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Watch Out for Medical Identity Fraud

by | Oct 24, 2012 | Blog, Medical Billing | 0 comments

Medical identity theft means when a person’s name or insurance information is fraudulently used without the person’s knowledge to make false claims for medical services. The victims often end up losing all their healthcare benefits.

It is estimated that up to 1.5 million Americans are victims of medical fraud every year, and that the average cost to restore identity after medical identity theft is about $20,160. The average price of a new car is $28,400!

Medical identity theft is difficult to prevent, detect and resolve. People may discover that they have been duped only after a long time, sometimes two years after the fraud takes place. Issues the victims experience include

  • Loss of credit
  • Higher health care premiums
  • Loss of all health care coverage benefits
  • Expenses on legal procedures

It is difficult to completely avoid medical identity theft, but the Federal Trade Commission (FTC) says that there are some things people can do to reduce the risks.

  • Be careful while sharing your medical and health insurance information.
  • Read and understand “Explanation of Benefits” (EOB) forms properly.
  • Verify the source before you share the information. Medical identity thieves can approach you pretending to be employees of insurance companies or doctors’ offices. They trick you into revealing your medical identity details and use the information to submit fake claims for reimbursement.
  • You should order copy of your credit reports every year. This will provide details of your accounts and you can check whether bills are paid promptly.

If you are a victim of medical identity theft, you can use your rights under HIPAA to correct any errors in your medical billing records.

Physicians should also watch out for such medical billing fraud as they may inadvertently bill the wrong patient. It is important for the physician and their staff to be vigilant and ensure that they don’t unknowingly get involved in fraudulent matters.

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