Your medical records have more value on the black market than your social security number...technology can certainly help with query based software that can immediately alert activity outside the normal realm of business...information can be both text and pictorial based with charts that analyze information in real time..if you wait for paper methodologies these days, it's too late..and as the article states once fraudulent information is added to a legitimate medical record, it's just something else one needs to battle with insurance coverage...as it appears the burden of responsibility is on the patient with seeking out advocacy help in many instances, which will also usually come at a cost to the consumer...BD
Dixon said there is a black market for medical records, with the police reporting that a person's medical records can sell for about $50 on the street, compared with a dollar or two for Social Security numbers.
The records are used by fake clinics to file fraudulent claims so that they can bilk insurance companies out of millions of dollars.
Kenneth Faustine, director of special investigations at Cigna, said he is seeing more of these types of schemes. Criminals typically buy 1,000 medical records and set up a post office box to collect checks, he said. They hit quick, and by the time anyone realizes it, they [have] shut down," he said.
Faustine said Cigna developed a computerized system that helps detect such fraud. For example, if a certain doctor typically sends in 100 claims a month, the system will prompt an investigation if that doctor suddenly submits 500 claims.
It's difficult to remove erroneous information from medical records, Dixon said, because some health-care providers are reluctant to change records out of fear of violating federal health and privacy laws.
newsobserver.com | Doctors' offices try to ward off medical identity theft
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