Tech Solutions to Address the Alarming Rise of Healthcare Fraud

The FBI estimated costs associated with U.S. healthcare fraud was at $80 billion in 2013. A 2016 healthcare fraud sweep by the FBI involved $900 million in false billing and more than 301 individuals, including 61 medical professionals and 28 doctors. There a number of surprising and frightening ways that people internally and externally can game the system and that can lead to dire outcomes, including the lethal mistreatment of patients that are not properly identified and the ruin of personal finances.

“About 20 percent of victims have told us that they got the wrong diagnosis or treatment, or that their care was delayed because there was confusion about what was true in their records due to the identity theft,” says Ann Patterson, a senior vice president of the Medical Identity Fraud Alliance (MIFA), a group of several dozen healthcare organizations and businesses working to reduce the crime and its negative effects.

The good news is that there are solutions that are easy and effective to implement that will protect both healthcare institutions and patients safeguard. While adoption of new technology in healthcare is painfully slow, especially when it comes to operational efficiency, it is time that practices take notice of how simple and cost-friendly can make a big impact on operations. Case in point, the recent WannaCry Ransomware attack did not intentionally target hospitals but still caused a lot of damage to the NHS.

Common Fraud Schemes

There are several scenarios that are typical for fraud schemes. Below is a list of ways that people are gaming the system:

Rolling Lab Schemes. This healthcare fraud is the result of unnecessary tests that are charged to insurance companies. Insured individuals often get caught off guard because these tests are administered in friendly or familiar areas, such as retirement homes and local gyms.

Medicare/Medicaid Insurance Fraud. Medical service providers that sign off on unnecessary equipment or services (i.e. unnecessary testing) are often involved in this healthcare fraud scheme. They often work with equipment manufacturers who get access to seniors’ and other insured patients’ Medicare or Medicaid ID numbers.

Services Not Rendered. This type of fraud occurs when medical service providers or customers submit false or altered bills to the insurance companies for services that never happened.

Medical Equipment Fraud. In this scheme, insurers are charged for unnecessary medical equipment or undelivered medical equipment. These fraud cases often begin as a deceptive pitch or are presented to insured individuals as “free.”

Medical Identity Theft. This healthcare fraud involves perpetrators who retrieve insured individuals’ insurance identification and other information. They get this data several ways, including via collection of patient information during free screening at health fairs, recruiting corrupt medical staff with access to insured patients’ information, and buying patient information.

Prevention Methods

Prevent insurance fraud by safeguarding your patients’ benefit information and insurance cards, and your provider ID. You can also use a few quick and easy tech solutions to prevent gaming of the system:

Biometric Security Measures. This method includes implementing a biometric verification point, such as facial recognition, and strengthens the identification process. It can be used to match a person to their ID on file, or to confirm a real person that matches the ID on file is trying access information. Biometric Security is especially user-friendly for telehealth and mobile health apps by reducing the need to manually enter ID information or answer time-consuming, knowledge based questions that any fraudster might know, guess or hack.

ID Verification by ID Scanning. Presenting a valid ID is still a valuable way to prevent fraud. However, checking this manually at the front desk can be time consuming and error prone. Scanning an ID that can be authenticated as valid is quick and easy. Another benefit to scanning is accurate and clean data to populate into your data systems, such as EMR and HER, within seconds. This prevents records with wrong patient data and saves time at patient check-in. It also gives you the ability to verify patients’ identities every time the valid ID is presented.

Protect your Information. Patients must be more careful and pay attention to when and where they share their identity and healthcare insurance information. Anyone with access could be a gateway for fraud. And hackers are very wise about finding information via avenues such as social media to supplement the information they have, like a social security number. Cobbling together a patient profile allows them to present an identity that institutions will accept today.

Final Thoughts

Avoiding healthcare fraud may seem daunting, but it is simpler than you think and solutions exist today that can dramatically reduce the impact. Creating more user-friendly, frictionless ways to verify the identity of patients at every access point will go a long way to protect both healthcare institutions and patients from fraud. Set yourself up with tools that fit your needs, or consult a team of experts on biometric and ID verification security services for an effective and secure way to mitigate healthcare fraud.

