According to a press release, medical identity theft is a national healthcare issue with life-threatening and financial consequences, to the tune of $12.3 billion dollars in out-of-pocket expenses. According to the 2013 Survey on Medical Identity Theft conducted by Ponemon Institute, medical identity theft and family fraud have increased nearly 20 percent within the last year.
For the purposes of this study, medical identity theft occurs when someone uses an individual's name and personal identity to fraudulently receive medical services, goods, and/or prescription drugs, including attempts to commit fraudulent billing.
Among the key findings in the survey:
- Medical I.D. theft caused the victims to experience misdiagnosis, mistreatment, delay in treatment or were prescribed the wrong medicines.
- Half of respondents have done nothing to resolve the incident.
- 52 percent of the victims did not report the theft.
The Medical Identity Fraud Alliance (MIFA), also announced on Sept. 12 that this is the first cooperative public-private sector effort to unite all stakeholders involved in the protection of consumers: policy decision-makers, organizations that hold protected health information (PHI), health plans, law enforcement, regulatory agencies, companies, nonprofit organizations, and consumers. MIFA advocates to jointly develop best practices, solutions and technologies for the prevention, detection and remediation of medical identity theft and fraud.
It doesn't matter what type of healthcare people practice, it is up to individuals to stop the fraud. Survey respondents indicated they did not know it was fraud to loan their insurance cards to friends and family members without insurance. Times are hard and insurance isn't cheap, but the average American knows it is illegal to allow anyone to use their personal I.D. cards to obtain free or low-cost medical aid.
This is what every person should be doing to prevent medical fraud:
- Review your Explanation of Benefits (EOBs). Make sure the doctors listed and services provided are accurate. If you find an incorrect item, even if no money is owed, contact your insurance company immediately.
- Ask for your benefits request annually. Your insurance provider can provide a list of all benefits and services paid in your name, which you can review to confirm all the services listed were received.
- Keep your medical insurance card safe. Don't allow others to use it or to know the information on the card.
- Shred or file your Explanation of Benefits in a locked box.
- Report lost or stolen health insurance identification cards. Alert your insurance carrier of misplaced, lost, or stolen cards to avoid unauthorized use.
- Review credit reports annually.
Remember that medical fraud costs everyone. It could cost a life when two or more people are sharing the same patient chart with a stranger who takes medicine that you are allergic to. The nurses and doctors won't know that you are allergic to antibiotics when your chart shows that you take them due to infection.
While others may stick their heads in the sand over this issue, everyone must report lost or stolen cards immediately and point out any errors on your patient chart.