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5 Strategies to Ensure Revenue Integrity in Healthcare

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Many healthcare providers were struggling financially before the pandemic. But now, the U.S healthcare industry is on the verge of financial disaster. According to the American Hospital Association, hospitals are bleeding approximately $50 billion per month due to canceled elective procedures and costs associated with treating COVID-19 patients. Many non-COVID patients have also stopped seeking primary care visits, including patients with life-threatening conditions, because they are worried about exposures. In addition, claim errors, denials, and payment delays that result from inaccurate patient identification, duplicate medical records, and medical identity theft still persist, all of which affects revenue integrity. 

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Adopting Value-Based Reimbursement (VBR) models has shown to have economic advantages but poses a real challenge for healthcare providers alongside ever-changing healthcare compliance regulations. Siloed workflows, data proliferation, and disparate systems make it difficult to achieve the collaboration that is needed for VBR to yield optimal results. However, intelligent revenue cycle management can be the key to achieving financial stability and revenue integrity. 

Identify the problem

Today’s environment requires automating workflows and considering the whole revenue cycle process to ensure revenue integrity. Healthcare providers want an easy, seamless way to manage revenue cycle without errors, such as those caused by patient identification issues. Considering the lack of electronic medical record (EMR) system capabilities to adequately address the critical need for accurate patient identification, it is vital to leverage complementary technologies with core-specific competencies that can improve the overall revenue cycle. For example, improving patient identification and matching processes at the front-end of the revenue cycle process can significantly reduce costs. 

As an industry-leader in touchless patient authentication, RightPatient has been helping many healthcare organizations reduce claim errors and denied claims by ensuring accurate patient identification. By eliminating denied claims linked to identification errors, healthcare providers can reduce the burden of back-end activities in the revenue cycle and simplify the reimbursement process to ensure revenue integrity.

Rely on technology

Adopting technology is also essential to ensure that clinical teams across the healthcare ecosystem are accessing high quality shared data to produce the best outcomes. Augmenting the organization’s core systems with complementary technologies on a single, integrated platform enhances internal collaboration with other teams or departments. For instance, RightPatient crosses departmental silos and brings transparency to patient healthcare data across disparate domains. Transparency across teams is critical. RightPatient will ensure that a holistic and accurate medical record of each patient can be accessed by clinical and operational staff members no matter where the patient is authenticated. By automating the patient identification and authentication process, RightPatient improves clinical outcomes and enables staff to proactively focus on other areas where their expertise has the most impact.

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Ensure compliance

According to the National Association of Healthcare Revenue Integrity (NAHRI), the goal of revenue integrity is to prevent issues that lead to revenue leakage or compliance risks through effective, efficient, and internal controls across the care continuum, supported by strong documentation and sound financial practices that can withstand audits at any time. 

Violation of healthcare compliance is a major contributing factor to financial losses. For instance, HIPAA violations are becoming more common across the U.S healthcare system. HIPAA compliance software, on the other hand, can help address this issue. Such software allows healthcare providers to simplify their compliance efforts and manage training through an effective communication system. Ensuring HIPAA compliance prevents privacy issues that can impact proper revenue cycle management and helps to avoid costly financial losses.

Accurate documentation and coding

Unfortunately, as long as healthcare providers do not address the issue of front-end data validation, claim denials will continue to wreak havoc. Inaccurate patient identification and medical identity theft still remain a major contributing factor to denied claims and payment delays. However, through accurate patient identification, RightPatient enables healthcare providers to bill and code each patients’ information accurately. By ensuring accurate and clinical documentation, this platform significantly reduces inefficiencies of denials and rework, thereby strengthening revenue integrity. 

Improve hygiene and foster patient trust with RightPatient

Healthcare providers are witnessing a reduction in non-infected patient activity due to the fear of COVID-19. Visits for general check-ups or other routine procedures have decreased to the obvious financial detriment of healthcare providers. These providers need to reassure their patients that they are taking all precautionary steps to maintain hygiene and control this contagious disease. Adopting RightPatient is a sensible part of this strategy. 

