Medical Identity Theft, Trusted Insiders, Billing Architecture
Although medical identity theft existed 30 years ago, it’s easy to see why it was not much of a big issue. Back then, there were no computers to gobble up all the medical history information that was being charted by doctor’s, nurses, pharmacies, and insurance companies, that there is today. Instead, professionals kept paper records on each patient, documenting all of their important medical information. It would have been difficult for someone to walk unnoticed out of a medical office with boxes full of patient records so that they could in turn sell that information to medical-identity theft rings, who could then go on to sell the records to those who would use them to erroneously get medical treatment or submit fraudulent insurance claims.
Today, thanks to the computer systems used in the medical industry, it’s a whole other picture. Now, someone can simply use a sleek computer device, such as an iPod, portable computer storage device, or laptop, to steal the medical identity files of millions of people at once, without ever being noticed or stopped, for the most part. The systems used in medical offices allow users to network and store information. The digital architecture being used may make things more efficient when it comes to creating and storing patient records and histories, but it also makes stealing that information much easier to accomplish.
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Consumers are the innocent bystanders in all of this; they simply go to the doctor or other medical professional, seeking assistance. Once there, they provide their personal information to the person who asks for it, because they trust that the professionals in question are going to do the right thing with the data. Little do they realize, it’s the “trusted” people that are responsible for much of the medical identity theft that takes place. There are theft rings that make arrangements with insiders to purchase the information, as well as individuals who appear to be working innocently enough in the medical office, simply to gain access to such valuable information. As a case in point, the U.S. Department of Justice issued a press release in November of 2006, announcing that a former insurance representative for a medical billing company was being indicted on charges of stealing the medical identities of over 400 patients. In the theft, that representative was accused of stealing such information as patient names, dates of birth, Social Security numbers, addresses, hospital admission dates, doctors’ names, and diagnosis codes.
People may think that they are only handing their personal information to the receptionist at the doctor’s office. Little do they realize that, according to the World Privacy Forum, a nonprofit research organization, the current architecture of the medical billing system allows for tens of millions of individuals to have access to that data. This is due, in part, to the co-mingling of payment and treatment systems within the medical community. The organization also reports that this type of fraud is rampant, accounting for up to an estimated 10 percent of all health-care costs, or 80 to 120 billion dollars of loss per year.
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As you can see, medical identity theft is big business. While the powers that be are working to organize, streamline and make patient records more accessible to those professionals that legitimately need them, the information is still, for the most part, unprotected and is being compromised at an alarming rate. Of course, medical records need to go the way of digitization; it only makes sense, in the world we live in today. But stronger efforts to prevent medical identity theft must be taken. Until that happens, people will continue to be victimized by an architectural system that allows it to happen. Patients will also continue to be on their own when it comes to their efforts to keep their personal information secure. Luckily, there are several companies today that are offering protective options to consumers.
