Combating the rising tide

of medical identity theft
Medical Identity Theft spreads the pain
Medical identity theft is a growing crisis, striking
an estimated 1.5 million Americans last year
alone.
1
As new federal regulations incentivize
healthcare providers to move from paper to
online records, healthcare networks of all
sizes have become increasingly vulnerable to
medical data breaches.
A healthcare data breach can be a gold
mine for identity thieves, resulting in scores
of victims’ health insurance information and
other Protocted Health Information (PHI) being
sold on the black market. Networks of thieves
have developed elaborate scams, such as
creating false health care companies and billing
medicare for millions of dollars in services.
Awareness of medical identity theft
Medical identity theft is very difficult to detect,
which makes this form of fraud extremely
dangerous. More than 50% of medical identity
theft victims don’t discover they’re a victim until
at least a year after the incident occurred –
usually when they receive a collections notice in
the mail.
2
The following are a few examples that would
trigger an indication of potential medical
identity theft:
· V¦c¦¦n ¦s sen¦ an ¦nsUrance conrany
Explanation of Benefits statement (EOB) for
services that the victim did not receive
· V¦c¦¦n ¦s re¦Useo nea¦¦n ¦nsUrance oUe ¦o
“pre-existing condition” that the victim does
not have
· V¦c¦¦n ¦s oen¦eo creo¦¦ or a ¦oan oUe ¦o an
outstanding medical service bill that he/she
is not aware of
Who are medical identity thieves?
Medical identity thieves may be dishonest
people working in medical environments with
access to patients’ insurance and personal
information. They may be hackers stealing
people’s information online – a practice known
as “phishing”. Often times, medical identity
thieves are family members of their victims.
Most recorded data breaches can be attributed
to employee theft or mismanaged data
practices, often at the hands of disgruntled
or departing staff. Healthcare organizations
experience a high annual churn rate of
employees of 6.5 percent which is almost
double the national cross-industry average
turnover rate of 3.6 percent, according to the
Ponemon Institute.
3
Meanwhile, the expanded use of electronic
health records initiated by HITECH (Health
Information Technology for Economic and
Clinical Health Act) has increased the amount
of mobile data, opening the door for large scale
data breaches.
The cost of medical identity theft
According to a national Ponemon Institute
survey, it costs the average victim more than
$20,000 to resolve a case of medical identity
theft.
4
For organizations, the cost of medical
identity theft can be even more severe.
The average expense incurred for a company
to address a medical data breach is $211 per
record. Additionally, the research indicates
that those companies that do not closely follow
the new regulatory requirements established
through the HITECH Act can incur fines up to
$1.5 million.
5
This does not include any possible
civil suits or loss of brand equity.
Medical identity theft is very
difficult to detect, which makes
this form of fraud extremely
dangerous. More than 50% of
medical identity theft victims
don’t discover they’re a victim
until at least a year after the
incident occurred.
1
National Study on Medical Identity Theft, Prepared by Larry Poneman, April 30, 2010
2
The Poneman Institute in February 2010.
3
The Ponemon Institute Annual Study, “U.S, Cost of a data Breach.” February 2008
4
National Study on Medical Identity Theft, Prepared by Larry Poneman, April 30, 2010 Page 1
Protecting your brand
In the healthcare industry, a company’s name
is everything. When consumer trust is lost, the
impact on your company’s bottom line can be
severe. Deterring and detecting data breach
threats does not happen by chance. Leading
healthcare companies are taking advantage
of new processes and proven solutions used
in other industries, namely financial and
credit markets, to prevent data breaches from
occurring. However, it is possible that even with
precautionary measures data breaches can
happen.
Experian’s Fraud Resolution Team is
trained to diagnose and treat the often
debilitating crime of medical identity theft.
Experian
®
Data Breach Resolution employs a
powerful combination of tools to help victims
of fraud stop medical identity theft cold.
From monitoring to detection and resolution,
Experian has the experience and resources
to act as a partner in the fight against medical
identity theft.
Surveillance Alerts™
Experian’s Surveillance Alerts* monitor
for delinquent accounts linked to medical
providers, catching the crime as soon as
possible. Identifying medical identity theft early
allows the victim to stop further damage and
begin the process of resolving the situation so
the loss is minimized.
