Strengthening Healthcare Security: 3 Ways to Protect Against Payments Fraud 

Patients want ease, security and choice with healthcare payments, akin to their experiences as everyday consumers. But it is important to consider the security risks associated with healthcare payments. Businesses in the healthcare industry must prioritize secure and seamless payment transactions to protect against fraud and maintain trust with their patients. By implementing secure, HIPAA-compliant payment methods, healthcare businesses can maintain the integrity of their systems while strengthening their relationships with patients. 

We know fraud can have devastating impacts on patients, medical professionals and the businesses working hard to serve them, resulting in tens of billions of dollars in losses each year. As estimated by the U.S Department of Justice, fraud could account for up to 10% of all healthcare spending, potentially exceeding $100 billion annually. These losses not only strain resources but also undermine the quality and cost of patient care. Common types of healthcare fraud include identity theft, where individuals use another person’s health insurance, fake marketing schemes that trick people into sharing their insurance details for billing non-existent services or stealing identities, and impersonating healthcare professionals to provide or bill for unauthorized services.

Here are three ways healthcare providers can proactively protect themselves and their patients against financial loss: 

Educate Patients and Train Staff 

In 2023, roughly 725 healthcare data breaches were reported, exposing over 133 million records. Education is a powerful tool in combating healthcare fraud, making regular training sessions essential for keeping staff updated on recognizing and preventing such threats. These sessions should cover identifying red flags, understanding common schemes and learning best practices for protecting patient information. Also, informing patients about common fraud tactics and how to safeguard themselves is crucial. This can be achieved through informational materials, workshops or digital platforms, ensuring patients understand threats like identity theft and bogus marketing. Creating simple and user-friendly reporting channels for staff and patients to report suspicious activities is crucial. Options like hotlines, secure online forms or direct communication with fraud prevention teams make it easy to report concerns quickly. By educating both patients and staff, healthcare providers can build a vigilant community ready to spot and prevent fraud, helping to maintain the integrity and security of the healthcare system.

Implement Identity Verification Solutions 

Embedding identity verification tools into a healthcare provider’s tech stack is important. Fortunately, there are now ways to verify a patient’s identity before they even check out. By embedding verification tools into digital invoicing or payment processing, healthcare providers can not only prevent unauthorized access but also build trust between patients and their providers. This might include: 

• Using ID Document Verification: A service provider can implement identity match and ID document verification, which involves checking identification documents, such as driver’s licenses or passports, against a database to verify their authenticity. The use of identity matching technology or ID document verification offered by providers such as Everyware can also be implemented as part of digital invoice payment processing, either by holding transactions where the identity is not verified or monitoring them only. 

• Implementing Biometric Authentication: It is also possible to enhance security by requiring patients to send in a photo or use biometric authentication, such as fingerprint or facial recognition. These measures ensure that the person initiating the transaction is physically present and matches the identity on record, adding an extra layer of security to the verification process. 

• Requesting Multi-Factor Authentication: Further, service providers can require multiple forms of verification to confirm a patient or staff member is who they say they are. This is often broken down as something the user knows (password), something they have (security token) and something they are (biometric data). Multi-factor authentication adds further protection, making it harder for unauthorized people to access sensitive information or commit fraud. This comprehensive approach helps ensure strong identity verification.

To better understand the impacts of medical identity theft, imagine this: John Smith, a 50-year-old construction worker, went to his doctor for a routine check-up, only to discover that his medical records indicated numerous treatments and prescriptions he never received. An identity thief had stolen his personal information and used it to obtain expensive medical services and prescription drugs. As a result, John faced denied insurance claims for his legitimate health needs, higher premiums, and even demands for payment on fraudulent medical bills. The thief’s actions left John struggling to clear his name, restore his credit, and cover the out-of-pocket costs for the healthcare he needed. This experience highlights the devastating financial and emotional impact of medical identity theft and the critical need for patients to protect their personal information and monitor their medical records closely.

Strengthen Financial Transactions 

Strengthening financial transaction security is crucial for protecting healthcare businesses and their patients from fraud. One of the first steps should be implementing secure payment processing systems to guard against potential breaches. Monitoring transactions for suspicious activity is equally important. By using AI and machine learning, organizations can detect and flag unusual payment activities in real-time, allowing for quick action to prevent fraud. Working with a trusted payment processor further enhances this security, ensuring secure handling of patient payments and preventing identity theft and breaches. By combining these efforts, healthcare providers can significantly increase financial transaction security, safeguard patient information and build trust in the healthcare system.

Fintech and healthtech share common ground, particularly in combating financial loss due to identity fraud. Both sectors handle sensitive personal and financial information, making them prime targets for fraudsters. Like fintech, healthtech must implement security measures like 

educating staff and patients about fraud risks and strengthening financial transaction security with real-time monitoring and collaboration with trusted payment processors, to create a secure environment for transactions. These proactive steps will help mitigate the risks of fraud and identity theft and uphold the integrity of the healthcare system, ensuring patient safety and trust. Without trust, patients will likely feel less confident in sharing sensitive information and relying on the healthcare system for their needs.