RightPatient is a completely touchless biometric patient identification platform that can accurately identify patients throughout the continuum of care. After capturing a photo from a smartphone, tablet, or webcam, RightPatient instantly identifies patients and retrieves their correct medical record. By securing unauthorized access to medical records, hospitals are able to prevent medical identity theft, reduce denied claims, and duplicate records – all of which are vital to a high-performing revenue cycle. 

RightPatient also offers remote patient authentication, which is becoming increasingly necessary as people are maintaining social distance by staying at home and getting treatment through telehealth practices. During this process, RightPatient validates patient identities by comparing their ID (e.g. driver’s license) and selfie photos. This process can also help healthcare providers to save money on more expensive identity proofing solutions through credit agencies. 

As patient care becomes more complex, so does the management of the revenue cycle. RightPatient can help to simplify and manage the complexity by ensuring safe, ubiquitous patient authentication from various patient encounter points. Full financial recovery from this pandemic may take years, but adopting RightPatient will ensure that you are on a faster path to success.

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Medical Identity Theft Cases can hamper Telehealth – How are you Identifying Patients?

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COVID-19 has been one of the most impactful events in recent years. While some parts of the world are preparing to reopen or are easing lockdowns in phases, the general population is still on edge as there is no cure for the novel coronavirus, which has affected over 3.9 million people worldwide as of 8th May 2020. However, some applications have seen meteoric growth during this challenging period – telehealth is one area. However, since practitioners have to deal with patients remotely, there can be potential medical identity theft cases here as well. How can practitioners find out they are treating the right patient? Are there solutions available to ensure accurate patient identification?

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The rise of telehealth

Telehealth has been around for years now, with many people debating about its pros and cons. However, 2020 seems to be the year of telehealth. It has revealed how effective telehealth can be for virtual care visits and one of the most effective ways to provide patient care while we practice social distancing. Telehealth is at an all-time high – Forrester Research estimates that over a billion telehealth visits will take place this year alone, where 900 million of the visits will be due to COVID-19. Telehealth in March alone saw a 50% increase in services due to the pandemic. 

This huge increase in numbers was boosted due to the U.S. government encouraging patients to use telehealth instead of attending for physical visits to their medical professionals to minimize the risk of COVID-19 spread. 

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Medical identity theft cases may rise

Telehealth is having its long-overdue success and spotlight, thanks to how it is helping treat patients remotely right now as a result of the COVID-19 pandemic. However, it does have to keep some factors in mind to ensure that proper care is given to the right patients. Are caregivers ensuring that the proper patient is being treated? Do they have the tools to verify it? 

While people have shared their credentials with family members in the past, there is no guarantee that this will not repeat itself, especially given the current financial problems the pandemic is causing. With frequent data breaches occurring, it may be quite easy for someone else to assume the identity of another patient.

While there have not been any reported cases as of yet, caregivers must remain vigilant and attempt to verify a patient’s identity. Doing that can be challenging as practitioners are facing a huge number of calls per day and may not have the right tools or resources for effective patient identification. Medical identity theft cases were already prevalent during normal times, and the same might happen with telehealth too.

Thankfully, a solution exists

Leading healthcare providers have been using RightPatient for years now. It is a contactless biometric patient identification platform that locks the EHRs (electronic health record) of the patients with their biometric data. This ensures that outsiders cannot assume the identity of a patient and gain access to healthcare services. RightPatient has been successfully preventing medical identity theft cases, reducing duplicate record creation, and improving the revenue cycle of hospitals for years by ensuring accurate patient identification whenever patients arrive. 

How can it be used for telehealth? Well, RightPatient came up with the perfect solution for the pandemic – caregivers can now validate patients’ identities remotely. When a patient confirms the appointment with the practitioner, he/she is notified with a text message to provide a photo of their driver’s license as well as a selfie. RightPatient automatically matches the photos to ensure the patient’s identity, saving caregivers from financial burdens, and mitigating risks of treating the wrong patient. 

RightPatient already has years of experience, and with remote authentication, it has created the perfect tool for health care providers using telehealth. Ensure accurate patient identification and prevent medical identity theft, whether you’re treating patients in person or remotely via telehealth. 

