How Biometrics Help Prevent Medical and Insurance Fraud
By: Chris Neely
Healthcare fraud is a pervasive issue that impacts healthcare providers, insurance companies and people in need of care, leading to billions of dollars in financial losses each year. Medical identity theft and insurance fraud can result in false diagnoses, unnecessary treatments and inflated costs, all of which undermine the integrity of the healthcare system. ?At the core of healthcare fraud lies the pressing issue of patient identity, demanding a robust and reliable identity assurance solution.
The Scope of the Problem
In 2022, the U.S. Federal Trade Commission received 27,821 reports of medical identity theft, concurrently, 707 known healthcare data breaches affected almost 52 million patients. These staggering numbers underscore the vast scale of the issue and its profound impact on patients.?
The financial consequences of fraud are equally striking. According to recent figures from Allstate, the cost of medical identity theft amounts to $41 billion annually. This, together with fraud’s massive impact on patients, highlights the urgent need for effective measures to combat fraud in the healthcare industry.
Positive Patient Identification: Where It All Begins
Biometric technology presents a formidable solution to these challenges. Using one’s unique traits, biometric authentication and identification in healthcare deliver the most reliable identity assurance. Facial recognition, in particular, offers a reliable and secure method for verifying patient identities.?
Modern facial recognition systems can swiftly and accurately identify patients from their first interaction, reducing the risk of identity fraud. Multiple records for the same patient can result in incorrect treatment and potentially fraudulent activities. By linking a patient’s biometric data to their medical records, healthcare providers can ensure that the right person receives the right treatment while minimizing the chances of identity and medical fraud.
Similarly, by binding a patient’s biometric data with their prescriptions, healthcare providers can prevent unauthorized access to medications, thereby helping to fight against the rising epidemic of prescription drug abuse. Facial recognition technology ensures that only the authorized individual can access their prescription, reducing the potential for abuse and fraudulent claims.
Insurance fraud is a significant issue that drives up costs for both providers and patients. Fraudulent claims can be made by individuals who assume the identity of legitimate patients to receive medical services. By using facial recognition technology, healthcare providers and insurance companies can verify the identity of patients at every point of service, from initial check-in to treatment and billing. This verification and authentication approach ensures that the person receiving care is the same individual covered by the insurance policy, effectively preventing fraudulent claims.
Facial recognition technology can also streamline the claims process by expediting the verification of individuals, ensuring that all claims are associated with the right patient. This reduces the likelihood of fraudulent claims being accepted and speeds up the process for legitimate claims. Properly implemented, facial recognition technology can bolster and maintain the integrity of the insurance system and reduce overall costs.?
Features to Consider When Selecting Facial Recognition Technology for Healthcare?
To effectively combat medical and insurance fraud, healthcare providers should?choose systems that perform reliably under various conditions . Solutions must be able to detect sophisticated spoofing attempts to prevent fraud, while edge technology that performs biometric processing and liveness detection on-device should be considered to enhance performance, security and efficiency. Selecting systems with a privacy-first approach is essential to comply with regulations and protect sensitive data by default. And, ideally, the biometric authentication and verification system should be easy to implement and integrate with existing healthcare infrastructure.
To learn more about how biometrics are transforming healthcare and which technologies are best suited for the healthcare environment, download HID’s new eBook, Improving Patient Outcomes and Reducing Health Fraud With Biometrics .
Additional resources:?