In the era of COVID-19, fraud is rampant. It’s not just phishing and identity theft, but healthcare fraud as well. Last July, the FBI indicted a lab group, a dentist and a nurse practitioner with billing fraud and prescribing conspiracy.
In times of fear and uncertainty, hackers are hard at work trying to scam people looking for help or information. Tap or click here to see how fake COVID-19 tests lead to identity theft.
Just like keeping an eye on your credit score to prevent financial fraud, there is a hidden score that health agencies use to assess your risk factor. This hidden health credit report is based on medical records and determines eligibility for insurance and coverage.
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How to monitor your health credit report
Life insurance companies use your credit report to determine the extent of your risk. These reports give a reading of your overall health history and include details such as pre-existing conditions and any prescription drugs you have taken throughout your life.
Insurance companies do not compile these reports themselves. Instead, they rely on third-party companies to collect information on people applying for insurance, the same way credit bureaus work. Once this information is prepared, the report is sold to the insurance company that requests it.
But just like financial credit reports, health credit reports can also contain errors that accumulate over time. It’s a good idea to check your report every now and then to make sure everything looks normal.
You have the right to view your report whenever you want. And if you find errors like an incorrect prescription history or incorrect spelling of your name and address, you can correct those issues and potentially save money on your policy.
This is also where you are likely to find signs of fraud and abuse, such as insurance claims or hospital stays on your behalf.
Here are three of the best health credit report companies and how to contact them to learn more about your information.
Milliman IntelliScript has information about your prescription if you have authorized the release of your medical records to an insurance company and that company requests a report. To view your report, tap or click here to visit the official Milliman Intelliscript website. Be prepared to provide the following information:
- Last name and first name
- Postal address (and email address if you wish to receive your report by email)
- Your phone number (in case the company needs to call you with questions)
- Date of Birth
- The last four digits of your social security number
- The insurance company with which you have subscribed
ExamOne is a Quest Diagnostics company, which means it has access to lab tests that Quest Diagnostics and others have done for you over the years. Using this data, it builds reports to assess your risk factor for insurers.
To contact ExamOne and get your report, call 1-877-933-9261 or complete the contact form here. You can request a health report or a lab results report.
MIB Group was previously known as the Medical Information Bureau. It follows all those who request life, health or disability insurance taken out individually during the previous seven years.
To preview the contents of your MIB report, call 866-692-6901. You will be asked several personal questions to help the telephone agent access your file. MIB’s support hours are 6 a.m. to 12 p.m. Eastern Standard Time.
You can also tap or click here to complete an online report request.
It may take up to 10 business days to receive your report. The good news is that reports are free. We recommend that you review them even if you are not applying for life insurance to make sure there are no errors or evidence of fraud.
These agencies aren’t the only ones who keep tabs on your medical records. Tap or click here to see why Google has access to the health data of millions of Americans.
Obtain records from your doctors or health care providers
In accordance with HIPAA, the Health Insurance Portability and Accountability Act, all patients have the right to access their medical records and medical bills from healthcare providers. This includes:
- Notes or recordings created by your supplier.
- Diagnostic results that a provider has copies of, including biopsies, blood tests, genetic tests, mammograms, and x-rays.
- Information provided by another physician used to make a diagnosis and / or direct medical treatment.
Requests for psychotherapy notes or medical information compiled for legal purposes may be refused.
To get your records, most establishments or providers will have you fill out a form with personal information such as your name, social security number, address, and date of birth. Contact the doctor, practice or hospital whose records you wish to obtain and ask for a “record request form”. Usually the front desk can email or fax it to you to complete and mail back.
You may also be asked to pay a processing fee for your records, so don’t be surprised if this happens.
If your doctor no longer practices or if the establishment where you were treated no longer exists, contact your mutual insurance company. They may be able to locate records through other means or possibly locate your former caregiver for more information.
Correction of registration
Now that you’ve seen your “health credit report” and your medical records, it’s time to review them. Keep an eye out for inaccuracies that could drive up your insurance rates, like these:
- Errors in the spelling of your name. This may prevent your recordings from being exchanged between different providers.
- Incorrectly entered telephone numbers, addresses and contact details. This can lead to billing errors.
- Inaccurate data regarding your medical condition, symptoms, diagnosis or treatment plans. Fraudulent or mislabeled conditions can give the impression of a higher risk status.
Information that is less urgent to correct includes misspellings in diagnoses and conditions and poor appointment times. As long as appointment dates and times are mostly correct, these corrections are of less concern.
Request the fix
The next step is to contact the health care provider, hospital, or insurance company involved in the incorrect entries to ask if they have any forms to make changes to your records. You can usually request that these be sent to you by post or digitally by e-mail or fax.
Be clear, concise, and write the correction exactly as you think it should be noted. The idea is to make it very easy for your provider’s office to edit your records.
Make copies of the pages where you find inaccuracies, and on the page where you show the correction, cross out the inaccurate segments with a pen. Complete any additional forms required by your insurance company or hospital and attach the changes when you return them by mail or digitally.
More complex changes (such as fraud) may require a written letter explaining the circumstances in more detail.
Can my request be refused?
Suppliers and hospitals must respond to your request within 60 days, but that doesn’t mean they will always make the changes you request. Legally, they don’t have to, but they must explain why if they choose not to.
If your request is refused, it is usually because removing an entry would be detrimental to your well-being or your future treatment options.
It’s amazing how much data is being collected on you without you realizing it. If you think medical agencies have collected a lot of information, they don’t have anything on search engines. Tap or click here for instructions on how to clear everything Google knows about you.