Medical ID Theft: Pitfalls for Physicians

ID theft, medical ID theft

Imagine an emergency room trip where a patient is in pain. The ER physician checks his files and discovers that the patient is a drug-seeker and denies care. The only problem, the patient’s account has been hacked to procure drugs illegally and the patient legitimately needs medical care.

A twist on the above scenario: a physician is dropped from a private insurer. When he inquires why, he discovers it’s for prescription irregularities. Someone has used his medical license number and name to prescribe drugs illegally.

Hackers and other hucksters are making in-roads into medical ID theft. According to the US Department of Health and Human Services, medical ID theft occurs when a physician or patient loses control of their medical information. The information can be used to buy drugs, falsify claims, or seek medical care under a patient’s name.

Doctors and patients can both be victims

According to this month’s Kiplinger’s Magazine, 1.85 million Americans got caught up in medical ID theft in 2012. Physicians also can be ensnared in the chaos. If thieves get a hold of medical license numbers they can falsify patient records and prescriptions. Physicians can be victims from their own office employees, from billing agents, hackers obtaining data, or even from patients.

Physicians could potentially open themselves up to problems with reimbursements, and damage to their professional reputation.   According to one report, resolving cases of medical identity theft can cost about $22,346 per physician and can take more than a year.

How physicians can protect themselves

The American Medical News recommends the following protective steps:

  • Review Medicare remittance notices
  • Look for inconsistencies in patient health records
  • Ask for two pieces of ID when bringing new patients into your practice
  • Ask patients how they were referred into the office
  • Educate patients about protecting their own identity

While any identify theft can cause problems, medical ID theft can affect patient outcomes and a physician’s livelihood. If you’re not sure how to clear up issues quickly talk with a lawyer or accountant for assistance.

As a physician have you cared for a patient who was the victim of medical ID theft? Has anyone ever used your medical license number to procure treatment illegally? We will be discussing this more inside Sermo. If you’re an M.D. or D.O. please join us.

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