Identity theft can have serious financial implications, and medical identity theft can be equally devastating. On top of the financial issues, medical identity theft victims can experience problems when their health insurance reaches a cap, or health information that isn't their own is documented on their medical records.
"One seems to think that the elderly are preyed upon, but that's not necessarily true," said Debi Nelson, director of the health information management department at Trinity Health in Minot. "We have seen it happen to college-aged students without insurance and to middle-aged individuals. We haven't seen it much in children."
"In the cases that we know about -- which have been very few -- it (medical identity theft) occurs for the purpose of someone else gaining drugs or services for themselves," she said.
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Katina Tengesdal/MDN - - Debi Nelson, left, shows Kelli Migler part of her electronic medical record.
An important step individuals can take to guard against medical identity theft is to check any medical bills they receive carefully.
"I think one of the things we as a public tend to do is that we don't pay close enough attention to the bills we're getting," Nelson said. "We tend not to look closely at the dates of services or the providers, and I certainly recommend that needs to be done."
In addition, keeping close track of insurance cards and drivers licenses can help prevent medical identity theft.
"If we misplace our insurance card or driver's license, we tend to replace it, but we don't report it as a theft. You should report it to the police, and the health care facility that you visit, so that facility can put an extra alert on your account," Nelson said.
Individuals should also stay alert by listening to their caregivers when they go over past medical history, Nelson explained. While a current medical visit might fill an individual with anxiety, by listening to the past history the caregiver is getting from one's medical record, any mistakes could be identified.
Once a medical identity theft has occurred, it can take longer to be cleared up than financial identity theft.
"We've had conversations with people from other parts of the state, and they have indicated frustration in getting their medical identity cleared up," Nelson said. "Medical identity theft is fairly new, so facilities have not yet amped up their efforts. But as of May 1, there is a mandate that all facilities must have a 'red flag' plan."
'Red flag' plan
Trinity Health has a plan in place to spot red flags indicating a medical identity theft might have occurred. Red flags go up when a patient calls in and indicates they don't remember receiving services that they were billed for, an insurance company raises concerns that the information isn't consistent with the patient, or the patient is giving a very inconsistent medical history from what they had before.
"There are three main groups that steal medical identities -- people within the medical system, organized crime, and friends or relatives," Nelson said.
In the case of a theft, Trinity's health information management department does an investigation, and a medical identity theft committee is convened. The first issue to be straightened out is billing, and any medical information that was released on the false patient is corrected. An alert is then put into the patient's medical record so that caregivers can be on the lookout for any attempted theft in the future.
"Through electronic health records, we can remove the parts of the medical record that are the fraudulent patient," Nelson said. "If we figure out who that person (fraudulent patient) is, we can have the information added to their true record, and if not, we can put that information into a dummy record."
Trinity also works with those who might be concerned about identity theft. For those with questions on their bill, the business office can provide dates of service and providers. If individuals still have questions, they can set up an appointment to go over their records with a patient representative, by calling 857-5339.
"We do have some false alarms, but that's OK," Nelson said. "I would much rather have that happen then miss anyone. Some of it is just a misunderstanding -- for example, the patient may not recognize the name of a specialist they didn't see, such as a radiologist or pathologist."
"For other patients, they just want to come in and review their records, and those review visits can ease their mind," she said.
Typically, in the review sessions, the patient representative will go over only the past few months of medical records. Most patients know within three to four months if they have been a victim of medical identity theft.
In addition to helping patients keep track of their records, Trinity has additional security measures in place to prevent staff from viewing unauthorized areas of a patient's medical record. Nelson feels that electronic medical records have made the job easier.
"In the past, paper records were guarded at the nurse's station or being locked up, but there were always those transition times when somebody could open up a patient's record," Nelson said.
"With electronic records, we have two forms of security," she said. "We know right away if an unauthorized person is viewing the record."