It can rob a patient’s health and jeopardize a provider’s good-standing, too.

Identity theft is a hot topic in the field of medical fraud. According to research on privacy, data protection, and information security policy conducted by Ponemon Institute, more than 2.3 million people have been victims of medical identity fraud. This trend is on the rise, with nearly a 22 percent increase in 2015 over the previous year’s estimate. That’s approximately 500,000 new cases of fraud in one year. This year, the Ponemon Institute estimates that data breaches will cost the healthcare industry $6.2 billion.

Defining Medical Identity Theft
The most common type of medical identity theft is the misuse of a patient’s identity information to obtain medical goods or services without (or sometimes with) the victim’s knowledge. This kind of fraud can affect the individual, as well as the healthcare providers and facility. In addition to financial repercussions, medical identity theft can cause tremendous damage to the patient-provider relationship.

The Cost of Medical Identity Theft
The cost of medical identity theft can be measured in financial terms and in terms of its impact on the patient-provider relationship. On average, the Ponemon study found that it cost the victim approximately $13,500 to resolve an incident (when they were able to resolve it). Often, the respondents were victims of more than one type or instance of fraud. There is also the potential for serious health impacts. For example, the consequences of having the wrong blood type in the patients’ medical record could be devastating.

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December 1, 2016 By Edie Hamilton, AAPC