Man receives medical records for two strangers from insurer
November 7, 2014  //  By:   //  Investigative Reports  //  Comments are off

by Carol Thompson

Jay Jarvis was angered when bill collectors kept calling him demanding he pay a $40 copay bill from a March visit to Oswego Health Urgent Care located in Fulton, NY. The Hannibal, NY resident maintained he didn’t owe the money because his insurance company, Aetna, had already paid the bill. Despite this, the collection calls continued.

Jarvis decided to take matters into his own hands and contacted Aetna requesting a hard copy of an explanation of benefits be mailed to his home. He received it October 9 from Aetna’s Texas office.

When he opened the envelope and began to read the statement, there with his own information was the information for two complete strangers.  “What is this?” he said when he discovered the names of two women with their identification numbers, employers, and diagnostic codes. Both of the women had visited the same urgent care center around the same time as Jarvis.

He immediately called Aetna.

“They told me to just destroy the document. They never asked for the names of the people so they could be contacted,” Jarvis said, adding that no apology was given.

Jarvis then decided to attempt to contact the women himself. When he called the first woman listed her phone had been disconnected so he tried another number of someone with the same name. He reached a relative and learned that the woman had passed away.

He then called the second number belonging to Amber Munger, the second name listed. “She answered the phone and I was trying to explain it to her,” Jarvis said. At first Munger was suspicious. Jarvis asked her to allow him to further explain, then she became angry that her information had been disclosed. The two met in person so Jarvis could show Munger the information Aetna had erroneously sent to him.

Aetna responds to breach

Atena’s media communications representative Susan Millerick said in a written statement that the employee who released the information has been retrained and the company will offer free credit monitoring to the member whose information was inappropriately shared.

“Protecting member information is critically important to Aetna. This unfortunate but isolated incident was the result of a human error. The customer service agent involved understands the seriousness of her mistake and has been retrained on the best process to use in the future,” Millerick said. “While trying to assist a member with a billing dispute, the agent accidentally mailed the wrong document to the member. Our Privacy Office began an immediate investigation, confirmed that no financial or federal identification numbers were shared, and has reached out to the members involved.”

Millerick said  the company has apologized. “We have apologized to impacted individuals and will offer a free year of credit monitoring to the member whose information was inappropriately shared, although no financial information or social security number was shared.  We sincerely regret any stress or worry caused for our members. We work hard and train continuously to prevent incidents like this and we appreciate members calling us immediately with privacy concerns so we can investigate and address any issues promptly.”

Diagnostic codes easily accessed

Had Jarvis been curious, he could have easily looked up the diagnosis for both women. Diagnostic codes are easily obtainable on the Internet in a matter of seconds. The website Find-A-Code provides search information by code and by aliment name.

The Health Insurance Portability and Accountability Act, more commonly known as its acronym HIPAA, requires HIPAA covered entities and their business associates to provide notification following a breach of unsecured protected health information.

Jarvis said had he not contacted Munger she would have never known that he had obtained her personal information and reiterated that at no time during his conversations with representatives of Aetna was he asked for the names of those listed on the statement he received.

“She’s lucky I’m an honest person,” Jarvis said of Munger. “Who knows what someone else might have done.”

Despite the breach and confusion, Jarvis said he was able to resolve his billing error with Aetna.

About the Author :

Carol Thompson is a veteran investigative reporter residing in central New York. She spent 23 years with a local newspaper, The Valley News, before leaving for the Syracuse New Times, and now, VNN. Thompson has won dozens of first-place awards for investigative reporting and was the 2006 recipient of the Syracuse Press Club’s prestigious Selwyn Kershaw Professional Standards Award. Thompson’s reporting has resulted in the arrest of public officials and has prompted policy changes. She uncovered two money laundering schemes that traveled the globe and resulted in the indictments of several developers.

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