Fraud Alerts
Where there is evidence of fraudulent activity,
the Experian Fraud Resolution Agents can
place Fraud Alerts on individuals’ credit files.
A Fraud Alert can help prevent an identity thief
from opening additional accounts in people’s
name. We will also contact the other two credit
bureaus, placing Fraud Alerts on their versions
of individuals’ credit reports.
Dedicated Call Center Support
Experian’s Call Center is ready to assist if
individuals are concerned they are a victim or
have questions regarding a data breach. If a
fraud-related incident is suspected, a dedicated
Fraud Resolution Agent is assigned to the
individual, working with them hand-in-hand to
investigate and resolve the situation.
Fraud Resolution Agents
If medical identity theft is detected, our specially
trained Fraud Resolution Agents will:
· P¦ace a FraUo ~¦er¦ on ¦ne .¦c¦¦n's creo¦¦
reports, as well as contact the other two
bureaus to request Fraud Alerts
· Con¦ac¦ ¦av en¦orcenen¦ ¦o ass¦s¦ ¦n
filing a police report - the police report is
necessary to request copies of financial
transaction records and will assist the victim
in establishing his/her true identity
· Con¦ac¦ co¦¦ec¦¦ons agenc¦es
· Con¦ac¦ nea¦¦ncare rro.¦oers ¦o cance¦ ano
replace medical insurance cards and to notify
of any suspected fraudulent activity
· F¦¦¦ oU¦ ¦ne FTC ~¦¦¦oa.¦¦ vn¦cn sone
providers require along with a copy of the
police report
· Con¦ac¦ LMV¹EMV oerar¦nen¦s ¦o a¦er¦
them of any fraudulent driver’s license that
may have been used
· ~ss¦s¦ ¦n con¦ac¦¦ng ¦ne Soc¦a¦ SecUr¦¦y
Administration - if the person has a work
related injury or information shows that they
also are working as the victim
· Con¦ac¦ ¦ne ¦FS ¦¦ ¦ne rerre¦ra¦or ¦s vor|¦ng
as the victim, there may be tax related
consequences
Page 2
Futhermore, our Fraud Resolution Agents can
assist with building a case against the identity
perpetrator including:
· Co¦¦ec¦ ¦n¦orna¦¦on sUcn as nanovr¦¦¦ng
samples of the perpetrator as well as the
victim’s for comparison
· EU¦¦o a ca¦enoar o¦ ¦oca¦¦ons ano oa¦es ano
including contact information for persons to
corroborate the victim’s presence
· E¦one¦r¦c Conrar¦son crea¦e a conrar¦son
chart with the perpetrator’s and victim’s
descriptions to assist in the confirmation that
the victim was not the “patient”
From filing police reports to working with
insurance companies and doctors, we can help
reduce the pain of medical identity theft and
minimize loss.
Identity Theft Insurance
Once enrolled in one of Experian’s Identity Theft
products, individuals are covered by Identity
Theft Insurance** to reimburse them for loss
associated with fraud. This could include:
· ¦os¦ vages oUe ¦o ¦¦ne ¦a|en o¦¦ ¦ron vor|
· ¦ega¦ ano rr¦.a¦e ¦n.es¦¦ga¦or ¦ees
· C¦ner ¦ees ¦ncUrreo sUcn as cos¦s ¦or na¦¦¦ng.
application fees, and phone calls
Whether managing a data breach or proactively
protecting individuals against the threat of
medical identity theft, it takes a dedicated team
to get the job done. Put Experian’s Data Breach
professionals to work for your organization.
To learn more about data breach resolution, contact Experian at databreachinfo@experian.com or call 1 866 751 1323.
5
Ponemon Institute, “Electronic Health Information at Risk”, October 15, 2009
*This feature is only available with ProtectMyID
TM
.
**This feature is only available with ProtectMyID
TM
. Identity theft insurance is underwritten by insurance company subsidiaries or
afliates of Chartis Inc. The description herein is a summary and intended for informational purposes only and does not include all terms,
conditions and exclusions of the policies described. Please refer to the actual policies for terms, conditions, and exclusions of coverage
at http://www.protectmyid.com/evidence-of-coverage. Coverage may not be available in all jurisdictions.
