That’s Not My Blood Type: Financial Medical Identity Theft

Consumers are usually surprised to find out how far reaching identity theft can be. It can affect many different parts of a victim’s life. One growing form is medical identity theft, which is often difficult to deal with due to the Health Insurance Portability and Accountability Act (HIPAA) and other privacy laws. Even within the category of medical identity theft, there are multiple forms of the crime. Below is some basic information on one form of medical identity theft called financial medical identity theft, and also the process for cleaning up the mess.

Financial Medical Identity Theft:

Financial medical identity theft is when someone is getting medical help using your name and/or other information. Examples of this type of fraud would include a hospital or a doctor billing you for medical services given to another person. The thief may or may not have a copy of your private insurance card.

• Contact the billing department of the medical facility or doctor requesting payment. If you are receiving this notice from a collection agency, then contact the collection agency first. Explain that this is a case of identity theft or mistaken identity. If the billing department is reluctant to help, then contact the attending doctor or the medical facility’s fraud or legal department.
  • Ask what proof they have that this person is you. There is almost always a physical description of the patient. Does it match you? You might be able to show that your height, weight, skin color, age, blood type, or sex is not the same as the “patient.”
  • Ask when service was provided. You might be able to prove you were somewhere else during that period.
  • What service was provided? If surgery was done or a condition was diagnosed, you might be able to prove you don’t have a scar or that condition.
  • Ask if your Social Security number (SSN) was used or just a name and address. If your SSN was used, you will need to follow the information in ITRC Fact Sheet 100 Financial Identity Theft: the Beginning Steps and check your credit reports. This thief may be affecting your credit status in other ways. They may be opening new lines of credit or leaving other collection actions behind.
• Ask if this person used your medical insurance card or number. If so, contact your insurance company and report the problem. Ask for a new number on the replacement card.
• File a police report in your city and state of residence. You are a victim of a crime. At your earliest opportunity, obtain a copy of the police report.
• Send copies of your affidavit of fraud, the police report, any other supporting documentation proving identity theft to the medical billing department and any additional collection agencies which may be involved. Remember to mail this documentation certified, return receipt requested.
• Once the provider agrees this is a case of fraud or identity theft, get that agreement in writing and keep it in a safe place forever. This is called a Letter of Clearance.

The solution fits nicely into short written form, but the reality of the situation is usually much trickier. It takes time and effort to clear up financial medical identity theft and new issues may continue to pop up in the future. However, by protecting your personal information consumers can help protect themselves from this and other forms of identity theft.