 

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Customer-Friendly and Cost-Efficient Technology to Prevent eCommerce Fraud

Online fraud rose 15 percent between 2015 and 2016, and approximately $32 billion in costs associated with e-commerce fraud occurred in 2014. LexisNexis reported that 1.5 percent of retailers’ revenue is linked to fraudulent transactions. Continued data breaches also put online shoppers and retailers at risk. However, you can safeguard your eCommerce business from fraud by enhancing your existing security with easy to use, cost efficient technology tools.

How People Are Gaming the System

Before safeguarding your e-commerce operations, it’s important to understand how people are getting around security measures in the increasingly card not present (CNP) transactional environment. Some common ways eCommerce fraud occurs include:

Vulnerability in Mobile Devices and Infrastructures. Data breach occurs when vulnerabilities exist. Even the largest and most sophisticated businesses are vulnerable, as evidenced by headlines regarding Sony, Yahoo and retailers like eBay and Target. They can happen on almost any device, too, and with the rise in the use of mobile devices for both personal as well as business purposes, there has been an exponential growth in the number of well-organized cyber-crimes and independent hacks.

Account Takeover Fraud. Account takeover occurs when a fraudster uses a piece of stolen personal information to attempt to gain access to a private account. This does not have to be a social security number or PIN code – anything from an email address to a username, any identifier used in the validation process can work. As an example, a fraudster could use an email and login for any account and run that against services such as PayPal, eBay, Amazon and virtually any other mobile app – in minutes. Validated credentials can then be sold for hundreds or thousands of dollars on the Dark Web.

Chargebacks and Reversed Transactions. This form of “friendly fraud” happens more often than you think. More than 86 percent of chargebacks are estimated to be fraudulent. It makes it easy for customers to get a refund via their credit card companies by disputing charges while putting the burden on the e-retailer or business owner to prove that the charges are valid.

Identity Theft. While ushering in the EVM chip helps to reduce fraud in person, it doesn’t stop fraudsters from viewing the physical card number, recording it and using it online. Moreover, hackers can get personal data online from doxxing (the internet-based practice of researching and broadcasting private or identifiable information) and can often link public information with bits of personal data, such as the last four digits of the social security number and the birth date and address from a voter’s registration database online.

Tech Solutions That Work

With the increase of card not present (CNP) and mobile transactions, the good news is that you can safeguard your online business with the right tech tools. Here are some quick and easy tech solutions to instantly prevent eCommerce fraud:

ID Verification via ID Authentication. Quick and easy ID capture can allow online retailers to validate an ID in seconds. Forensic tests can be performed in real time to ensure that the ID presented is authentic. Scanning the ID also allows retailers to get necessary information that is accurate to populate into your point-of-sales (POS) system and CRM. This allows for quick verification of customer data such as age and address to verify the sale of an alcohol wine club membership or other age or geographically restricted business. It also removes the inconvenience of manually entering in data, improving shopping cart abandonment rates.

Biometric Security Measures. Facial recognition match makes it easier and more user-friendly to verify identities and integrate with existing apps or systems. Customers can simply snap selfies to verify that they match the photo on their government issued ID from a webcam or mobile device. This extra step prevents fraudulent transactions by further binding a person to their identity.

By recognizing that there are quick and cost-effective tech solutions to manage online retail fraud, you can instantly reduce your risk and recognize good transactions while flagging bad ones. As a bonus, you get the added benefits of:

  • Verifying Age and Address
  • Clean CRM/Customer Database with Accurate Information
  • Fast and Friendly Customer Check-out Experience

See what verification tools are right for your business!

 

IMPROVING IDENTITY VERIFICATION SOLUTIONS IN FINANCIAL SERVICES

Despite advances in technology, such as the spread of credit cards with microchips, in 2016 more than 15 million Americans lost $16 billion as a result of identity theft.

Financial services is an area where identity verification is crucial. Financial institutions must ensure that customers are who they claim to be, but they also do not want to make the verification process very difficult and annoying for customers. Mistakenly giving a malicious actor access to a user’s bank account could result in devastating consequences. But what are customers willing to do and what should they do in order to have security? We know that today, answering a few questions and providing a password is easily hacked by sophisticated fraudsters.

Fortunately, there are a number of solutions to protect customers from fraud that are also user-friendly and fast.

