Medical Identity Theft Research Paper

Identify theft, in general, can affect a person for a lifetime. Federal law defines medical identity theft as “A fraud committed or attempted using the identifying information of another person without authority to obtain medical services or goods, or when someone uses the person’s identity to obtain money by falsifying claims for medical services and falsifying medical records to support those claims.” (“Red Flag Rule - Identity Theft Prevention Policy”, 2009). However, medical identity theft is not as easily traced compared to something such as, credit card theft. With the crime being less traceable and the ever-expanding health care system, it is not surprising that medical identity theft is continually rising. Medical identity theft accounts

Recent developments in technology have changed the delivery of health care and the system used to record and retrieve health information. In addition to using paper medical records, healthcare professionals, hospitals and insurers routinely use computers, phones, faxes, and other methods or recording and transferring information. In many instances, this information - which could include medical diagnoses, prescriptions, or insurance information - is readily available to anyone (including clerical and other staff) who walks by a fax machine or logs on to a computer. This lack of privacy has the potential to undermine patients' relationships with providers and adversely affect the quality of care. Patients may also fear that the exposure of personal health information, including the results of genetic tests that are becoming increasing available, could result in the loss or denial of health insurance, job discrimination or personal embarrassment.

Secondly, healthcare organizations should inoculate yourself by having a solid data encryption system. There are different types of data encryption for different kind of data. When the data is at rest, data encryption can be employed in multiple locations and cover structured and unstructured data. The only way to truly be safe is to encrypt the data itself. With the value of data changing over time, new data will require an immediate and new data encryption plan. When the data is in motion, it is easy for hackers to

When providers or patients submit false or misleading information intentionally to a health plan, this is fraud. Some examples of healthcare fraud and abuse include filing claims for services or medications not actually performed or obtained, billing for services for non-covered items using codes for billable services or items, altering medical records, waiving co-pays and deductibles, up coding and unbundling, using someone’s insurance card, billing Medicare patients at a higher fee than non-Medicare patients, and accepting kickbacks for referring patients, to name just a few. Fraud can be committed by hospitals, medical providers, laboratories, pharmacists, billing services, medical equipment suppliers, and even patients. Patients can protect themselves from healthcare fraud and abuse by knowing their healthcare benefits, reviewing the explanation of benefits, asking the doctor to explain the service that was given, report discrepancies, protect insurance cards and member identification numbers, beware of free services, report copayment and deductibles being waived, and never sign blank insurance forms.

Fraud and abuse encompasses the actions of fraud, abuse, and waste in the health care system (McWay, 2014). It is a nationwide problem that affects all of us and can be committed by anyone. Schemes can be committed by a single person or a by an institution or group. The National Health Care Anti-Fraud Association (NHCAA) estimates that

Hospital and health facility administrators face hardened criminals who hack medical records with ever-increasing sophistication. Hackers gain access to critical information, such as medical claims, financial data, Social Security numbers and credit card data that enable identity theft, credit card fraud and other privacy breaches. One of the major security failures in the news was the CareFirst BlueCross BlueShield attack that exposed 1.1 million of its members to thefts of their personal information.[1] Combined with high-profile breaches at Anthem and Premera Blue Cross, the breach illustrates the changing role of medical administrators

In today’s health care industry providing quality patient care and avoiding harm are the foundations of ethical practices. However, many health care professionals are not meeting the guidelines or expectations of the American College of Healthcare Executives (ACHE) or obeying the organizations code of ethics policies, especially with the use of electronic medical records (EMR). Many patients fear that their personal health information (PHI) will be disclosed by hackers or unauthorized users. According to Carel (2010) “ethical concerns shroud the

Privacy of health information has become an area of emphasis across the healthcare industry. It is important to understand what data is protected under federal regulations, how it can be shared, and how to prevent any accidental exposure of protected data. It is possible that data that should be protected can be exposed without anyone even realizing a violation has occurred. Exposure of protected healthcare data can result in medical identity theft and is therefore a very important and hot topic. The security and privacy of healthcare data is necessary to ensure consumer confidence in the healthcare industry and to prevent medical identity theft.

Get into the habit of reviewing this data every month so, should a serious problem arise, you’ve caught it before it potentially leads to an even more serious problem.

Medical identify theft is the biggest challenges face by both health care organization and patient. It is the practice in which someone uses another individual’s identifying information such as health insurance information, SSN, address, phone number and other personal information without individual knowledge or permission to obtain medial services, goods or to obtain money by falsifying claims for medical service and falsifying medical records to support those claims ( Mancini, 2014). Healthcare organization, Providers, insurance payers and patient are negatively affect by the medical identity theft. Among them, Patient are the biggest victims because they are the one who will receive unwanted treatment and medication which may be life threatening,

The first thing you can do is to closely read and monitor any explanation of benefits you get from your health insurance company. If there's anything on there you don't understand, or procedures you didn't have, you need to contact your health insurance company immediately. It could be a mistake, or it could be medical

Privacy and confidentiality are basic rights in our society. Safeguarding those rights, with respect to an individual’s personal health information, is our ethical and legal obligation as health care providers. Doing so in today’s health care environment is increasingly challenging (OJIN, 2005).

Although personal health records are done online, they are not the same as electronic health records. Personal health records are controlled by an individual or patient therefore the patient can control who has access to the record. Personal health records online are becoming more available so it will require those using them to be diligent in making sure their information is secure. Establishing a personal health record can be beneficial in that it allows the patient to better manage and become more engaged in their personal healthcare. PHR’s also allow for: co-ordination of information from multiple providers, easy access when traveling or during an emergency,

It is critical now more than ever, due to the lack sufficient security, to protect patient data in the healthcare industry. Therefore, in order to accomplish this goal, investigation into the possible causes of inadequate security as well as the other causes of healthcare breaches and cyber-threats must be explored. Without this analysis, patient data will continue to be compromised, which will cause devastating damage to both patients and healthcare organizations. From the extensive research on the outbreak of healthcare data breaches, the major factors that contribute to the increase of this issue were discovered. By thorough analysis of these factors, useful solutions will be developed to decrease the compromise of patient data as well as healthcare organizations implementing better security measures.

Second Contact one of the three major credit bureaus who will be able to work with you to find a solution.