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Healthcare Data Breach Statistics show 40 Million Patients were affected in 2019

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Data breaches – this topic has been covered a lot here. That’s because it is so prevalent and is constantly haunting big and small healthcare providers across the U.S. In 2019, a whopping 40 million people were affected by healthcare data breaches. To put this in perspective, 14 million people were affected, according to healthcare data breach statistics in 2018.

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A recent study has also shown that 2019’s numbers were higher than the 2015 data breaches where over 113 million records were exposed. The report from the study emphasizes how over 400 organizations experienced breaches consisting of more than 500 patient records. Even though some providers are working to increase security, they are finding it challenging to stay ahead of the curve.

The reported data breaches increased by 38 percent from January to October 2019, compared to 2018. More than 429 organizations reported breaches, which is considerably higher than the 371 organizations reporting data breaches in 2018. 

The result? 

40 million people were affected by these data breaches, and these are the data breaches that were actually reported. However, the aforementioned study claimed that more than 480 organizations would be affected by data breaches in 2019.

Hacking was consistently the main cause of data breaches from 2016. However, hacking stole the spotlight in 2019with 59 percent of the reported data breaches a result of hacking. 

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Another tool used by cybercriminals is email.

Stolen medical records often contain sensitive information of the patients – their medical history, their medications, test results, names, addresses, and so on. The hackers usually sell this information on the black market where buyers assume the identities of the affected patients.  

Patients can serve hospitals with lawsuits for not protecting their sensitive data. Some patients spend a lot of time having their medical records fixed, which is costly for the patients, the hospitals, as well as the insurers. It is a loss for everyone involved.

What can hospitals do?

While data breaches can not be stopped so easily, thankfully medical identity theft can be prevented. This is where RightPatient comes in – it locks the medical records of the patients with their biometric data and also attaches a photo to the medical records. Even if the medical records are stolen, the patient data will remain safe. If a  person attempts to assume the identity of a patient, RightPatient immediately red flags the user and lets authorities know, preventing medical identity theft in real-time. Healthcare providers are protecting millions of patient records with RightPatient, mitigating losses, improving the revenue cycle, preventing being a part of healthcare data breach statistics, and enhancing patient safety – are you one of them? 

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Healthcare Data Breaches can lead to Medical Identity Theft

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As per The Health Information Technology for Economic and Clinical Health Act (HITECH)  requirement, breaches that expose protected health information (PHI) affecting 500 or more individuals must be listed. The Breach Reporting Tool of Health Insurance Portability and Accountability Act (HIPAA), reveals that 26 new incidents were added to the portal at the end of March 2020. These incidents are all related to healthcare data breaches. 

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The security incidents in the portal list are currently under investigation by the Office of Civil Rights (OCR). It has been reported that out of 26 incidents, 13 were caused by hacks or other IT related incidents, affecting 338,334 individuals. Other noteworthy healthcare data breaches affecting 44,592 individuals were caused by theft, loss, and unauthorized access or disclosure of information.

Healthcare data breaches have had a sustained impact on the quality of delivery care and have made healthcare providers more prone to medical identity thefts. Healthcare data breaches are becoming a pressing concern for providers and there’s no sign of the data breaches slowing down. 

How do criminals capitalize on stolen personal health information?

Personal health information (PHI) is any information or data entry that can identify an individual. PHI includes sensitive information such as names, addresses, Social Security of Medical Insurance numbers, information about beneficiaries, financial details including account numbers, and diagnostic images. This type of information can be created or collected by your health plan providers, employers, healthcare providers, or other healthcare entities.

Medical records are not only highly sought out by criminals but are highly desired on black markets too. This kind of information can sell for as much as $1000, depending on the amount of the victim’s information is available. Cyber thieves and criminals can later use stolen healthcare records and they plot illegal schemes, such as medical identity thefts.

How can healthcare providers mitigate negative outcomes?

Healthcare data breaches and medical identity thefts are wreaking havoc on revenue cycle management of hospitals by increasing operational costs and negatively impacting patient experience. 

To reduce the risk of healthcare data breaches, hospitals need to implement adequate security measures as per the HIPAA Privacy and Security Rule requirement. In addition to the Security Rule, covered entities are required to issue notifications to affected individuals in the event of breaches to unsecured protected health information, as per The HIPAA Breach Notification Rule. Healthcare providers can use a HIPAA compliance management solution to simplify their administrative operations. 

