To catch a thief nearly always has been the job description for El Dorado Hills’ Michael Brandt.

These days, it’s identity thieves, many of them wearing white smocks and signing “M.D.” after their names, who are the prey for Brandt, senior special-investigations manager for Blue Shield of California.

Brandt, 66, a former police detective, feels a hunter’s quickened pulse when he sees strings of lengthy doctor’s visits billed by an M.D. whose specialty, for example pediatrics, is associated with short doctor visits.

“Cancer, we understand,” Brandt said. “But a general practitioner in flu season shouldn’t be billing for 45 minutes.”

These malefactor health-care providers are participating in a crime, medical-identity theft leading to insurance fraud, that no one really knows the extent of, because it’s so difficult to detect, Brandt said.

“Eventually, greed takes over, but some providers feel (insurance payers) don’t pay enough.”

Making the pond even murkier to fish in is the fact it’s not just doctors who can get into med-ID theft -- it’s anyone, including patients, who touch medical records.

“Maybe somebody in a doctor’s office took numbers and sold them,” Brandt said. “They are gatekeepers, and theft can happen anywhere along the gate -- x-ray, physical therapy, outpatient centers, hospitals.”

Brandt said it is routine for as many as 50 people to touch one patient’s medical records on the way to an insurance claim.

“Sometimes, patients will sell an insurance card, which can be used at unscrupulous providers,” Brandt said.

According to the Federal Trade Commission, as of 2006 only 3 percent of identity-theft cases involved med-ID theft and health-insurance fraud.

But as Brandt point out, that corresponds to 3 percent of a total of $2.1 trillion paid out by insurance payers, private and public, in the U.S. The math indicates payers were scammed out of more than $60 billion nationwide.

One of Brandt’s favorite horror stories involves a patient that managed to “borrow” an insurance card from his brother.

“After several months of hospital time and treatment, for cancer, the patient died,” Brandt said. “When the family saw the death certificate, they said, ‘Whoa!’ He probably could have gotten state assistance, but took the easy way out.”

Brandt’s work has led to criminal convictions, but he’s more concerned to get hospitals more involved in cutting down the ease of the crime. He noted instances where a patient can say he lost a card, identify himself as “John J. Jones,” and have a clerk check a data base and say, “John J. Jones of Oxnard?” followed by a quick, “Oh, yeah, Oxnard.”

A worst-case scenario involves a theft-victim’s records being altered to reflect a prescription or treatment he or she never got, resulting in danger of maltreatment based on faulty records.

“We can’t call the police department, and discuss medical records,” Brandt said. “So, we encourage members (victimized) to report it to the police department.”

The Telegraph’s Roger Phelps can be reached at rogerp@goldcountrymedia.com, or post a comment at folsomtelegraph.com