Know Your Patient – A Great Solution to Keep Hospitals Free From Fraud

The healthcare sector is likewise becoming digitalized, much like other sectors. To satisfy the varied demands of the population, interdisciplinary teams of skilled professionals are divided into different sub-sectors within the healthcare industry. The coronavirus pandemic brought about a number of emerging innovations and services, but it has also resulted in a rise in crime rates, including data theft and identity fraud, during the past five years, which has been fairly significant for the suppliers of health services. Around 80 million people become victimized by data breaches due to illegal activity. However, in a breach against Anthem in 2015, hackers obtained 78.8 million patient data, including extremely sensitive data.

As a result, regulatory requirements are now applicable to the healthcare sector. Thus, regulatory organizations such as HIPAA, NHS, and many others have created know your patient requirements that are designed to ensure that just legitimate organizations sign up, which is the only method to decrease the level of crimes.

Know Your Patient Solution- Preventing Scams in Healthcare

Most of the time, individuals choose to ignore the hospital’s incompetence, but what if someone files a lawsuit against the management of the hospital? The facility will undoubtedly suffer financial and reputational losses as a result. So why not stop all this devastation with a little patient verification? 

Know your customer is a crucial process that the corporate sector frequently employs to protect their operations and onboard legitimate consumers. In a similar fashion, know your patient is growing in importance for the healthcare sector. Making the patient onboarding procedure simple and safe from Medicare fraud is essential. ID verification for pharmacies ensures that databases at hospitals and other healthcare facilities are safe from cyberattacks. It also ensures that private patient data is always handled with care.

1. Patient Identification 

Security of the healthcare business and telehealth providers has become a major global concern, and then this sector needs automatic identity verification systems for identifying patients and reducing medical identity theft and many other associated crimes.

Health centers must verify patient identity prior to enrolling them in order to make sure they are legitimate patients. Otherwise, the possible risk linked with the consumers could negatively affect digital operations. Because of this, companies that accept Medicare are required to collect the patients’ personally identifiable information, including their Identity card numbers, medical IDs, and other details, in order to carry out correct verification. In addition to this, other additional documents like the bills as well as insurance records must be obtained.

2. Ongoing Monitoring and AML Screening 

When the patient is aboard, the narrative doesn’t come to an end. Because crooks are growing more skilled, there is always a chance of deception. As a result, in order to identify patients, medical institutes must monitor patients’ actions. In order to achieve this, technical advancements have created patient verification and AML screening technologies that yield precise results. The patients could be quickly grouped as per the risk they pose by incorporating such technologies. For insurance firms, this is quite important because it might allow them to lower the incidence of bogus claims. Additionally, for enhanced risk analysis, health facilities can check patient backgrounds against financial crime databases as well as international watchlists using continuous monitoring and AML scanning technologies.

3. Enhanced Due Diligence (EDD)

Healthcare facilities can evaluate whether they need to do enhanced due diligence or just simplified due diligence using patient risk assessment methods. Whatever the situation, it’s critical for online service providers to conduct client due diligence processes in a polite manner in order to determine whether or not increased due diligence is required. Due diligence must be performed periodically because this is a continuing process and clients may move from low-risk categories to high-risk ones as time goes on.

Final Thoughts

Verifying each patient’s legitimacy is seen to be the key to guaranteeing that only genuine patients board. The health sector is compelled to abide by know your patient because it is a regulatory requirement. Nevertheless, if Medicare centers don’t use ID verification methods or aren’t compliant, they risk heavy fines and other monetary losses.

A feasible solution for the healthcare sector is a comprehensive know your patient verification service. The onboarding procedure is frictionless and more transparent due to AI-based patient identity verification technology. ID verification services are supported by tens of thousands of algorithms, which reduce the danger of illegal activity and help businesses stay up to date with changing regulatory requirements.