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There's a new threat lurking on the identity theft horizon with serious implications for your health and medical treatment.

Medical ID theft occurs when fraudsters use your identity for medical care or medical services, or they introduce changes to your medical record that can be nearly impossible to correct.

According to the World Privacy Forum, a nonprofit advocacy group in San Diego, as many as half a million Americans already are victims of medical ID fraud.

A stolen name and Social Security number can lead to a shopping spree for medical care--including actual operations, prescription drugs, or fraudulent Medicare claims. If you're a victim, you could be left with more than just unpaid bills--you may have false entries in your health records at hospitals, doctor's offices, pharmacies, and insurance companies.

How do you find out if you're a victim? It's not easy, and it's usually after the fact. You may find out when a debt collector sends a letter or calls. Your insurance investigator may tell you there's a problem. Or you may discover errors in your medical file or get a strange bill for medical services you didn't receive or office visits you didn't make.

If you think you may have been a victim of medical ID theft, do the following:

  • Request, at least annually, an accounting of disclosures from your health-care providers and health insurers. A history of disclosures is a record of personal health information shared by health care providers or insurers—what was disclosed, when it was disclosed, why it was disclosed, and who received it. Use this information to track who may have received information about you, particularly if the information was erroneous. Look in the record keeper's notice of privacy practices for instructions on how to make such a request.
  • Request a copy of current medical files from each health-care provider. You may be charged a fee, so start by asking only for specific records that will provide the information you need. Providers may reject your request if they believe the information in your file is not about you. If the provider refuses to give you files in your name, file an appeal of the denial per instructions in the privacy policy.
  • If you discover errors in your medical or insurance records, demand that the information be corrected. Make sure the insurance company's records are corrected, as well as laboratory or pharmacy records. Each record keeper has an obligation to inform others to whom it disclosed the original information, but it's a good idea to follow up and ask if the corrections were received.
  • File a police report. Send copies of the police report to insurers, providers, and credit bureaus.
  • Check your credit report. Look for collection notices for hospital, lab, or medical services. Visit annualcreditreport.com for more information.
  • File a medical ID theft complaint with the Federal Trade Commission by calling 877-IDTHEFT (438-4338).

Published July 31, 2007

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