Health insurance, by design, provides access to necessary treatments, preventive services and emergency care to individuals and families. But, sadly, now it’s also used to hand out paydays to scammers — medical fraud.
In February 2024, Change Healthcare came under cyber-attack, impacting thousands of health care providers, insurers and policyholders nationwide. Reports suggest that around 50% of all US medical claims could be at risk. Once your medical information is exposed online, these identity thieves can use it to file false claims, buy expensive prescriptions and more — all conveniently billed to your account.
The worst part is how some people are finding out they were affected. Some are facing tax or mortgage fraud, while others are going to the doctor to find out if they need a procedure, but getting denied by insurance. The insurance company will claim they won’t cover it because you’ve “exhausted your benefits from multiple other procedures this year”. But, THEY didn’t have any other procedures. Someone stole their medical ID and used it for their own benefit.
Individuals aren’t the only ones that should worry about medical fraud.
Manipulative organizations can use your medical information for fake billing schemes. These organizations submit false claims for medical services you never requested, received or knew anything about. Then, they collect their payday and stick you with the bill. In July, over 190 defendants, including 76 doctors, nurse practitioners and other licensed medical professionals, were charged for their alleged participation in several different healthcare fraud schemes. These schemes resulted in $2.75 billion in false billings to federal programs.
How Do You Know If You’re A Victim?
There are 10 signs that your medical ID may have been stolen and is currently being used by cybercriminals:
- Unexpected Medical Bills: Receiving bills for medical services you didn’t receive is a major red flag.
- Collection Notices: Being contacted by debt collectors for unpaid medical bills that aren’t yours or that you know nothing about.
- Errors In Medical Records: Finding inaccuracies in your medical records. Maybe it’s treatments you never had, incorrect diagnoses or unfamiliar medical histories.
- Insurance Issues: Your health insurance claims are denied because your benefits have been “maxed out” or you’re told you’ve reached your coverage limit, despite not using the services.
- Notification From Your Insurance Provider: Receiving alerts from your health insurance provider about claims or services you don’t recognize.
- Unknown Accounts: Discovering new health insurance accounts or medical records under your name that you didn’t create.
- Discrepancies In Your Explanation Of Benefits (EOB): Your EOB statements from your insurer list medical services you didn’t receive.
- Being Denied Insurance: Having difficulty obtaining life or health insurance because medical conditions that you don’t have are listed in your records.
- Calls From Medical Providers: Receiving calls from doctors or medical facilities about appointments or follow-ups for treatments you never had.
- Unfamiliar Prescriptions: Notices about prescriptions being filled in your name that you did not authorize or receive.
How Can You Prevent Becoming A Victim Of Medical ID Fraud?
Don’t become the next medical ID theft victim. Here are a few steps you can take to protect yourself:
- Check For Healthcare Breaches: Use a searchable database, like this one, to find out if your health care information has been compromised.
- Secure Your Records: Store paper copies of medical records in a safe or lockbox to prevent unauthorized access. If your health care organization’s system is compromised and records are lost, altered or unable to be accessed, you will be glad you did this.
- Shred Documents: Shred any documents with personal information before disposing of them, especially those with your social security number on it.
- Monitor Your Medical Records: Regularly request and review your medical records from your health care providers and look for unfamiliar treatments, diagnoses or other discrepancies.
- Review Insurance Bills: Carefully review explanation of benefits (EOB) statements from your insurance provider for any services you did not receive and question unfamiliar or unclear charges. Contact your insurer immediately if you see any charges or services that you don’t recognize. Afterward, report any billing errors to the credit bureaus at IdentityTheft.gov.
- Dispose Of Prescription Labels: Remove labels from empty prescription bottles before discarding them! These labels can contain information that, believe it or not, can be used to steal your identity.
- Monitor Your Credit: At AnnualCreditReport.com, you are able to get three (3) free reports a year to keep an eye on any suspicious activity. Some credit cards even have this monitoring service built in. Utilize it!
Health care will always be around and will also always be a target for hackers.
Attacks on hospitals, doctors’ offices and other medical facilities will continue. It’s important that you are taking proactive measures to protect yourself. Fortifi Cyber Security can help you find out how your business could be at risk with a FREE Vulnerability Scan. Using this technology, they can quickly find out if there are any “open doors” to your infrastructure and help you implement a strategic security plan to keep your company safe. To schedule your vulnerability scan, call 888-500-9111 or click here.
For all your IT needs, including creating a business continuity plan, call Atlantic Technology Services at 410-860-9899 or click here to schedule a consultation.
