Medical identity theft occurs when a person uses someone else's identity to obtain medical services or medications. The problem is widespread, with the Federal Trade Commission estimating that 10 million Americans have their identities stolen each year, with 3 to 5 percent of these thefts involving theft for medical purposes.
"We're seeing more of it now than we did five years ago. People are getting more desperate with the financial downturn. Those who would never steal something from a store don't see it as illegal to borrow someone's medical insurance, not realizing the devastating and unsafe effects it might have," said Debi Nelson, Director of Health Information Management and Privacy Officer for Trinity Health.
Nelson has spoken to service clubs and organizations to raise awareness of the problem, which has occurred around the state and at Trinity Health.
"The awareness level isn't as high as it should be. In our conservative, trust everyone culture, people don't want to be aware that this type of theft is going on," Nelson said.
Medical identity theft is most commonly committed by relatives of the victim, who have access to documents or have knowledge of a victim's medical history. Others include insiders such as health-care workers, and organized crime rings or general thieves. Nelson said North Dakota hasn't had any reports of medical theft by health-care workers.
For victims of theft, the results can be devastating. They may lose health insurance coverage because of bills run up in their name, or they may have health conditions noted in their medical reports that aren't theirs, causing them to be at a medical risk.
Nelson offered tips for people to help prevent medical identity theft, such as never lending your Social Security number, driver's license, or health insurance cards to someone else; reporting the theft or loss of cards to your medical facility; periodically checking your insurance claims and reporting suspicious activity; and reviewing your medical records.
Nelson explained that Trinity Health has a red flag alert system put into place to spot medical identity theft. Red flags that indicate theft include a patient receiving a bill for another individual, receiving a bill for a product or service the patient never received or from a provider the patient never patronized, or a medical record that is inconsistent with a patient's physical examination or reported medical history.
"We want to encourage people to check their bill. There are cases where patients don't remember when they received a service, but we are able to discuss it with them and verify it," Nelson said.
"When the physician is going through their medical history, it is another key place to make sure it's the correct information. Don't hesitate to call if you've been to the doctor and something sounds weird to you," she added.
If the claims have been checked out and discussed, and medical identity theft is found, Nelson's department takes action to correct it. The patient's medical and billing records are reviewed. Any incorrect medical information that has been added to a patient's medical record is removed and placed into the correct record if that record is known, or is removed and put in a "dummy record."
Patients are also encouraged to file a police report reporting the theft. If narcotics were obtained as a result of the theft, the police may be notified by Trinity's Health Information Management department.
As a further deterrent to medical identity theft, Trinity has also begun checking photo ID's for patients visiting the Emergency Trauma Center, as well as new patients who visit the walk-in clinics and retail pharmacies.