Medical identity theft has been a growing issue for some hospitals and other medical facilities. It has become the fastest-growing type of identity theft in the world and an estimated 2 million people become a victim of identity theft each year while more than 5,300 physicians have listed themselves as having to track medical identity theft.
This occurs when “someone uses a person’s name and sometimes other parts of their identity- such as insurance information-without the person’s knowledge or consent to obtain medical services or goods, or uses the person’s identity information to make false claims for medical services or goods”.
There are two types of medical identity theft: (1) patient identity is copied and (2) physician’s professional identities being stolen. The latter type is more damaging to the medical community since this affects their reputation and professional records. To remedy this, the victimized physicians need to spend a lot of time and money in order to clear their names from previously bad records branded to them by identity thefts.
Legal cases could also be filed against the physician and the institution as mandated by the Health Insurance Portability and Accountability Act for their lapse in protecting the confidential data of their patients. This also involves the loss of trust of the patient with his/her attending physician and the medical institution.
On the other hand, when patient identity theft is committed, the physicians are not the only ones who face the repercussions. Grave medical mistakes could be an outcome of these crimes as medical errors and bad outcomes can be the result when two patients are believed to have the same identities. That is not the only consequence for the patients however, they too could end up spending a hefty sum to clean up the damage to their own identity and credit when theft is committed by unscrupulous institution personnel.
We are all victims when medical identity theft occurs even those of us who are not directly involved since it also involves the loss of public funds in cases of medicare or other government programs. Because public funds are not limitless there is the human cost of those who may not get the medical treatment they need. Plus the cost to the private sector is then passed onto the consumer via higher policy premiums. Clearly, you can see how this affects us all, and therefore it should be taken seriously and reported immediately.
Medical identity theft could be easily identified unlike other forms of identity theft. All it takes is for the physician and patients to connect the dots linking to the clues. In order to fight off medical identity theft, the cooperation of patients, employees, and other involved individuals are needed. Everyone must be aware of what medical identity theft is and how to detect it. Some of the measures that may be taken in order to avoid id theft in hospitals include the following according to Dolan, P.L of American Medical News:
1. Be wary of calls asking for the medical conditions and personal information of patients. If doctors receive suspicious calls asking for confidential information about their patients without permission from the patient, it should be an immediate warning sign that this is a possible case of identity fraud.
2. Unfamiliar names on Medicare summary notices and explanation of benefits documents from private insurers should also be noted. This may be seen by reviewing these notices sent for services that were never performed or payments which were not received. If a case would be tracked down, Medicare and other authorities must be immediately notified.
3. Do routine checks of Medicare’s Provider Enrolment, Chain, and Ownership System. This provides a list of medical practices performed by the physician so any entry that was listed which he/she has not performed should be immediately reported for investigation.
4. Ask for two pieces of identification. The front desk or the receiving area of a hospital serves as the first line of defense against criminals such as identity thieves. Patients checking in should be checked for their IDs. If they present an insurance card with no photo or if the identification looks fake or the descriptions do not match, be wary.
5. Ask for referral sources. This is especially applicable for first-time patients since generally, they would be only visiting a hospital looking for a particular physician if they were referred to it. These referrals could be used to establish the identity of the person.
6.Check for inconsistencies in records. This can be easily done at present due to the advancement of health information exchanges. Hospitals could now access patient’s records from another facility by asking for this information from the facility it makes it easier to track down any discrepancies in their medical conditions.
When medical identity theft is suspected, the first thing that doctors should do is to report it to their insurer to call for an investigation. For patients, they should also immediately report this to their medical plan companies.
A good reputation and credibility are very important in the medical field. Identity theft in hospitals could easily cause the loss of these so extreme precautions should be taken by the practitioners, patients, and health care organizations. The general public should also understand how this affects us all; it is by no means a victimless crime.