When hospitals adhere to the HIPAA rules effectively, it means they are using appropriate safeguarding measures to keep their protected health information secure. As a result, their networks and devices will have increased protection from cyber attackers and hackers.

To prevent medical identity thefts, hospitals can simply use a biometric patient identification platform such as RightPatient.

How can RightPatient prevent medical identity thefts?

RightPatient is a biometric patient identification platform that locks patients’ medical records. During registration, the patient just needs to provide their biological data such as iris patterns or facial photo, and the platform will use this data to lock their medical records. Next time when the patient arrives at the care continuum, all the patient needs to do is just look at the camera and the platform will accurately identify the individual and bring up their medical records.

This platform prevents fraudsters from illegally accessing medical records by encrypting sensitive information using the patient’s biological characteristics. A fraudster will not be able to simply walk in and use stolen PHI to receive medical services or benefits. 

By using RightPatient leading hospitals will have improved patient experiences and healthcare quality and will also reduce the number of denied claims, from which hospitals lose millions of dollars each year. 

It is forecasted that the Global Healthcare Biometrics market will reach a market value of $5.8 billion by 2025, at an expected CAGR (Compound Annual Growth Rate) of 19.3% (2017-2025). Implement RightPatient now and stay ahead of the curve.

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Protecting Patient Data is a Topmost Priority During the Coronavirus Pandemic

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The last few months have been excruciating for the whole world due to the COVID-19 outbreak. Hospitals have been working tirelessly, tending to the unprecedented number of patients coming in. However, that has not stopped them from experiencing unwanted incidents like data breaches. However, even in this scenario, protecting patient data is a must. 

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An example

On March 20, University of Utah Health started notifying a number of its patients regarding a phishing incident followed by a malware attack. Back in February, the provider detected unusual activities on their employees’ email accounts. After conducting a thorough examination, they concluded that an outsider gained unauthorized access to those employees’ email accounts between January 7 and February 21.

The outsider did this by acting as a trusted source. Thankfully, the U of U Health was successful in securing the affected accounts. Some of the patient data, which was potentially exposed consisted of patient names, DOB, medical record numbers, as well as some clinical information. 

However, that was not the end of the data breach.

After detecting the phishing attack,  U of U Health found out that an employee’s machine might have contained downloaded malware on February 3. After scrutiny, the experts at  U of U Health stated that the malware potentially allowed access to parts of patient data, just like the previous one – names, DOB, medical record numbers, as well as some clinical information.

The matter is still being investigated, and however, U of U Health stated that they did not find any evidence that the affected patient data was misused. The healthcare provider is making changes to ensure that such unwanted incidents do not happen again. 

That is just one healthcare provider. There are numerous that are still facing data breaches, even during the coronavirus pandemic. The crisis makes it ripe for hackers to steal sensitive patient information, as hospitals are having a hard time dealing with the whole situation at hand.

Medical identity theft issues 

The hackers can steal patient data, and either use it for their purposes or sell it to other parties. The outcome is medical identity theft – someone else assumes the identity of the patients and uses healthcare services, which were initially meant for the patients. Medical identity theft causes the victims to receive shocking bills for services they never used. It can also lead to the healthcare providers being hit with lawsuits by the patients, claiming that the providers did not protect their sensitive patient data well enough. 

How are hospitals protecting patient data?

This is where RightPatient can help. With this contactless patient identification platform, medical identity theft can be prevented easily. RightPatient uses biometric data (such as iris) to store medical records along with capture photos of the patient. Later on, all a registered patient needs to do is look at the camera – RightPatient identifies the accurate medical records within seconds and provides it to the hospital staff. Even in the case of a data breach, patient records are locked with the patients’ biometric information. Thus, also if a third-party assumes the identity of the patient, the platform will immediately detect the fraudster – preventing medical identity theft and protecting patient data.

Also, it is of paramount importance that hygiene is maintained within hospitals, which is why RightPatient’s contactless identification platform makes it ideal for detecting accurate patient records during this crucial time without causing infection control issues. 

