Educating Employees on Medical Identity Fraud

Today's consumer is well-aware of the devastating effects identity fraud and theft can have on one's credit. But what most people don't realize is how the same crime can negatively affect a victim's medical history in the setting of a hospital or a doctor's office. That is why it is important for employers to become more proactive in educating their employees about medical identity fraud and how to take steps to avoid falling victim to it - especially in the wake of extended access through healthcare reform.

Medical-Records-StolenIn cases of medical identity fraud, the perpetrator would use another person's name, social security number and/or insurance information without prior consent to obtain medical goods or services or make false claims for those goods or services. This often results in erroneous information being entered into existing medical records or even the creation of fictitious medical records in the victim's name. As a result, the victim could be at risk of unnecessary financial responsibility, but even worse, additional health risks resulting from false information of things like blood type or medications or alterations of medical charts.

How does it happen? While many hospitals and physician's offices are well-equipped to protect confidential patient data, such information can be stolen by staff members, or people posing as maintenance workers or contractors - and sometimes by other patients. In a recent case near Chicago, seven people were arrested for their part in an identity theft ring involving medical records from Northwestern Memorial Hospital. The records were obtained when one of the ring leaders got a temp job as a maintenance subcontractor and was granted unsupervised after-hours access to rooms where confidential patient records were stored. Such conditions provide the perfect opportunity for medical identity theft.

Despite the risks posed by medical identity fraud, it continues to be the one of the least studied, under-documented and difficult to fix of all identity theft crimes, which is why the employer's role as a source of information can be critical to prevention. Employers can advise workers to make sure they receive a hard copy of their health records, so that even if their medical charts are altered, the employee has proof of what they used to look like.  It is also good practice to have employees monitor their own health records, specifically Explanation of Benefits (EOBs) from carriers, as well as their personal credit reports. Employers can also point their workers in the direction of valuable resources, like the World Privacy Forum, which has put together a list of helpful consumer tips on the subject.

Medical identity fraud can leave a trail of false information that can haunt your employees for years, and in this age of healthcare reform where more and more people are getting access to care, one can never be too careful in the protection of their own medical information. Often, employers can be a source of guidance in a confusing world; and the more you can communicate and educate your workforce, the better of it will be for your entire company.

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