Beware of Physician Identity Theft
Please be aware that an increase in physician identity theft is occurring. Individuals have used the stolen physician identities to establish provider numbers and bill Medicare fraudulently. Listed below are two identity theft scenarios.
In one scenario, individuals are soliciting personal identification information from physicians by posing as a Medicare Carrier. In one instance, a provider received a fax on what appeared to be the Carrier's letterhead. The fax was labeled "CMS File Update" and asked for a series of documents, including copies of the physician's medical license and driver's license. The physician faxed the requested information to a toll-free "877" number. The unknown party then submitted a Medicare provider application (CMS 855) under the provider's name and set up a 'fake' office in another city. The real physician discovered the fraud when a third party insurer contacted him for a refund on a patient that was not his.
In another scenario, a physician learned his identity may have been stolen as a result of submitting his personal information in response to employment ads.
Once the thieves obtain the personal information, they submit fraudulent applications to Medicare and obtain provider numbers for new practice locations. These individuals then rapidly submit a large volume of fraudulent claims to the Medicare Carrier for payment.
Protect Your Identity!
If you have recently received a phone call or fax from an alleged Contractor Employee asking for a "CMS File Update," please contact the provider enrollment department immediately for verification.
If you are responding to employment advertisements, please verify with whom you are corresponding with before you send personal information.
Remember, it takes all of us working together to protect the Medicare Trust Fund.
Page Last Updated: Thursday, 18-Mar-2010 05:48:59 CDT
