Health insurance is meant to provide access to necessary treatments, preventive services, and emergency care for individuals and families. Unfortunately, it has also become a lucrative target for scammers.

Earlier this year, Change Healthcare suffered a cyber-attack that impacted thousands of healthcare providers, insurers, and policyholders across the nation. Reports indicate that up to 50% of all U.S. medical claims could be at risk! To put that into perspective, if you're sitting in a waiting room with nine other people, there’s a good chance that five of you could become victims of medical identity theft within the next year. The fallout from such fraud is severe, affecting countless individuals and their access to healthcare. Once your medical information is exposed online, identity thieves can use it to file false claims, purchase expensive prescriptions, and more—all charged to your account.

The worst part is how some people are discovering they've been affected. Some are dealing with tax or mortgage fraud, while others go to the doctor for a procedure only to be told by their insurance provider that their benefits have been exhausted due to multiple procedures they never had. This is because someone stole their medical ID and used it for their own treatments.

It’s not just individuals who are at risk; fraudulent organizations can also exploit your medical information for fake billing schemes. They submit false claims for medical services you never requested, received, or even knew about, collecting their payday while sticking you with the bill. In July, 193 defendants—including 76 doctors, nurse practitioners, and other licensed medical professionals—were charged for their involvement in several healthcare fraud schemes, resulting in $2.75 billion in false billings to federal programs. Medical fraud is a real and present danger.

How to Recognize Medical Fraud

Here are 10 signs that your medical ID might 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.
  1. Collection Notices: Being contacted by debt collectors for unpaid medical bills that aren’t yours.
  1. Errors in Medical Records: Finding inaccuracies in your medical records, such as treatments you never had, incorrect diagnoses, or unfamiliar medical histories.
  1. Insurance Issues: Having your health insurance claims denied because your benefits have been maxed out, despite not using the services.
  1. Notification from Your Insurance Provider: Receiving alerts from your health insurance provider about claims or services you don’t recognize.
  1. Unknown Accounts: Discovering new health insurance accounts or medical records under your name that you didn’t create.
  1. Discrepancies in Your Explanation of Benefits (EOB): Noticing that your EOB statements list medical services you didn’t receive.
  1. Being Denied Insurance: Struggling to obtain life or health insurance due to medical conditions listed in your records that you don’t actually have.
  1. Calls from Medical Providers: Getting calls from doctors or medical facilities about appointments or follow-ups for treatments you never had.
  1. Unfamiliar Prescriptions: Receiving notices about prescriptions being filled in your name that you did not authorize or receive.

How to Protect Yourself from Medical ID Fraud

Don’t become the next victim of medical ID theft. Here are a few steps you can take to safeguard your information:

  • Check for Healthcare Breaches: Use a searchable database 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 did this.
  • Shred Documents: Shred any documents containing personal information before disposing of them.
  • Monitor Your Medical Records: Regularly request and review your medical records from your healthcare providers. Look for unfamiliar treatments, diagnoses, or other discrepancies.
  • Review Insurance Bills: Carefully review your Explanation of Benefits (EOB) statements from your insurance provider. Question any services you did not receive and contact your insurer immediately if you see charges or services you don’t recognize. 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 could be used to steal your identity.
  • Monitor Your Credit: Obtain three free credit reports a year from AnnualCreditReport.com to keep an eye on any suspicious activity.

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. We can help you find out how 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 985-871-0333 or click here.