Medical Identity Theft

Meet Katie. Katie is a healthy 32-year-old with a great job, excellent health insurance, and a snazzy sense of style. One day, Katie comes home from that great job, checks the mail, and is shocked to find a bill for a several-thousand-dollar knee replacement surgery in her mailbox. “New knee?” she frowns to herself. “I didn’t get a new knee.”

Katie has just become a victim of “medical identity theft.” Someone has stolen her private medical insurance information and passed it off as their own so they could get themselves some medical treatment. In this case it’s a new knee, but medical identity theft can be used for everything from surgical procedures to outpatient check-ups to prescription drug coverage. It’s become more prevalent now that most of our PHI (protected health information) is managed digitally.

So what can she do about it? First things first, she needs to call her insurance company and report the fraud. That’s definitely step one. It might take a while to get this mess cleared up, but it should be fairly easy for her to prove that she has not, in fact, recently installed a brand-new knee. Then, once the insurance confusion is straightened out, she should also make sure her PHI is accurate. We don’t want her medical records to indicate she’s got bad knees and has had major surgery...when she hasn’t.