©2010 Experian Information Solutions, Inc. All rights reserved. Experian and the marks used herein are service marks or registered
trademarks of Experian Information Solutions, Inc. Other product and company names mentioned herein may be the trademarks of their
respective owners.
Combating the rising tide of medical identity theft

A Fraud Alert can help prevent an identity thief from opening additional accounts in people’s name. Identity theft insurance is underwritten by insurance company subsidiaries or af liates of Chartis Inc. From monitoring to detection and resolution. Leading healthcare companies are taking advantage of new processes and proven solutions used in other industries. All rights reserved. working with them hand-in-hand to investigate and resolve the situation.if the person has a work related injury or information shows that they also are working as the victim as the victim. the impact on your company’s bottom line can be severe. October 15. Please refer to the actual policies for terms. Experian’s Fraud Resolution Team is trained to diagnose and treat the often debilitating crime of medical identity theft. and phone calls them of any fraudulent driver’s license that may have been used Administration . Other product and company names mentioned herein may be the trademarks of their respective owners. Page 2 . ©2010 Experian Information Solutions. Inc. Coverage may not be available in all jurisdictions. To learn more about data breach resolution. a company’s name is everything. individuals are covered by Identity Theft Insurance** to reimburse them for loss associated with fraud. 2009 *This feature is only available with ProtectMyIDTM. contact Experian at databreachinfo@experian. We will also contact the other two credit bureaus. to prevent data breaches from occurring. namely financial and credit markets.com or call 1 866 751 1323. the Experian Fraud Resolution Agents can place Fraud Alerts on individuals’ credit files. Experian has the experience and resources to act as a partner in the fight against medical identity theft.the police report is necessary to request copies of financial transaction records and will assist the victim in establishing his/her true identity Futhermore. catching the crime as soon as possible. This could include: replace medical insurance cards and to notify of any suspected fraudulent activity providers require along with a copy of the police report Surveillance Alerts™ Experian’s Surveillance Alerts* monitor for delinquent accounts linked to medical providers. placing Fraud Alerts on their versions of individuals’ credit reports.com/evidence-of-coverage. there may be tax related consequences Whether managing a data breach or proactively protecting individuals against the threat of medical identity theft. ® Dedicated Call Center Support Experian’s Call Center is ready to assist if individuals are concerned they are a victim or have questions regarding a data breach. Experian Data Breach Resolution employs a powerful combination of tools to help victims of fraud stop medical identity theft cold. **This feature is only available with ProtectMyIDTM. it is possible that even with precautionary measures data breaches can happen. If a fraud-related incident is suspected.protectmyid. Fraud Resolution Agents If medical identity theft is detected. conditions and exclusions of the policies described. “Electronic Health Information at Risk”. The description herein is a summary and intended for informational purposes only and does not include all terms. a dedicated Fraud Resolution Agent is assigned to the individual. Fraud Alerts Where there is evidence of fraudulent activity. and exclusions of coverage at http://www. application fees. However. 5 Ponemon Institute.Combating the rising tide of medical identity theft Protecting your brand In the healthcare industry. Experian and the marks used herein are service marks or registered trademarks of Experian Information Solutions. Identity Theft Insurance Once enrolled in one of Experian’s Identity Theft products. conditions. our specially trained Fraud Resolution Agents will: reports. Identifying medical identity theft early allows the victim to stop further damage and begin the process of resolving the situation so the loss is minimized. Put Experian’s Data Breach professionals to work for your organization. Inc. our Fraud Resolution Agents can assist with building a case against the identity perpetrator including: samples of the perpetrator as well as the victim’s for comparison including contact information for persons to corroborate the victim’s presence chart with the perpetrator’s and victim’s descriptions to assist in the confirmation that the victim was not the “patient” From filing police reports to working with insurance companies and doctors. as well as contact the other two bureaus to request Fraud Alerts filing a police report . Deterring and detecting data breach threats does not happen by chance. we can help reduce the pain of medical identity theft and minimize loss. When consumer trust is lost. it takes a dedicated team to get the job done.

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