2016 Healthcare Industry Wisdom on Medical Identity Fraud Healthcare Industry Wisdom on Medical Identity Fraud is a collection of expertise by anti-fraud experts to help businesses within the healthcare industry better understand how to deal with medical identity fraud. It offers various food-for-thought on what a healthcare organization or business associate might consider when building or fine-tuning their anti-fraud programs. Topics discussed in the paper include a look at the Medical Loss Ratio mandate and how it may be affecting health plans’ ability to invest more heavily in fraud prevention, health IT issues, and patient authentication. Key points include: 1. […]

2017 Know Your Patient (KYP) Training Guide This training deck for use by healthcare providers to aid in their understanding of medical identity fraud and to inform their processes regarding patient identity. Key points include: 1. Definition of Know Your Patient and its importance. 2. Understanding your patient identity risks. 3. Identity proofing and verification, including validation checks. 4. Gathering proofing materials. It also includes a links to standards and other useful information regarding identity management. The information in the slide deck does not constitute “best practices” or “industry guidelines” and should not be viewed as such. The information may […]

If you have Medicare, you can protect your identity and help prevent health care fraud by guarding your Medicare card like you would a credit card. Identity theft arising from stolen Medicare numbers is becoming more common. Medicare is in the process of removing Social Security numbers from Medicare cards and replacing them with a new, unique number for each person with Medicare. Medicare will mail new Medicare cards with the new numbers between April 2018 and April 2019. The new card won’t change your Medicare coverage or benefits. And there’s no charge for your new card. But watch out […]

High-profile data breaches are making headlines, and affected consumers are no-doubt on high alert when it comes to their credit, banking, and brokerage accounts—but have you thought about the relation between identity theft and medical care? According to the Federal Trade Commission, medical identity theft occurs when a thief uses “your name or health insurance numbers to see a doctor, get prescription drugs, file claims with your insurance provider, or get other care. If the thief’s information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected.” If you were affected by a data […]

You check your credit and bank statements regularly, don’t give out your Social Security number to anyone, and are scrupulous about avoiding phishing emails and online scams. But have you checked your doctor’s bill lately? According to the Identity Theft Resource Center, more than 171 million Americans have had their personal records exposed to hackers between January and mid-October this year. And while run-of-the-mill ID theft is a huge hassle to deal with, most ID theft victims shelled out just $55 in 2015 to deal with the problem. On the other hand, medical ID theft victims spent nearly $13,500, including […]

Health care organizations need to proactively protect themselves and their employees because if there is a breach, their employees and patients could both be victims. Medical identity theft is on the rise and hackers are being more creative about obtaining personal medical information. Providing a comprehensive set of services around identity theft protection is a key focus for enterprises everywhere. Although you have solid security policies, your employees are still exposed due to the nature of the digital world we live in. A fraudster could use your employee’s health insurance information to receive services, which could then cause the employee’s […]

There are other dangers you should know about. Here’s how to protect yourself. If you’ve placed a security freeze on your credit reports at Equifax, Experian, TransUnion, and Innovis, that will help prevent fraudsters from opening new credit accounts in your name. But a freeze doesn’t protect you against every identity fraud threat arising from the data breach. With the information that hackers got, including access to Social Security numbers, birthdates, and an unspecified number of drivers license numbers, you need to take other steps to help lock down your finances. Social Security Benefits Crooks with your Social Security number, […]

Medicare cards are getting a makeover to fight identity theft. No more Social Security numbers plastered on the card. Next April, Medicare will begin mailing every beneficiary a new card with a unique new number to identify them. “Criminals are increasingly targeting people age 65 and older for medical identity theft,” said Medicare chief Seema Verma. “We are committed to preventing fraud.” The government is gearing up for a massive transition that will involve coordination with 58 million beneficiaries and their family members, plus hospitals, doctors, insurance companies, pharmacies and state governments. While the first mailings of new cards begin […]

Just because you freeze your file does not mean you are out of risk. Last week, Equifax announced a staggering data breach that has impacted 143 million Americans. This is considered the worst theft of consumer data in American history. Fraudsters now have access to 143 million Social Security numbers, dates of birth and address information. Putting a credit freeze on your credit bureau has become the most common advice to protect yourself. A credit freeze allows you to restrict access to your credit report, which in turn makes it more difficult for identity thieves to open new accounts in […]

Medical records are valued at 20 to 50 times more than financial identities on the black market. Medical identity theft is on the rise. Medical records are a hot target for hackers because, according to the FBI, medical identities are valued at 20 to 50 times more than financial identities on the black market. Data breaches appear to be the leading cause of this growth, and the number of data breaches continues to grow. The number of healthcare organizations falling victim to data breaches reached an all-time high of nearly 400 reported breaches in 2016, according to the Identity Theft […]

Health care organizations have increasingly become the target of hackers. The data breach of Anthem, the second-largest U.S. health insurer, was among the major headlines of 2015. The breach, which exposed private data of as many as 78.8 million customers, was the result of a cyberattacks attributed earlier this year to someone acting on behalf of a foreign government. While health care industry breaches of this magnitude may be infrequent, health care organizations have increasingly become the target of hackers. One of the reasons is the value of medical identity records on the dark web. Because they have a much […]