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Medical Identity Theft – How to Spot it, How to Fix it




Tens of thousands of people each year become the victim of medical identity theft. Because of this, it is important to stay vigilant, and keep your eyes open, to stay on the lookout for possible medical identity theft. Below, you can find some pointers that will help you to spot medical identity theft, and if you discover it, you will find what you need to do in order to fix it.

How to Spot Medical Identity Theft

[ Jump down to "Fixing Your Medical Records" ]

Did you get an unexpected bill for medical or health services that you know you never used? If you did, then you are probably the victim of an identity theft. In this case, you should contact the medical provider, talk to them about the situation, and see if you can work to clear your name.

Look at your medical records regularly, if possible. If you find that those records show that you have medical conditions that you know in fact that you don’t have, then you should work to rectify the situation and get rid of those conditions. To learn more about how to fix mistakes in your medical records, go down to "Fixing Your Medical Records."

Did your medical claim get rejected by your health care provider? If it did, and they claim that you’ve reached the limits of your health benefits, and you know that you haven’t used your health insurance, then you probably had your personal information stolen by some identity thief somewhere.

Did an insurance provider deny you coverage because of conditions that you know you don’t have? Similar to what you see above, except in this case, you can’t get insurance when you look for it because they claim that you have some conditions that you know you don’t have. With the new health care laws in place in the U.S., you probably won’t get turned down for having these conditions, but you still need to look to make sure that there aren’t any conditions on your medical records that aren’t true.

Did you get a call from a debt collector regarding some medical service that you know you didn’t use? If you keep getting phone calls from medical clinics or debt collectors working for medical clinics or health care providers, and they claim that you own them money because of some medical services that they claimed that you used, even though you know that you didn't, then you need to check your medical records, find any errors in them, and work to correct them.

Do you see collection notices concerning health care and medical items on your credit report regarding things that you know you didn’t use, or that you know nothing about? If so, you will not only need to work to correct your medical records, but you will also have to work to clean up any errors in your credit reports.



Fixing Your Medical Records

[ Jump up to "How to Spot Medical Identity Theft" ]

If you do think that there are errors and mistakes inside of your medical record, make sure to get a copy of those records, which you are entitled to get per federal law. Because this is the case, you should have no trouble getting those records from your health care provider. When you do get it, you should look through it, and find the specific items that you know are, or believe to be, false, and write down the details.

Write down the name of the place that provided that incorrect information, whether it’s a doctor’s office, a hospital, a pharmacy, a laboratory, a clinic, or whatever the case may be. Write down the name, address, phone number, email addresses, and names of doctors doing business at this location. Once you get this information, it is then your job to connect with each of these locations, that provided the incorrect information, and let them know that you believe there is an error on your records that came from that location, and get any viable information that you can, including any description of any person who may have been using your identity to use their services. This also includes any health care providers or health care plan that are listed in the records.

If the organization refuses to give you any information or records, you should then look at their legal fine print, and find and contact the person they may refer to as the Ombudsman, the Patient Representative, or the person listed in their Notice of Privacy Practices. These are typically the people responsible for providing your records to you. You may have to pay a fee to get those records, but you should still be able to get them if you verify that it is, in fact, you asking for the records and not someone else. If they won’t give you the records you ask for, then click here to find out more from the U.S. federal government about what you can do.

Also Ask for an “Accounting of Disclosures.” What you are asking ofr is a record of who got copies of your medical records, including what medical information was sent, why the info was sent, who got the info, and when it was sent. You ask for this document from your medical providers and health care plans. You are, by law, allowed to ask for one free copy of this document from your health care providers every year (12 months). You can use this document to find out who you will need to contact to clear up any errors in your medical records that you may find.

Contact your health care providers and medical providers and report to them any errors or inaccuracies that you see inside your medical history files. Make sure to include a copy of your medical record with the discrepancy highlighted so that your provider can easily find the item you are disputing. Include any documents that you can use as proof to back up your claim, including any possible police report and identity theft report that you may have filed with the Federal Trade Commission (FTC). And, make sure to have a letter to put everything together. If you want a sample template of how this letter might be written, you should go to this article and tailor the letter template in our section “Correcting Errors in Your Credit Report” so that it works for sending a letter to a health care or medical provider.

NOTE: When you send a letter, you will want to have records that you sent the letter for your personal records and for possible legal reasons. Because of this, when you send these letters, you will want to make sure you go to the post office to send them, and do via certified mail, and ask for a return receipt so that you know that they received it.

If you have an identity theft report from the FTC, and a police report, you will also want to send that information to the three major credit bureaus so that they can take note. Use this sample letter to do so. You are also entitled to order copies of your credit reports from the three bureaus by contacting them using the following information:

Equifax:     www.equifax.com     866-640-2273
Experian:     www.experian.com     1-888-397-3742
TransUnion:     www.transunion.com     877-322-8228

PLEASE NOTE: When you are applying to get your annual free credit reports, you need to go through annualcreditreport.com, but when you are getting a credit report because you believe that you have been the victim of identity theft, including medical identity theft, you need to contact the credit bureaus directly. To learn more about getting your annual free credit reports, read our article on the subject.

You may also want to read our articles "8 Ways to Save Money on Health Care" and "6 Ways to Save Money With Your Prescriptions."

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