrying is that identity theft could lead to the wrong line of treatment. If someone is diagnosed with your identity, you are more likely to be treated based on the test results of the person possessing your identity. 

What to do if you’re a victim of medical identity theft

It’s hard to come to terms with the fact that you have been a victim of medical data theft. However, it is imperative to act calmly and swiftly.  Here are the following measures you can take in the case of medical identity theft.

 Dealing with medical identity theft

1. Report the fraud to the Federal Trade Commission (FTC)

Visit the IdentifyTheft.gov website and file a report. The FTC will aid you in formulating a recovery plan to deal with the situation.

2. Report medicare fraud to the Office of Inspector General

This office investigates fraud about affairs run by the Department of Health and Human Services, including medicare.

3. Get copies of your medical records

Ask your medical services providers or any providers listed in claims through insurance or Medicare to furnish your medical records. You can then go through these records to detect any anomalies.

4. Get hold of your credit report

Your credit report will disclose information about any new accounts opened in your name, or if any medical accounts have been sent to collections. In case you notice any new accounts, immediately get in touch with the credit bureaus to set up a credit freeze, or fraud alert to ensure no further new accounts are opened in your name.

5. Report identity theft to the police

Some insurance providers and debt collection agencies demand that identity theft be duly reported to the police.

Conclusion 

On a final note, medical identity theft presents a formidable challenge for healthcare CISOs, which strikes hard at the core of patient trust, data integrity, and organizational security. The stakes are higher than ever, with each breach potentially costing millions and eroding the very foundation of patient care.  

Yet, in these challenges lie opportunities for CISOs to demonstrate their strategic value. CISOs must navigate a complex landscape of evolving threats, regulatory pressures, and technological advancements.

Worried about medical identity theft? Sensfrx,  powered with AI, can protect from medical identity theft. Click here to try it free

FAQs About Medical Identity Theft

1. How do you resolve medical identity theft?

Examine records and credit reports for fraudulent activity. Contact providers for information about suspicious charges. Then, report the fraud to government authorities and credit bureaus.

2. How can I find out who has accessed my medical records?

Contact your healthcare providers and insurers directly. They can provide information about who has accessed your medical records.

3. What information can be stolen from someone’s medical records?

Personal details (names, addresses, phone numbers), financial information (credit card numbers), insurance details (policy information, Medicare numbers), and health-related data (medical history, prescriptions).

4. How do you recover from medical identity theft?

Start by filing a report at IdentityTheft.gov. The FTC will create a personalized recovery plan based on your circumstances and guide you through reclaiming your identity.

5. Why is medical identity theft serious?

It can have far-reaching consequences, affecting both your financial and medical well-being. Prompt action and thorough documentation are crucial when dealing with this type of fraud.