Healthcare Organizations vs. Fraud: Three Potent Weapons
In an environment challenged by Coronavirus, the already significant problem of healthcare fraud is more harmful than ever. Blue Cross Blue Shield reports:
The National Heath Care Anti-Fraud Association estimates conservatively that health care fraud costs the nation about $68 billion annually — about 3 percent of the nation’s $2.26 trillion in health care spending. Other estimates range as high as 10 percent of annual health care expenditure, or $230 billion.
The U.S. Department of Health and Human Services recently published an informative video detailing healthcare fraud during the pandemic.
In addition to the above video, the U.S. Department of Health and Human Services also produced a series of quick, 1-minute videos to build awareness of text scams targeting unsuspecting people:
These videos educate the public, but what can healthcare providers do to stop the trend in fraud?
While fraud is a difficult challenge to overcome, an article at The Future of Things points out that there are three important ways to combat the threat:
- SECURE CHECKS: Secure checks are specially created to prevent such instances of payment fraud. These checks will have been created with features such as heat-sensitive icons, intricate holograms and security coatings. The paying bank utilizing image analysis technologies are able to analyze these checks and compare them to previously cleared items to detect counterfeits, forgeries, and alterations.
- PATIENT ANALYTICS: The more information that can be efficiently gathered and stored, the more useful data like patterns and frequency of visits, as well as relationships to specific doctors, can be easily accessed to identify potential fraud behavior before damage occurs. This is also where Artificial Intelligence becomes a potent tool.
- UPGRADE ONLINE SECURITY: With great data comes great responsibility — healthcare organizations have to protect the confidential patient details and medical records which they store online. Ensuring state of the art security and analytics — as well as staff in place to operate this tech — is absolutely crucial.
As the healthcare industry increases its adoption of new technologies, it is critical that these technologies are safe and protecting patient healthcare information (PHI) as they use the data to analyze trends that identify suspicious activities. If you are partnering with outside vendors and third party business processors, take the time to understand their processes and controls for HIPAA compliance.
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