February 6, 2023 12:51 AM
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The healthcare sector is facing identity fraud, medical scams, data breaches, false insurance claims, and illegitimate onboarding. Where on one side medical care providers are striving to bring convenience and digital treatments to patients, criminals on the other are using sophisticated ways to exploit benefits. For instance, they commit data breaches and use the information to avail medical benefits. 

This calls for better mechanisms to not only streamline the patient onboarding and treatment process but also provide security to their records. Regulatory authorities are also coming up with new requirements for the protection of patient identity data. Therefore, medicare providers require efficient patient verification solutions to ensure legitimate onboarding. The blog discusses some of the most prominent use cases of  KYP checks. 

Patient Identity Verification – Addressing Fraud Risks Healthcare Sector Face 

Digitization is bringing various shifts in the healthcare sectors such as telemedicine. However, criminals are using advanced methods to illegitimately reap the benefits. Therefore, regulatory authorities are enforcing several restrictions like accurate patient verification. As per guidelines by the Health Insurance Portability and Accountability Act (HIPAA), medical centers should collect, analyze, and protect patient identity information. This calls for better and more efficient know your patient mechanisms that are not prone to errors and identify imposters accurately. As per Shufti Pro News, criminals use fake credentials to avail insurance coverage, pay for expensive treatments, and buy restricted drugs. More of the major threats include: 

Medical Records Breaches and Scams

The medical records, payment details, insurance data, and other such information is worth a fortune to fraudsters. This is because they can sell it on the dark web or use it for personal gains. According to the stats by HIPAA, global healthcare sectors faced more than 44 million medical data breaches in 2021.

Keeping this in view, global regulatory bodies are enacting more strict restrictions on medicare providers to verify patient identity and combat criminal attempts. Moreover, not just the hospital but also other subsidiaries need to perform accurate verification. Here, healthcare centers with effective identifying patient mechanisms can ensure better compliance while shielding the patients’ digital records. 

Rise in Cyberattacks 

Considering the change brought by the pandemic and digitization, healthcare providers are bringing innovation to their operations. Patients can now upload their prescriptions and order medicine online, also they can schedule a virtual check-up. However, these shifts are raising other threats such as cyberattacks. 

Medicare providers are using technologically advanced gadgets to verify patient identity and hold their records. These are becoming the main attraction for criminals because they can commit illicit activities like insurance fraud. For this, they require robust AI-powered identity verification solutions. 

Security Hacks Reaching Alarming Stage  

While digital transformations have a myriad of advantages, they also have a few downsides. These shifts are opening loopholes for criminals to dodge patient verification checks and commit security hacks. Criminals are using different methods to get their hands on patient identity information to avail illegal benefits. 

This compromises the security of legit patients. Also, minors are using their elders’ information and documents to buy medicines online which exposes them to fatal consequences. Therefore, the healthcare sector should employ patient age verification along with the validation of their documents.  

Major Benefits of Identifying Patients Solutions for Medicare Providers

The healthcare industry faces various challenges in providing a better experience to patients while keeping their data secure. For this, they need to employ patient verification solutions. This is because they offer convenience, authenticity, and security. More of the benefits are discussed later on. 

Reduces Chances of Inaccurate and Mistyped Information

In manual data entry and verification, there are high chances of mistyped or inaccurate information. This leads to damaging concerns like inappropriate treatments and wrong allocation of benefits. Moreover, medical records and case histories are hard to change which is why precautions should be taken in the beginning. Shufti Pro Funding highlights that know your patient solutions here provide such measures to safeguard the medical databases.

Accurately Verify Patients’ Identities 

Various authorities like HIPAA and HITECH are made in charge by states to enforce identifying patient regulations. The requirements mandate all medical centers, pharmacies, and their affiliates to identify patients before giving them any treatments. Failure in comparison can lead to hefty penalties.  

In the End

Criminals use fake information to apply for illegitimate medical benefits such as to either pay for their costly treatments or reap insurance benefits. Therefore, the healthcare sector and all its affiliates should accurately identify patient identities. As per the restrictions, the medicare sector should perform efficient know-your-patient checks. The AI-powered solutions help healthcare centers not only combat digital medical scams but also safeguard patients’ records. 

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