Identity Theft Strikes Again: What's in Your Medical Records?

Having just recently done an installment on the issue of Identity theft in regards to Illegal Immigration, I found it incredibly fitting to open up my latest edition of Reader's Digest to an article about Identity theft in regards to Medical Records. The only correlation between this article and the last is the topic of identity theft. My research thus far has not tied the issue of illegal immigration to this particular brand of identity theft, however... that doesn't mean that it doesn't exist, nor does it mean that the topic does not warrant further research on the part of the average consumer, beyond this article and beyond others that may be written on this topic.

Most of the time when people think of identity theft, stolen credit cards with frivolous, fraudulent charges are generally what come to mind. Or someone obtaining an SSN and opening a line of credit to buy a computer or a vehicle. Most people do not think of medical records or billing, or how those two things can affect one's ability to obtain health or life insurance, or even employment. According to the Los Angeles Times, "Although the most typical of the millions of identity theft cases in the each year involve credit cards, a 2003 federal report estimated that at least 200,000 instances involved medical identity fraud. Experts believe that the rising cost of healthcare is driving more identity theft, and that many people are unaware they have become victims unless they receive a hospital bill or query from their insurer."

The problem comes when a person seeks out medical treatment for very expensive care, such as surgeries or medications, or even debilitating conditions or diseases. Once these things are entered onto your medical record, they become redundant on the records that are shared with pharmacies, insurance companies, and other healthcare providers. One example for instance would be a patient whose appendix ruptures. If there is a fraudulent use of the medical records which indicates the person has already had their appendix removed, Doctors may waste invaluable time seeking out other causes for the pain, acting on the information contained in the patients medical records as it exists. In some cases a person has found that their blood type has been changed, that they have had very costly surgeries for conditions they do not have, or have had members amputated that quite obviously they have not. This can affect the way doctors treat their patients, and prescribe medications. Also it is difficult for health care entities to expunge bogus information because of their own liability. For instance if a doctor has prescribed a narcotic for a severe and painful condition, they have to be able to justify the prescription of that medication should there ever be an inquiry.

Reader's Digest magazine also cites the case of a man named Joe Ryan. In Mr. Ryan's case, he was billed $41,188 for a surgery he never had, at a hospital he had never set foot in. In Mr. Ryan's case, he was a pilot in Vail, CO trying to get his new business up and off the ground, literally and figuratively. He had thought a few phone calls would clear the matter up, but two years later he was still trying to get his credit repaired. And when trying to pursue his business, lenders approved of his business plans, but balked at his credit history, which has him struggling to keep from going bankrupt instead of building the successful business he planned for.

To make matters worse, when a person finds out that their identity has been used to fraudulently obtain health care, it becomes a struggle to even be able to review your own records, because of the HIPAA laws that were intended to protect an individual's privacy and medical history. It becomes difficult to establish that you are truly the owner of that identity and privy to your own medical records to make sure they are accurate. Also hospitals may argue that the information contained in the record, be it inaccurate is someone else's medical information that you are not privy to. Not only does this make it difficult to insure that you will receive proper medical treatment in the future, but it makes it difficult also to prove responsibility or lack thereof for charges.

This becomes an issue especially when the debt is sold to collection. Because the debt can be resold and resold again to different collection agencies who tack their own fees onto the debt. Each one of these collections goes onto a person's credit report, which takes time and money to investigate and dispute. And even when one is disputed that will not stop it from being sold again and re-appearing.

In many instances Fortune 500 companies also review medical records for promotions or hiring. In many cases companies will also run a credit report. If the information on either is inaccurate it can bar a person from employment they are actually qualified for. The same applies to insurance carriers.

Fraud can also occur, but rarely does on the end of the caregivers, who may charge a patient out of pocket for care, and then turn around and bill insurance for the same care, or even bill the insurance for care they did not render, as in the case of Dr. Richard Skodnek, who was convicted on 136 charges of fraud in 1996. Even though this man was caught and was forced to repay the money, patients are still having trouble expunging fraudulent diagnoses and treatments from their medical records.

In many cases however it is a friend or family member who performs this fraud. Veterans are highly targeted by family members who have easy access to their personal information.

So how do you protect yourself from this sort of Identity theft? One way is to be sure to review every medical bill and detail of services paid for by your insurance carrier closely. Stay on top of anything that appears there that you know is incorrect. Always protect your SSN and Identification. Along with the protection of your identification and SSN is the protection of your Insurance card. Reader's Digest warns, "Treat your insurance card like a credit card." Because in all honesty that is what it is. You pay for a line of credit on medical treatment with your insurance carrier, and it can be abused as easily as a Visa or MasterCard. Also under the HIPAA you have a right to request accounting disclosures from every health care provider you visit annually. It will give you details on what information was released and to which health care providers. Also, it is recommended you stay on top of your credit report. This is harder to do for some people than others, but it is becoming more and more vital.

With the quick spread of information in this day and age, you are the best defense you have for your own identity. It's yours! Protect it!