Greg's Corner

Medical identity theft prevents crucial treatment

By Greg Collier

Imagine receiving a cancer diagnosis, only to discover that your path to treatment is obstructed by an identity theft scam. This was the reality for a patient at a free clinic in Brevard County, Florida. She had canceled her legitimate health insurance because she couldn’t afford the copays, and was depending on the clinic’s partnership with a top-tier cancer hospital to access the necessary care through an indigent care program.

When the clinic attempted to enroll her in the hospital’s financial assistance program, they discovered that someone had stolen her social security number and taken out a fraudulent insurance policy in her name. This policy was used by the scammer to earn a commission, with the premiums being paid using a tax credit and sent to a fake address. As a result, the hospital’s system showed she already had insurance, disqualifying her from the assistance program she desperately needed.

The fraudulent policy cost the patient precious time. She went months without any cancer treatment, a critical period when early intervention is paramount. The volunteer-led clinic realized the extent of the problem and sought help from the cancer hospital. However, the fraudulent policy blocked this route.

Upon uncovering the scam, the clinic’s director filed a fraud report and managed to get the fake policy canceled. They are now working diligently to expedite her access to the cancer treatment she needs. Despite this progress, the delay has already had serious implications for her health.

Medical identity theft can be difficult to prevent entirely, especially for those who are already vulnerable. However, there are several proactive steps individuals can take to help protect themselves from such scams.

Request a copy of your medical records annually from your healthcare providers to ensure there are no inaccuracies or unfamiliar services listed. Shred documents containing personal information, such as medical bills, insurance statements, and other records that include your SSN or medical details. If contacted by someone claiming to be from a healthcare provider or insurance company, verify their identity by calling the organization directly using a known phone number. Carefully review any Explanation of Benefits (EOB) statements you receive from your insurance provider. Look for unfamiliar services or charges and report any discrepancies immediately.

By taking these precautions, individuals can significantly reduce the risk of becoming victims of medical identity theft and be better prepared to address any issues swiftly if they arise.