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Lessons and stories from the front lines of fighting identity theft.


Medical Fraud: Dangerous or Benign?

Oct 21


How much do you know about how medical bills affect your credit? Some folks believe they don’t affect your credit scores at all, while others believe they do. Those on both sides of the issue are right, in a way: medical bills paid on time don’t affect your credit scores, but unpaid medical bills sent to a collection agency can negatively impact your credit scores.

That’s good to know for starters, but what about medical fraud? Is it widespread enough to be something you should be concerned about, or is it not yet happening enough to worry about? According to the Federal Bureau of Investigation, medical fraud is a rising threat – currently costing the country tens of billions of dollars annually, so it’s not an uncommon occurrence.

Identity thieves are expanding their focus into many different types of information theft, with medical fraud being among the fastest-growing. Medical fraud occurs when someone other than you uses your name or your health insurance information to obtain medical care or a prescription. “If the thief’s health information is mixed with yours, your treatment, insurance and payment records, and credit report may be affected,” the Federal Trade Commission explains.

Make sure you review your medical and insurance statements on a regular basis, and maintain either a digital or hard copy as a resource you can refer to. When you pay attention, it’s possible to spot early indicators of medical identity theft if you know what to look for. Some of those signs include:

  • A bill for medical services you did not receive
  • A call from a debt collection agency about a medical debt you know you don’t owe
  • Medical collection notices for debts you do not owe appearing on your credit report
  • A letter from your health insurance provider stating that you have reached your benefit limit when you know you have not done so, and
  • Being denied for insurance based on factors that do not apply to you

Under ordinary circumstances, these discrepancies might just be enough to make you scratch your head – but now you know they can actually be indicators of something more serious at work.

“The consequences of financial identity theft are bad enough,” asserts Experian’s ProtectMyID, “but medical identity theft carries the extra danger that errors in your medical file could lead to a misdiagnosis or mistreatment when you seek medical care in the future. Even if changes to an individual’s medical records are not a deliberate part of the thief’s scam, they may nonetheless be the result.”

With healthcare coverage comes a flurry of documentation that explains coverage, charges and benefits. The good news is that, while the amount of information can sometimes feel excessive, it provides a solid framework to check for fraudulent or suspicious entries. But occasionally it’s not enough simply to scan over your medical information alone. One of the most effective and proactive ways to combat medical fraud is to also monitor your credit report closely in tandem with your medical records review. Reviewing your credit report periodically and considering a credit monitoring product are two ways you can work improve the frequency of your interactions with your credit.


This article is provided for general guidance and information. It is not intended as, nor should it be construed to be, legal, financial or other professional advice. Please consult with your attorney or financial advisor to discuss any legal or financial issues involved with credit decisions.

Published by permission from, Inc., an Experian company. © 2015, Inc. All rights reserved.