Use Case of Patient Identifier and the Need for Know Your Patient 

The health care industry is huge and complicated and it deals with sensitive matters, one of them being the personal information of the patient. This is why it is extremely important for the healthcare sector to be more vigilant with the identity information of the patient. Patient identifier is the way of verifying the patient’s identity and it can be done to prevent identity theft in the medical industry.

Patient identifier is identifiable information of the patient like their identity card, passport, birth certificate, medical number, insurance card.  Just like knowing your customer, know your patient is the requirement of the verification of the patient through patient identifiers to ensure that the patient really is who they say they are. Shufti Pro Know your customer is a regulatory requirement to fight fraud and know your patient is also a way of fighting fraud through regulatory requirements but in the healthcare sector.

The Healthcare industry can easily become a target for fraudsters due to the multiple parties involved. One patient might require the services of a doctor, surgeon, pharmacies, laboratories, specialists, the insurance company, government body, hospital, clinic, etc.  Each of these sectors of the healthcare industry must ensure the identity of the patient to know the right person is being treated and they match with their medical records. On top of that, the medical industry must also ensure that their data is kept safe. All these reasons require the patient identifiers for patient verification so that the identity of the patient is ensured and secured and no fraudster or the wrong person is treated.

Here are some Uses Cases of Patient Verification

1.    Requirement of Patient Verification for HIPPA

The regulations regarding the verification of the patient’s identity are regulated by global bodies like HIPPA, HITECH, and CLIA. HIPAA has developed a set of standards for securing the data of the patients. According to HIPAA, patient data must be maintained through electronic means. The data must be recorded online and there should be a proper system to secure the data of the patient.

Any company dealing with the healthcare sector must ensure that they have a proper system of verifying the patient’s identity and then the proper system of recording the information safely so it does not fall into the wrong hands. The protective measures include security measures, cybersecurity, patient verification solutions, and record of patient data. In the case of the faultier to comply with such regulations, the company involved can face millions of dollars of penalties through these regulatory bodies.

2.    Medical Identity Theft

The expense of health treatment is really high especially if it is not covered through insurance. This is one of the major reasons that medical identity has become a major target of identity theft. Criminals illegally obtain personal information as patient identifiers and get medical treatment in someone else’s place.

 A study conducted states that in 2017, the total amount of breaches in healthcare was 300 and exposed 171 million data of the patient. The average cost of the victim of medical identity theft was $13,500 and this is expected to increase. The victims of identity theft in the medical industry have to face the loss of damaged credit history, risk of criminal charges, and loss of insurance.

3.    Wrong Medical information  

The most dangerous of these frauds can be the altering of the medical records of the patient that can prove to be life-alternative for the victim. Medical records are permanent records of a person’s health, and someone else being treated under someone else’s name can be a reason for altering medical records. The worst part is, the third party involvement in the altering of the medical records is permanent and it will be changed. However, if the identity of the patient is ensured at the initial stage, the medical industry, as well as the patient, can avoid the hassle of losing their data and eliminate the fraudulent activities and miss charging of bills.

How to Improve Patient Identification

Online patient verification is a prevalent way of avoiding fraud in the medical industry. From pharmacies to patient onboarding, hospitals can verify the identity of the patient by scanning their patient identifiers through an AI-powered solution of identity verification. This will not only enable the verification process within seconds but also ensure the prevention of misuse of the medical records and the non-compliance with the patient identification regulations.