It can be a nightmare for someone who becomes a victim of health-care fraud.
This crime is committed when a medical identification thief steals personal information, said Dottie Callina, a spokeswoman for Better Business Bureau Serving Metro Atlanta, Athens & Northeast Georgia Inc.
Thieves may use the information to get treatment, or cheat insurers by making false health claims, she said.
“Repairing damage to your good name and credit record can be difficult enough, but medical [identification] theft can have serious consequences,” said Callina. “If a scammer gets treatment in your name, that person’s health problems could become a part of your medical record.”
The fraud can affect a person’s ability to obtain medical care and insurance benefits, as well as affect the choices made by doctors for future treatment, she said. Unpaid medical debts caused by scammers could also affect a victim’s credit report, which could have far-reaching consequences, she added.
The good news, however, is that you can catch medical identity theft in its early stages, she said. People should read the “Explanation of Benefits” statement from their health insurer and follow up on unrecognizable items, said Callina. Customers should also, annually, ask their health insurer for a list of benefits it paid in their name.
Consumers should regularly check their credit reports, advised Callina. Georgians have the right to two free reports, a year, from Equifax, TransUnion and Experian. They can get them by visiting: www.annualcreditreport.com. For more information about consumer rights, she said, visit the Federal Trade Commission’s web site at www.ftc.gov.
Those who believe they have been a victim of medical identity theft, should ask their doctor or hospital for their medical records, said Callina. “You have the right to get copies of your current medical files from each health-care provider, though you may have to pay for them,” she said.
Consumers also have the right to get inaccurate or incomplete information removed from their records, she said. “If a health-care provider refuses [your request], you can file a complaint with the [Department of Health and Human Services] Office of Civil Rights,” she added.
Consumers can also search Georgia’s laws online by visiting the Georgetown University Center on Medical Rights and Privacy’s web site, at: http://hpi.georgetown.edu/privacy/records.html, she said. “Many hospitals have ombudsmen or patient advocates who also can help.”
To learn about your rights in the health-care system under federal law, visit the U.S. Department of Health and Human Services’ web site at www.hhs.gov.