Technology Trends Can Curb Identity Theft in Medical Insurance Industry?

Medical Insurance Industry

Best Technologies that Made Major Impact on Insurance Industry

The healthcare industry is a lucrative one, not to mention a sensitive as well because it tackles with life and death matters for your loved ones. Just as the banking and finance sector, the healthcare industry is often prone to fraud as well. Collectively, fraud and fraudulent activities take a collective sum of 80 billion dollars a year from insurance and healthcare providers. Such a staggering amount of fraud puts a heavy burden on hospitals and insurance companies, not to mention the sort of trouble that fraud victims have to go through. Thus identity verification is becoming a pressing need for healthcare providers and the medical insurance industry.

But it is also important to consider the ramifications of implementing an identity theft protection solution, how to make sure that the data collected remains secure in a digital age where constant data breaches have created a menace of identity theft and scams of their own. It is also important to comply with data protection protocols and user privacy guidelines when implementing an identity verification solution. Although most of the medical service provider has an added advantage as compared to other digital service providers as they mostly fall under a single jurisdiction which means that regulatory compliance becomes easier for them to adapt to as compared to a Fintech company that is operating in multiple territories and serving clients from multiple jurisdictions.

With the advancement in the methods for fraud prevention tools and methods, there are a number of services available out there that use modern technology like artificial intelligence and machine learning to detect fraud. Each of these solutions provides the perfect solution for detecting fraud and improving costs for the health insurance industry. Terms like medical identity theft are not new to the fraud landscape that surrounds the medical industry. It is easier for fraudsters to defraud a health insurance provider rather than a financial institute, as the latter uses better prevention tools to thwart identity thieves and scammers. Some of the reasons why medical insurance industry needs to adopt patient identity verification include;

Cost Effective

If insurance providers think that implementing identity verification for patients is an added cost, think again. Where frauds end up costing the insurance providers a significant amount of profits, is it not worth it to implement a sound anti-fraud solution that can eliminate such detrimental costs. What is noteworthy is the fact that the fraud detection solutions available in the market are highly cost-effective and implement identity verification to existing systems without causing any trouble to the existing web interfaces. New systems take a lot of resources to develop. The online identity verification tools that are available through SaaS products are cost effective and easy to integrate for businesses.

Most of the online identity verification services have a superlative analytical approach when it comes to tracking the verifications being performed and even in some cases, KYC service providers are even offering geolocation details including details about the device, Operating system of that device and even the browser information that is used to perform a given verification. This kind of data-rich verification not only makes the entire user authentication process secure but also makes the pricing aspect of verification software more accurate.

This is the very reason why KYC service providers like Shufti Pro are offering Pay As You Go pricing model to its customers. This not only eliminates the need for a minimum verification volume but also puts the verification party in charge of the entire billing process.

Reduce Fraud

What is a fraud protection system that doesn’t reduce the levels of fraud for a company? The primary function of such a system is to reduce fraudulent activity across the company. By implementing digital patient identity verification a company can authenticate the credentials of a patient in real time and find out if the person demanding medical care is a real patient or someone using stolen credentials. It is not new for a fraudster to use stolen medical insurance cards or health insurance numbers to gain medical treatments or procedures. Criminals also use these credentials to purchase prescription drugs which are more often than not narcotics. ID verification via document scans and facial recognition can weed out such criminals and addicts.

Facial Spoofing attempts can be effectively curbed by features such as liveness detection to check that the person performing the verification is actually present in front of a webcam while the entire verification is being carried out by a third party service provider. Biometric features can be authenticated with relative ease and this form of facial verification is much more effective at curb identity theft and frauds originating from it, not to forget the ability to verify the identity of a buyer or patient even at remote locations. There is an added advantage of cost-effectiveness as all other biometric verification formats (fingerprint & iris scans) involve installation of specialized hardware in order to verify the biometric features of a verifying individual while no special equipment is required for facial verification as nowadays every connected device – desktop, laptop, smartphone, and tablet – comes with a webcam.

Faster and More Efficient

Digital methods of IDV make the whole process of patient identification smoother and faster. By digitally scanning a patient’s documents, the OCR (Optical Character Recognition) technology can extract accurate details of a patient and registers their name in the hospital records. Manual procedures require the medical attendant to verify each and every detail by hand and authenticating it through other documents or records. Each and every detail of the patient including their social security number, medical insurance number, age, date of birth and all other details are automatically entered by the system and thus making the admitting procedure of patients much faster, giving them access to instant healthcare.

After all, what good is a verification system for the medical industry that creates friction during the patient registration process or service delivery to those who are in need of immediate medical assistance? Machine learning algorithms are being incorporated into the identity verification and document authentication software to make them not only more accurate but also adapt to the multiple fraud formats being adopted by scams and fraudsters across the globe. This technology allows verification and identification platforms to “learn” from their earlier verifications and detect any similar attempt at a much quicker pace.

Increase Patient Trust

As medical insurance companies and healthcare providers take more decisive measures against fraud and make attempts to reduce it, patients gain a certain peace of mind. They gain more trust in the system and their insurance providers. This can also help insurance providers gain more clients.

As the world moves towards digitization, automated fraud detection solutions present the perfect fix for frauds like identity theft and credit card fraud. AI-enabled systems have lent more effectiveness, productivity, and accuracy to such solutions, not to mention the fact that they are not a burden on a company’s finances. The medical insurance industry may well benefit from fraud detection systems like identity verification and KYC verification services, as they reduce fraud and help control cases of medical identity theft.


It is obvious that whenever there is the talk of the latest tech trends helping medical care industry, they are mostly in the form of service delivery and patient treatment domain but identity verification and credential authentication is something that will be beneficial both for the medical insurance industry as well as the customers availing medical treatment because of this industry.

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