Onboarding and New Account Creation

Bringing new customers on board needs to be quick and easy, but also secure in order to protect both institutions and customers. When a new bank account is opened, it’s the institution’s responsibility to verify the identity of the user. The bank must first verify that the given name and Social Security number match a real person, typically by contacting one of the three major credit bureaus. Next, the bank must verify that applicants are who they claim to be by asking questions about their personal history, such as cities or streets where the applicant has lived in the past.

Financial institutions in the U.S. also need to comply with applicable security regulations when opening new accounts. “Know Your Customer” (KYC) is a policy for businesses who need to verify the identity of their clients in order to prevent crimes such as fraud, identity theft, and money laundering. KYC programs begin by collecting and verifying information about customers and checking them against a list of known criminals. Higher-risk customers have additional information collected, and their activity is monitored for potential red flags.

All of these processes can be streamlined and automated by the intake and authentication of data from a government issued ID, like a driver’s license. Authentication solutions that scan an ID, on a desktop or mobile device, can verify a credential in seconds to validate it. This then allows the institution to match the verified credential to the person. You may do this visually at a bank, or through a mobile facial recognition app that will match the photo on the ID to a selfie taken.

Mobile Banking

Mobile banking is a trend that is set for explosive growth in the years to come. In 2015, KPMG estimated that the number of mobile banking users would double in the next 4 years to 1.8 billion people.

This rapid growth of mobile banking makes the identity verification process even more important. Traditionally, mobile banking customers have logged onto their accounts using a username and password. In the event that they forget this information, customers need to provide data such as their Social Security number or credit card, or answer “out-of-wallet” security questions.

However, in recent years, banks have explored alternate security measures, such as biometric security. For example, many banking apps now make use of fingerprint and facial recognition technologies. In addition, some financial institutions allow users to verify their identity using their voice when they call the company’s phone number.

It is possible today to open an account and conduct all your banking without ever stepping foot in a bank, but you want to make sure that your financial institution is taking proper security measures and all the better if they are fast and easy for customers!

 

Avoiding ID Fraud, Car Theft and Auto Rental Chargebacks

The advent of the Internet of Things has turned 20th-century cars into automated smart cars that harness sensors and the Internet for connectivity and convenience. In fact, connected cars can contain as much as 100 million lines of coded information. With such large amounts of data, the chances for a possible hack and access to personal data increase; moreover, the growth in car sharing services as a car rental option or a growing division of an existing company also presents cybersecurity issues. However, these problems are resolvable by taking the right steps to avoid ID fraud, car theft and auto rental chargebacks. Here are a few actions to consider.

1. Consider ID scanning & verification

Car rental and car sharing services are susceptible to fake IDs and auto theft, especially during a test drive or when loyalty programs can make it easy for multiple online reservations without the need to swipe a card. However, ID scanning can help reduce this issue. Solutions via mobile devices or scanners allow for quick data capture, ID authentication and even identity verification in real time.

2. Use biometric technology

According to the FBI, more than 700,000 cars are stolen on an annual basis in the United States, with one stolen every 45 seconds, as of 2015. Weak links in code and anti-theft systems explain why car thieves can easily steal vehicles and access personal data from consumers and even suppliers and manufacturers. However, biometric technology, such as facial recognition, offer viable solutions for mitigating this issue. For instance, facial recognition can be used in real-time to authenticate the driver and send a text message to the owner of the vehicle, should an unauthorized person enter the car.

3. Spot potential chargeback signs

While the sharing economy offers car sharing as a new revenue stream, dishonest customers can present security issues in the form of chargebacks. Chargeback fraud is often associated with increased customer complaints, and a history of chargebacks can increase this fraud. That’s why it is vital to recognize risks. Additionally, car sharing services can engage facial recognition to ensure that only drivers signed up for the program are using the authorized account and consider engaging further ID verification services while assessing vulnerabilities.

Final Thoughts

Technology is very often the driver of better services and better products for cars. However, connected cars can leave their drivers and passengers vulnerable to ID fraud and car theft if not secured properly. Business owners and managers of car sharing services or traditional car rental services can also leave their businesses exposed to chargeback fraud from their own customers. You can prevent these actions by using the right technology or consulting with an expert on ID verifications and security services.