When you begin receiving bills in the mail for a medical provider you’ve never seen or you are denied coverage for an appointment because you’ve exhausted your benefits much earlier than anticipated, you may assume these are clerical errors. Unfortunately, however, they are likely a sign of a much more serious issue: medical identity theft. This form of fraud can not only impact your credit score and finances but also your health information, which is why it is imperative to take the necessary steps to remedy these matters as quickly as possible. The following blog explores what you should know about how to report medical identity theft to your providers and insurance, as well as the importance of working with a Michigan identity theft lawyer to assist you through these difficult times.
What Is Medical Identity Theft and How Does It Happen?
Medical identity theft is a form of identity theft in which someone uses your personal information, like your social security number, full legal name, and date of birth, to obtain medical care in your name and under your benefits. This can leave you with unpaid medical bills and impact your insurance benefits, which can result in legal action for unpaid debts and denied coverage.
Unfortunately, this may not only impact your insurance coverage and deductibles. You may find that if someone has obtained medical care in your name, it can result in incorrect and fraudulent information on your medical reports, which can be life-threatening when you seek the care you need.
Medical identity theft most often occurs as a result of a data breach, particularly those that target insurance companies or healthcare facilities. However, thieves may also access this information through phishing scams, insider scams, and even physical theft of wallets or mail.
How Do I File a Report With My Insurance Company After Medical Identity Theft?
If you have reason to believe you are the victim of medical identity theft in Michigan, it is imperative to take the necessary steps to file a claim with your insurance company. Before calling, you should obtain copies of your medical records, as well as your insurance card and explanation of benefits statements. Next, you should call the fraud department of your insurance company to explain the situation. They will likely initiate a temporary account freeze while they investigate the claims.
You’ll also need to submit a formal statement to the fraud department explaining your circumstances and formally disputing the fraudulent charges. You should request that the insurance company issue a new member ID and invalidate the old claim number. If sending by mail, you should send this dispute through certified mail, so you can ensure you receive a receipt that your dispute was received by your insurer.
How Do I Correct My Medical Records?
In addition to contacting and filing a report with your insurance company, you should also contact your medical providers to inform them of the situation and ask them to correct your medical records. Under the Health Insurance Portability and Accountability Act (HIPAA), you have the right to review and correct incorrect information on your medical records.
To file a report, you should highlight all errors in your medical records from that provider and send a written request for the provider to remove the error or fraudulent information. You should explain that you were a victim of medical identity theft and provide the supporting documentation from the FTC report, your insurance company, and any other evidence that helps support your claim. By Law, your provider must follow up within 60 days of receiving the report.
Medical identity theft is an incredibly stressful and difficult matter to navigate, which is why working with an experienced attorney with Lyngklip & Associates is in your best interest. Our team understands how difficult these matters can be, which is why we will do everything in our power to help you through these overwhelming times. Contact us today to learn more.
