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A Practical Guide to Protecting Yourself from Medical Fraud

10 Indicators to Monitor and How to Protect Yourself

Health insurance is designed to provide essential treatments, preventive services, and emergency care, but it has also become a lucrative target for scammers. In February, Change Healthcare experienced a cyber-attack that put around 50% of all U.S. medical claims at risk. The consequences are severe—identity thieves can use stolen medical information to file false claims, buy expensive prescriptions, and leave you with the bill. Many people only discover they’ve been affected when they face tax fraud, mortgage issues, or are denied legitimate medical procedures because their benefits have supposedly been exhausted.

It’s not just individuals who need to be cautious; unscrupulous organizations can exploit your medical information in fake billing schemes. They submit false claims for services you never received, collect the payout, and stick you with the financial burden. In July, 193 defendants, including medical professionals, were charged for their involvement in healthcare fraud schemes that resulted in $2.75 billion in false billings to federal programs. Medical fraud is a widespread and growing problem.

How Do You Know If You’re a Victim?

Here are ten warning signs that your medical ID may have been stolen and is being used by cybercriminals: 

  1. Unexpected Medical Bills: Receiving bills for medical services you didn’t receive is a major red flag.
  2. Collection Notices: Debt collectors contacting you for unpaid medical bills that aren’t yours.
  3. Errors in Medical Records: Finding inaccuracies in your medical records, such as treatments you never had, incorrect diagnoses, or unfamiliar medical histories.
  4. 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.
  5. Notification from Your Insurance Provider: Alerts from your health insurance provider about claims or services you don’t recognize.
  6. Unknown Accounts: Discovering new health insurance accounts or medical records under your name that you didn’t create.
  7. Discrepancies in Your Explanation of Benefits (EOB): Your EOB statements from your insurer list medical services you didn’t receive.
  8. Being Denied Insurance: Difficulty obtaining life or health insurance due to medical conditions that you don’t have being listed in your records.
  9. Calls from Medical Providers: Receiving calls from doctors or medical facilities about appointments or follow-ups for treatments you never had.
  10. Unfamiliar Prescriptions: Notices about prescriptions being filled in your name that you did not authorize or receive.

How Can You Protect Yourself from Medical ID Fraud?

Don’t let yourself become the next victim of medical ID theft. Here are some proactive steps you can take to protect yourself:

  • Check for Healthcare Breaches
    Use searchable databases to find out if your healthcare information has been compromised.
  • Secure Your Records
    Store paper copies of medical records in a safe or lockbox to prevent unauthorized access. If your healthcare organization’s system is compromised, you’ll be glad you have these backups.
  • Shred Documents
    Shred any documents containing personal information before disposing of them.
  • Monitor Your Medical Records
    Regularly request and review your medical records from healthcare providers to 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 any unfamiliar or unclear charges. Contact your insurer immediately if you see any charges or services 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 can be used to steal your identity.
  • Monitor Your Credit
    At AnnualCreditReport.com, you can obtain three free reports a year to keep an eye on any suspicious activity.

Healthcare will always be around, and so will the threats posed by hackers. Attacks on hospitals, doctors’ offices, and other medical facilities are likely to continue. It’s crucial to take proactive measures to protect yourself. We can help you determine if you’re at risk with our FREE Dark Web Scan. Using this technology, we can quickly find out if your information has been put up for sale on the dark web or if you’ve been a victim of a data breach. To book your Dark Web Scan, call us at 505-792-2375 or click here.