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Robo de identificación médica

Robo de identificación médica

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El robo de identidad médica se produce cuando alguien roba o utiliza su información personal (como su nombre, número de la Seguridad Social o número de Medicare), para presentar reclamaciones fraudulentas a Medicare y otras aseguradoras de salud sin su autorización. Un ladrón puede utilizar su nombre o los números de su seguro médico para ver a un médico, obtener medicamentos recetados, presentar reclamaciones a su proveedor de seguros u obtener otro tipo de atención. Si la información sanitaria del ladrón se mezcla con la suya, su tratamiento, sus registros de seguros y pagos y su informe de crédito pueden verse afectados.

Los signos de robo de identidad médica incluyen:

  • a bill for medical services you didn’t receive.
  • a call from a debt collector about a medical debt you don’t owe.
  • medical collection notices on your credit report that you don’t recognize.
  • a notice from your health plan saying you reached your benefits limit.
  • una denegación del seguro porque su historial médico muestra una enfermedad que no tiene.

Cómo se comprometen los historiales médicos:

Your medical records can be a mix of a criminal's information and your stolen personal identifiable information (P.I.I.).  Data breaches and dark web marketplaces are the most common sources of stolen medical information.  Breaches of unsecured protected health information affecting 500 or more individuals are reported to the U.S. Department of Health & Human Services.  

Haga clic aquí para ver una lista completa de todas las violaciones de datos comunicadas que afectan a los historiales médicos personales.  

Consejos para los consumidores

  • No facilite información innecesaria - Puede que no parezca una petición peligrosa, pero permitir que el consultorio médico fotocopie su carné de conducir o su tarjeta de crédito no es una medida inteligente, y a menudo ni siquiera es necesario para recibir los servicios. Si en la recepción le piden algo más que su tarjeta de seguro, pregunte por qué la necesitan y cómo piensa el consultorio proteger su información. Si no te sientes cómodo con su respuesta, no les des tu documento de identidad ni tu tarjeta de crédito.
  • Read every explanation of benefits - These statements are documents sent by your insurance company that lists medical services you received and how those services were paid for.  They are complicated and can be difficult to interpret, especially for those with multiple health conditions and frequent visits to providers. Look at things like dates of service or provider names. If you see something you don't recognize, follow up right away.
  • Get a copy of your medical records - Under the Health Insurance Portability and Accountability Act (HIPAA), you are legally entitled to a copy of your medical and billing records held by health plans and providers.  Once you have these records, keep them somewhere safe and add new information each time you visit a doctor. This way you'll have proof that it was altered if someone begins using your information illegally.
  • Online Access to Your Health Informationhttps://www.healthit.gov/topic/patient-access-information-individuals-get-it-check-it-use-it

    Some hospitals, doctors’ offices, and clinics may provide access to a website that stores the personal medical records of their patients. Depending on the website’s features and functions, you may be able to view your test results or a list of your medications, access your medical records, schedule appointments, obtain follow-up instructions, pay bills and refill prescriptions. Check with your providers or physicians to see if they offer online access to your medical records. Terms sometimes used to describe electronic access to these data include “personal health record,” “PHR”, or “patient portal.”
  • Ask for corrections if there are errors in your health information:
    Write to your health plan and medical providers and explain which information is not accurate. Send copies of the documents that support your position. You can include a copy of your medical record and circle the disputed items. Ask the provider to correct or delete each error. Keep the original documents.  Send your letter by certified mail, and ask for a “return receipt,” so you have a record of what the plan or provider received. Keep copies of the letters and documents you sent.

    The health plan or medical provider that made the mistakes in your files must change the information. It should also inform labs, other healthcare providers, and anyone else that might have gotten the wrong information. If a health plan or medical provider won’t make the changes you request, ask it to include a statement of your dispute in your record.
  • Revise periódicamente los informes de crédito.
  • Mantenga el control de las tarjetas de identidad médica. La pérdida o el robo de las tarjetas de Medicare y de la Seguridad Social debe comunicarse inmediatamente a la Administración de la Seguridad Social. 
  • Review everything - This includes medical benefit explanations, medical bills, and prescription invoices and reports questionable charges or fraud.
    Questionable Charges?  Contact your healthcare provider first to see if it's a mistake. If your issue is not resolved by your provider, report the questionable charges to 1-800-MEDICARE or contact your local Senior Medicare Patrol for assistance: 1-877-808-2468 or www.SMPResource.org.



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