THE OBSTACLES THAT IMPEDE THE DEVELOPMENT OF BRAZIL IN THE CONTEMPORARY ERA A...
Medical Identity Theft
1. Consumer Affairs Branch
Fairfax County Department of
Cable and Consumer Services
fairfaxcounty.gov/consumer
Medical Identity Theft
2. Medical identity theft happens when
someone steals your personal
information and uses it to commit
health care fraud.
3. An individual has no health insurance, but needs
treatment, surgery or prescription drugs and uses
your medical information to obtain those services
People working in a medical setting submit false bills
to collect money
An individual may steal someone’s identity to hide
pre-existing medical conditions from employers or
insurance providers
4. A record is created in your name with the imposter’s
medical information
◦ Individual and family medical history
◦ Blood type
◦ History of smoking and drug or alcohol use
◦ Lab test results
◦ Diagnosis of illness, allergy, diseases or other
conditions
◦ Prescriptions
5. You receive a bill for medical services you didn’t
receive
A debt collector contacts you about medical debt that
you don’t owe
You see unrecognizable medical collection notices on
your credit report
6. Your health insurance denies a legitimate
medical claim because you’ve reached your
limit on benefits
You are denied insurance because your
medical records show a condition you don’t
have
7. Verify a source before sharing information
◦ Don’t give out personal information on the phone
or through the mail unless you’ve initiated the
contact
◦ Be wary of offers of “free” health services or
products from providers who require you to give
them your health plan ID number.
8. Safeguard your medical and health insurance
information
◦ Keep copies of your medical or health insurance
records secure
◦ If asked to share your social security number or,
insurance account information or other details – ask
WHY?
◦ Be on guard when using the internet. Read website
privacy policies and make sure the site is secure
9. Treat your trash carefully
◦ Shred health insurance forms and prescription and
physician statements
◦ Destroy labels on your prescription bottles and
packages before throwing them out
10. Read the Explanation of Benefits (EOB)
statement
◦ Medicare beneficiaries – read Medicare Summary
Notice
◦ Make sure claims match the care you received
◦ Verify the name of the provider, the date of service
and the service provided
◦ If there is a discrepancy – contact your health plan
to report the problem
11. Keep track of communications with health
plan and providers
◦ Postal and email correspondence
◦ Phone calls, conversation and activities
Order a copy of your credit reports
◦ Review carefully
◦ Law requires each reporting agency to provide a
free report annually if you ask for it
12. Annual Credit Report Request Service
P.O. Box 105281
Atlanta, GA 30348-5281
www.AnnualCreditReport.com
1-877-322-8228
www.ftc.gov/freereports
13. Ask for a copy of your medical records
◦ The Health Insurance Portability and Accountability Act
(HIPAA) Privacy Act Rule
◦ Right to copies of your records that are maintained
by health plans and medical providers covered by
the law
◦ Required to give you your files within 30 days after
you ask for them
◦ Make a request to each provider
14. Make a request to each provider
◦ Doctors
◦ Clinics
◦ Hospitals
◦ Pharmacies
◦ Laboratories
◦ Health Plans
A written request and a fee for the records
may be required
15. If you are denied access to your records – you
must be provided a reason in writing
◦ You have the right to appeal if your request is
denied
◦ Contact the Person identified in the Notice of
Privacy Practices
◦ US Department of Health and Human Services’
Office for Civil Rights – www.hhs.gov.ocr
16. Obtain a copy of the accounting disclosures
for your medical record
◦ Date of the disclosure
◦ Name of the person or entity who received the
information
◦ Brief description of the information disclosed
◦ Brief statement of the purpose of the disclosure
The law allows one free copy of the
accounting from each of your providers every
12 months
17. U.S. Department of Health and Human
Services, Office of Civil Rights at
www.hhs.gov/ocr
World Privacy Forum at
www.worldprivacyforum.org/FAQ_medical
recordprivacy.html
18. File a complaint with the Federal Trade
Commission
◦ https://www.ftccomplaintassistant.gov
◦ 1-877-ID-THEFT (438-4338)
◦ TTY 1-866-653-4261
19. File a report with your local police
◦ Send copies of the report to
your health plan’s fraud department
Your health care provider(s)
The three nationwide credit reporting companies
More information about how to file a police
report is at
www.ftc.gov/idtheft/consumers/defend.html
20. Exercise your right under HIPAA to correct
errors in your medical and billing records
◦ Write to your health plan or provider detailing the
information that seems inaccurate
◦ Include copies (keep originals) of any document
that supports your position
◦ Identify each item in your record that you dispute
◦ State the facts and reasons for disputing the
information
◦ Request that each item be corrected or deleted
21. Exercise your right under HIPAA to correct
errors in your medical and billing records
◦ Request that each item be corrected or deleted
◦ You may want to include a copy of your medical
record with the items in question circled
◦ Send your letter by certified mail and ask for a
“return receipt”
◦ Keep copies of the dispute letter and enclosures
22. Generally the health plan or medical provider
must respond
◦ The creator of the information is obligated to
amend the inaccurate or incomplete information
◦ It should notify other parties, like labs or other
health care providers, that they may have received
incorrect information
◦ If the investigation does not resolve your dispute –
request that a statement of the dispute be included
in your record
23. Fraud Alert – can help prevent an identity
thief from opening additional accounts in
your name
Contact each of the three nationwide credit
reporting companies
◦ TransUnion
◦ Equifax
◦ Experian
24. Security Freeze – also known as a credit
freeze, is a warning to businesses or others
who may use your credit file. It locks down
your credit file and blocks access by potential
creditors
◦ Does not affect your credit score
◦ Does not keep you from obtaining your free annual
credit report
◦ Does not keep your from buying your credit report
or score
It can be temporarily lifted or removed by
request
25. Center on Medical Record Rights and
Privacy
Health Policy Institute
Georgetown University
Box 57144
Washington, DC 20057-1485
202-687-0880
http://ihcrp.georgetown.edu/privacy/records.html
26. World Privacy Forum
2033 San Elijo Avenue, #402
Cardiff by the Sea, CA 92007
760-436-2489
www.worldprivacyforum.org
27. U.S. Department of Health and Human
Services
Office of Civil Rights
200 Independence Avenue, SW
Washington, DC 20201
www.hhs.gov/ocr
www.fairfaxcounty.gov/consumer
28. Medical Information Bureau (MIB)
Has records of individuals that have applied for
individual insurance in the last seven years with
an MIB Member
Get a copy of your MIB consumer file annually
without charge
Phone 866-692-6901
TTY 866-346-3642
www.fairfaxcounty.gov/consumer
29. Fairfax County Financial Crimes Division of the
Fairfax County Police Department
703-246-7800
http://www.fairfaxcounty.gov/police
www.fairfaxcounty.gov/consumer
30. Virginia Department of Health Professions
Enforcement Division
6603 West Broad Street, 5th Floor
Richmond, VA 23230-1712
800-533-1560
804-662-7079
www.dhp.virginia.gov
www.fairfaxcounty.gov/consumer