Know Your Patient – Preventing Medical Industry from Identity Fraud

It’s about time for the healthcare sector to consider more than just giving people medical care. Patient Identity, privacy and data security are becoming more and more important. Scams or frauds are an issue that every sector in today’s world must deal with. These scams are not uncommon in the healthcare sector. A recent data breach at AMCA resulted in the exposure of 2.2 million patient records and the company’s insolvency. 

Patient verification screening is becoming more and more necessary. The necessity for Know Your Patient (KYP), which involves doing patient identity checks, arises from the need to monitor the world’s increasing digitalization.

Know Your Patient – A Comprehensive Overview 

Illegally obtained medical records occasionally sell for more than $1,000 each due to the vast amounts of sensitive information they contain. Following HIPAA regulations is not enough to protect sensitive patient data. Some activists are calling for the adoption of a new standard called Know Your Patient (KYP).

Know Your Customer (KYC) regulations are crucial banking practices that require consumers to be verified in order to combat financial theft. On the other hand, KYP enables healthcare companies to check insurance plans and prescriptions, in order to provide protection to patients from financial and identity fraud. KYP screening begins with the website/web portal, pharmacy, and a solution that combines age and patient identity verification. After the completion of the onboarding process, the patient undergoes various checks using identity documents for authentication. 

3 Common Use Cases of Know Your Patient (KYP) 

• Medical Identity Theft

The intentional use of a patient’s medical data for fraud is known as medical identity theft. Commonly, fraudsters use stolen credentials to obtain discounted prescription medications, insurance coverage, free medical care, or simply abuse a patient’s payment details. According to the research, 1 in 3 health records got breached by cybercriminals. This resulted in the credibility loss of the medical institutions and financial damages experienced by patients. The five consequences of medical identity theft are quite severe:

• Treatment delays
• Misdiagnosis
• Imperfect patient care
• Inaccurate data entry
• Fatalities 

Sometimes, the public ignores hospital carelessness, but what about those who sue the administration? It results in financial loss for the health center and harms its reputation. So, medical institutions should prevent their losses by implementing smart patient identity verification solutions. It will not only streamline their regular business operations but also facilitate compliance with AML/KYC regulations. Consequently, it helps them evade permanent bans and other severe consequences from the global regulatory bodies.

•  Patient Age Verification in Pharmacies

The General Pharmaceutical Council recommends that pharmacies check customers’ age before giving them any prescription medications. Sometimes, kids obtain medicines that are inappropriate for them via an elder’s prescription. Prescription drug abuse results in drug addiction and excessive drug usage by minors can result in fatalities.

Therefore, proper patient record-keeping and information security are crucial to comply with data protection rules. Pharmacies should always use a patient age verification system before administering any prescribed medications.

• Verify Patient Identity – Hippa Compliance

The healthcare provider sector is expanding, and over time, digital technologies and solutions are becoming more prevalent. People can contact doctors online and obtain prescriptions through healthcare applications. Patient data misuse, breaches, and unauthorized usage pose a threat to this expansion. On the other hand, when a patient doesn’t interact with the doctor in person, there is a great chance of misinforming. One of the finest ways to maintain open communication between doctors and patients in the cloud era is Know Your Patient (KYP) screening. It ensures that the patient is describing the proper symptoms and is not lying to obtain a prescription for medication.

There is a rising requirement for solutions that are similarly proficient for patient identification verification in this environment where fraud and the healthcare sector are emerging. With the use of digital identity screening technologies, it can be carried out.

Conclusion

As healthcare security has become a global concern, more and more identity verification solutions driven by AI are being used to verify patient identity. This security solution will be beneficial to the medical industry as they onboard real patients and combat medical fraud. Patient identity theft, false insurance claims, and other issues are examples of these frauds. The integrity of the healthcare sector can be defended via Know Your Patient (KYP) compliance systems. Furthermore, due to advanced patient identity verification technology, the onboarding process is now transparent and frictionless.