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What is Medical Identity Theft and What is the solution for it?

Identity theft is a major crime on online platforms. Criminals use some other person’s information like name, national id numbers, credit card numbers, or bank account numbers. Then they pretend to be that person by giving these credentials to websites and open accounts on them.

For instance, a criminal makes an account on a social media website with another person’s data and pictures. Now he can scam the genuine person’s contacts, by asking for money. The motive is to commit crimes with a little risk of being caught. Medical identity theft.

Medical Identity Theft

Today identity theft is not limited to social media accounts or online bank accounts. The medical sector is also affected by it (medical identity theft). When a criminal uses the medical information of a person to claim health or insurance benefits. It can also be utilized to get worker benefits or reimbursements.

Criminals not only use it to get financial benefits but they can also receive free medical services or pharmaceutical drugs. In some cases, it is used to manipulate the billing of health services. Because it exposes the most sensitive information of the victim. According to a report by Ponemon Institute, an average victim pays 13,500 US Dollars to fix his medical identity theft.

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Below are some signs of it:

  • An unknown bill from a healthcare provider
  • Unexplored medical debts
  • Non-consensual medical bill payments through credit/debit card
  • Denial of insurance service because someone has already availed

Types of Medical Identity Theft

Medical identity theft is classified into three categories. The criteria of the classification depend on who is the beneficiary of this crime.


The synopsis in which some unknown person steals or gets access to stolen medical records falls under outsider medical identity theft. There can be another possibility that the medical records of patients were not secure, and a fraudster can access them easily. In this case, healthcare is responsible for identity theft.


When some person of the healthcare system uses the patients’ medical records without his permission. For instance, a doctor alters the patient data and claims health benefits on that. Medical identity theft becomes easy to commit if an insider is involved in it. Because he can access and modify the medical data easily.

Friendly Fraud

When a person gives his medical information to a criminal. For example, some online users do not verify the surveys and give their information to that page. The other situation may be a known person of the victim assists in accessing the information. Both these plots are very difficult to catch because they can’t be investigated easily. The reason is that the criminal may use it after years of having the information

What’s the Solution

The ultimate solution to identity theft is patient identification or Know Your Patient verification. It is the same as Know Your Customer in the financial industry. Banks use verification services for verifying and authenticating their customers. This helps them in onboarding only legitimate customers. The more the number of verified patients is, the fewer will be criminal agents. Every onboarding patient will be verified through his government-issued identity documents. These documents will help in accurately identifying the name, age, and address of the patient.

The whole verification process is robust, done by software in real-time. Below is the process of verification of patients

  • A picture of the patient holding an identity document is uploaded
  • The verification software detects the areas of information and extracts that
  • The originality of the document is confirmed
  • The face of the patient is confirmed with the image on the document
  • The patient is informed of the verification results (verified or not verified)

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The risk of medical identity thefts, data breaches, and other online health crimes can rise if strict measures are not taken. But thanks to Know Your Patient verification that can help to reduce the hazards associated with it. It also verifies the age of the patient which is very helpful in the treatment and sale of prescribed only drugs. Document verification can mitigate the chances of fake health certificates. Patients will have more trust in those healthcare providers that have patient verification services.

Red Note: 30 September 2022

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