Fraudulent Medical Records Risk Patient Privacy

Medical records and Stethoscope


Determining Who Is at Fault for Medical Record Errors and Medical Identify Theft

An Advocate Christ Medical Center patient is speaking out after he says the hospital sent him someone else’s medical records and his insurer declared fraud. The hospital located in Oak Lawn, Illinois, released a statement to CBS Chicago declaring “Protecting patient privacy is one of our top priorities. We are taking this seriously and conducting a thorough review.”

The patient, identified as Darnell Payne, told the Chicago news outlet that he requested his medical records in hopes to release them to his insurer. He later was notified by his insurer that his claim was fraudulent because the files that were released belonged to a different patient and did not support his request for coverage or payment.

While this may be an unfortunate clerical mistake, Mr. Payne is still in possession of another patient’s private records because the health system refuses to collect them. He also said he is still waiting to receive copies of his records. When a patient is denied insurance support for his injury as a result of medical report error or suspected fraud, the next question should be, “Who is responsible?”.

Clerical Errors or Medical Identity Theft?

Medical records are perhaps the most essential piece of evidence in supporting an Illinois medical claim and personal injury case. Fraudulent documents also impact the access to benefits under a policy since each time a false claim is processed with the wrong information, the dollar amount counts toward that patient’s lifetime and may exhaust their coverage limits.

Also, when a patient or their insurer, or hospital is sent the wrong medical record, it may flag medical identity theft. This type of theft can happen when a person’s name or other identifying information is used without that person’s knowledge or consent to obtain medical services or goods. These records can be used illegally to submit false insurance claims for payment.

Victims of medical record mistakes or medical identity theft may:

  • receive the wrong medical treatment
  • find that their health insurance benefits have been exhausted
  • could become uninsurable for both life and health insurance coverage

If you find yourself in this situation, you should immediately report any inconsistencies in your record and speak with your insurance company as health insurance fraud and identify theft are real issues. In addition, stay informed about the health care services you receive, the doctors who are treating you and in general, keep good records of your medical care and the medical bills you receive.

Request Legal Help to Investigate and Prosecute Healthcare Fraud and Abuse

Becoming injured or having your medical identity stolen as the result of a medical error or fraud, figuring out where things went wrong and determining liability can be extremely complex. Our attorneys are committed to finding the truth and securing the best possible result and protection for you and your loved ones.

Please, contact us for a free consultation by calling 312-332-2872 or completing our online case evaluation request form.

Also read: Chicago Medical Malpractice

Lawyer Monthly - Legal Awards Winner
The National Trial Lawyers
Elder Care Matters Alliance
American Association for Justice
Fellow Litigation Counsel of America
Super Lawyers
Contact Information