Medical Identity Theft

exclamation point  Medical identity theft occurs when someone uses your medical information without your knowledge or consent to get medical treatment, buy prescription drugs, or submit bills in your name for nonexistent medical treatment or services.  Not only does the misuse of medical information have financial consequences, but it can be hazardous to your health if information belonging to a thief ends up in your medical records.  Consider the following preventive actions to reduce the ill effects of medical identity theft:

  • Read the Explanation of Benefits (EOB) statement carefully. This is the statement your insurance company sends to you after healthcare services have been paid by the insurance company. 
  • Make sure the claims paid on the EOB match the care you received and you recognize the provider of the services.
  • Challenge any inaccurate or inconsistent information, even if no payment is required.
  • If you get a Medicare-covered service, you will get a Medicare Summary notice (MSN) in the mail every three months, or you can check it anytime at the Medicare government site.  Review it carefully and immediately dispute inaccurate information.
  • Get your free credit reports from Look for medical debt you don’t owe as well as names, addresses, or health care providers you don’t recognize.  Dispute all fraudulent information immediately. 
  • If you have applied for individual life, health, or disability income insurance in the last seven years, the Medical information Bureau (MIB) may have a consumer file on you.  To find out call the MIB at 866-692-6901 or visit them online. Review and correct any inaccurate or incomplete information in your record.
  • Get copies of the records maintained by your health plans and medical providers regularly.  Unlike credit reports, there is no central source for getting medical records.
  • You have the right to get copies of your medical and health records based on the Health Insurance Portability and Accountability Act (HIPAA).  Check your records for accuracy and request that incorrect medical or billing records be amended. Make sure to get a copy of the amended record.  Information about your rights under HIPAA is available at the US Department of Health and Human Services.
  • If your medical insurance card is lost or stolen, notify the insurance provider right away and request a new card and number.
  • Do not provide medical information to telephone marketers, door-to-door solicitors or online unless you initiated the contact and you are sure you know who you are providing information to.
  • Be suspicious of accepting “free” medical services or if you are offered gifts or discounts to go to designated clinics or offices.  
  • Protect and guard your health plan membership identification card and Medicare card just like a credit card.

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Office: 703-222-8435 (8:00 a.m. - 4:30 p.m. Monday-Friday)
Fax: 703-653-1310



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