A Canton woman says 16 insurance notices listed medical treatments she never received, including cancer care, bloodwork and a colonoscopy. She spent more than a year seeking an explanation from her insurer and doctor's office.
Susan Kelly, who lives in Canton, Michigan, said the notices started arriving at the end of 2024 and kept coming, with notices for cancer treatments, bloodwork and a colonoscopy she says she never received, according to WDIV ClickOnDetroit. “Some of them said I was getting cancer treatments, some were saying I was getting bloodwork, some were a colonoscopy,” Kelly said, according to ClickOnDetroit. Each notice bore her name, UnitedHealthcare letterhead and her correct member ID, making the paperwork look unmistakably real even though she said she never had cancer treatment or any of the other procedures listed.
Kelly told WDIV ClickOnDetroit that she spent more than a year trying to resolve the notices. She said the insurer referred her to a help line, where she spent six months seeking answers, while her insurer and doctor's office directed her back and forth.
Insurer Points to a Florida Provider
When Local 4 asked about the claims, UnitedHealthcare said it had traced them to a provider in Florida that billed the treatments in Kelly's name. The insurer said the claims were denied, according to WDIV ClickOnDetroit. The company had also previously pointed to a possible billing problem at Kelly's doctor's office as a factor in the confusion.
The accounts differ on whether any money was paid. UnitedHealthcare told Local 4 that Kelly has no financial responsibility for the claims and said an Explanation of Benefits notice is generated whenever a claim is processed, including when it is denied. Kelly said, “There were a few that United Healthcare paid.”
Still Searching for How It Happened
The available reporting does not explain how the Florida provider obtained Kelly's information or why claims were filed in her name. She said she still wants answers and described getting a response after more than a year as “about time.”
Medical identity theft — the use of someone's personal information to submit unauthorized claims to a health insurer — is a recognized problem nationally. The U.S. Department of Health and Human Services' Office of Inspector General warns that this kind of activity can disrupt a patient's medical care and waste taxpayer dollars.
If an Insurance Notice Looks Wrong
For Michigan consumers who remain dissatisfied after contacting their health insurer, the Department of Insurance and Financial Services says they can ask about the insurer’s appeal process or file a complaint with the department, according to DIFS.
Canton has seen scrutiny over medical billing before, though in a separate and unrelated matter. Back in 2016, a doctor at Canton Urgent Care faced 22 fraud charges for allegedly billing Medicaid and Blue Cross Blue Shield for services he never provided, a case that began after Canton Township Police contacted the Michigan attorney general's Health Care Fraud Division. There is nothing in the record connecting that older case to what Kelly experienced.
