Identity Theft Resource Center Fact Sheet 130 Basic Medical Identity Theft
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From Identity Theft Resource Center
Fact Sheet 130 Basic Medical Identity Theft Posted in: Fact Sheets By Identity Theft Resource Center May 17, 2007 - 3:03:30 PM
Fact Sheet 130 Basic Medical Identity Theft In this guide, you will find the beginning steps to take as a victim of medical identity theft. It is not meant to cover complex cases. If your case is not easily solved, please call our office for further assistance. Other guides on this website will discuss correcting the accuracy of medical records or files, and your privacy rights regarding medical records. z z z
Financial Medical Identity Theft: Someone is getting medical help using your name and/or other information. Criminal Medical Identity Theft: You are being held responsible for the actions of another’s criminal behavior. Government Benefit Fraud: Your medical benefits are being used by another person.
1. Financial Medical Identity Theft: 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. z
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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 there is a condition diagnosed, you can show you don’t have a scar or that condition. { Ask if your Social Security number was used or just your name and address. If your SSN was used, you will need to follow the information in Fact Sheet 100 Beginning Financial Identity Theft, and to 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. They may also have a fraud department that tracks cases. 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. Please 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.
For more details on financial identity theft please see our Fact Sheet 100 Beginning Financial Identity Theft and Fact Sheet 100A Financial Identity Theft – More Complex Cases . 2 Criminal Medical Identity Theft:
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Identity Theft Resource Center Fact Sheet 130 Basic Medical Identity Theft
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An example of Criminal Medical Identity Theft is a woman who gave birth to a crack addicted baby and fled from the hospital. This woman had used the name of another person. The police arrested the second woman (victim) and Child Protective Services took her children. She had to prove she had NOT just given birth. She was cleared and her children returned later that day. z
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Attempt to determine fully the situation or events that are creating the possible charges against you. { Where did the events happen? { Ask what proof they have that this person is you. For instance, you can 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 there is a condition diagnosed, you can show you don’t have a scar or that condition. For instance, the woman in the example had an exam to prove she didn’t just give birth. { Provide to law enforcement any and all proof to show that you are not the individual that was involved. Once it is determined that you were not the person they are looking for, get a letter of clearance. Keep that letter in a safe place forever. Also, make sure any criminal charges that were made are dropped at the local level. If they also forwarded them to the state level, ask to have that dropped as well. If possible, have the local prosecuting attorney switch any and all warrants from your identity to “Jane/John Doe”. It is important to get your name off the base warrant, so that you are not re-arrested, nor lose future employment.
For additional information on criminal identity theft, please read Fact Sheet 110 Criminal Identity Theft
3. Government Benefit Fraud: You apply for medical benefits but are denied because someone else is already receiving benefits. You may be told that you used up all your medical benefits for the month but you know you didn’t. Clearly someone has your information and is using it. z z z z
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Contact the governmental agency that issues your benefits, and protest the use of benefits in your name. Talk only with the fraud department. Explain the situation and that you are a victim of identity theft, or possible clerical error. Ask what steps they recommend you take. They should be able to track your medical records to see when service was provided and where. Ask that they contact those providers and help to prove it was not you. Use your physical description and an alibi of where you were when the service was provided. For example, if you don’t drive and the service was in a city 500 miles away, it is unlikely that it is you. You may have been at work, with friends, or otherwise occupied with others who can account for your activities and location for that time. Ask what service was provided. If they had surgery to remove a diseased organ, you can prove you don’t have a scar or that you still have that organ. Ask if your Social Security number was used. If so, you need to follow the steps in Fact Sheet 100 Beginning Financial Identity Theft to check your credit report. It is possible this person is also doing other things using your information. Ask to have your benefits temporarily reinstated while the investigation is going on so that you can continue to receive medical help, if necessary. Once it is determined that you were not the person they are looking for, get a letter of clearance. Keep that letter in a safe place forever.
Fact Sheet 130A - Correcting Misinformation on Medical Records
Copyright: Identity Theft Resource Center™, Inc. Jan. 2007. All rights reserved. Written by: ITRC The text of this copyrighted document may not be used or altered without the express authorization of the Id tit Th ft R C t Thi f t h t h ld t b di l f f i ll l di l
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Identity Theft Resource Center Fact Sheet 130 Basic Medical Identity Theft
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or psychological advice.
Š Copyright 2008 by Identity Theft Resource Center
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