False medical claims leads to data breach

September 27th, 2015 by admin Leave a reply »

Unauthorized individuals posed as physicians to file false medical claims and the incident is related to New Jersey-based health insurer. Claims may have led to data breach for some patients.

Horizon Blue Cross Blue Shield of New Jersey announced the incident on its website explaining potential healthcare fraud was detected.. A special investigation’s unit at the insurer find out that these unauthorized individuals obtained Horizon BCBSNJ member identification (ID) numbers, and potentially other personal information.

Approximately 1,100 customers were affected by the incident, and Horizon BCBSNJ stated that it is working with the FBI and the US Attorney’s Office.

Affected information includes names, dates of birth, gender and member ID numbers. However, medical information, financial information and Social Security Numbers were not accessed or disclosed, according to the insurer’s statement.

Data breach notification letters began to be sent out to potentially affected individuals.Horizon BCBSNJ’s Special Investigations Unit would have already reached individuals by phone if their member ID or address were used to file false claims.

“Horizon BCBSNJ has no reason to believe that the personal information obtained was used for any purposes beyond submitting false claims by these specific perpetrators,”the statement read. “The information accessed can only specifically be used to submit claims to Horizon BCBSNJ.”

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