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Medical Identity Theft Stories are Common in Emergency Departments

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Medical identity theft stories are quite common – many patients in the Emergency departments (ED) may suffer from it. Many healthcare providers are unaware of this growing concern. Verifying the identity of patients when they meet in the emergency room often reveals red flags, and this usually happens. Healthcare personnel, both within and outside of E.D., need to be trained regarding the precise signs of medical identity theft. They also need to activate institutional policies to prevent virtual offenders like these from engaging in further illegal activities. 

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What’s the reason for medical identity theft?

Healthcare institutions have been facing the growth of medical identity theft incidents. The perpetrators will try to use other individuals’ personal information, such as health insurance or social security number, without any acknowledgment of him/her. Most reasons for medical identity theft are receiving medical treatment and drugs, acquiring money by false claims of medical treatment, and fabricating medical records corresponding to those claims. These are the types of offenses that cause medical identity theft.

What’s the level of threat?

A survey conducted by the Federal Trade Commission ( FTC) showed that in 2005, 3% of all identity thefts, or 249,000 attempts, were related to medical identity theft. The Ponemon Institute conducted another assessment in 2013 and found that 1.84 million individuals were victims of medical identity theft. The identity theft rate in the emergency department may be higher as they are handling comparatively more patients, and such surveys do not show individual departments’ numbers. 

Who are the victims?

Healthcare providers, payers, and many other several parties are impacted by medical identity theft. But the patients might be the most prominent victims in these offenses. Inappropriate treatment and use of drugs may lead to alarming incidents. This may also lead to financial burdens, as healthcare providers will bill actual medical identity holders or their insurance carriers for the treatments they did not receive.

A threatening story of Identity Theft

Some cases demonstrate common incidents at emergency medical departments, which eventually resurfaced as medical identity theft. The joint efforts of multiple healthcare associates, registration clerks, nursing staff, security officers, and physicians made it possible to discover the incidents. On the positive side, they managed to deal with these situations without compromising patient care, and they followed the Emergency Medical Treatment and Labor Act (EMTALA) regulations throughout the process.

A notable incident is that an 18-year old male came to the Emergency Department with a headache due to his fall twelve hours before reporting. Afterward, he was questioned by the hospital security manager and a local police officer, as he appeared to the Emergency Department without any personal identification and didn’t validate his identity to the nursing staff or registration clerk. Moreover, his signatures on the hospital’s standard financial agreement and patient identification form weren’t matching with signatures given on the previous encounter. After 13 days, he was prosecuted with the information obtained by hospital security for the felony of medical identity theft and insurance fraud.

Put an end to new medical identity theft stories

Emergency Departments play an essential role in the cure of patients’ diseases. Such crimes can reduce patients’ trust in the healthcare system. RightPatient can extinguish this risk with its biometric patient identification platform. It locks the medical records with biometric data of the patients. Once the patient registers biometric data such as irises or fingerprints, only patients who have been verified by biometrics can access the record, thereby avoiding the opportunity for medical identity theft. This also helps hospitals identify accurate patient records within seconds. RightPatient can also eliminate patient matching errors by ensuring precise patient identification – enhancing patient safety.

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Employees Can Compromise Medical Records – How Can Hospitals Protect Patient Data?

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As harsh as it may sound, employees getting fired for accessing medical records without any malicious intent is very common. More than 4.5 million records were compromised in unauthorized access or disclosure incidents caused by employee errors, negligence, and acts by malicious insiders in 2019, according to the HIPAA data breach statistics report. Thus, providers need to find out strategies to protect patient data better. 

In 2019 Northwestern hospital dismissed nearly 50 employees for accessing a celebrity’s medical record without consent. Recently mentioned in another similar series of unfortunate events is the Hawaii Pacific Health in Honolulu.  

RightPatient-can-help-protect-patient-dataHawaii Pacific Health discovered that an employee had erroneously accessed patients’ medical records. As a result, 3772 patients’ records may have been compromised, according to the HHS Office for Civil Rights data breach portal. The employee who worked at Straub Medical Center was later terminated. The organization believes that the employee only acted out of curiosity and did not intend to embezzle their identities. 

Consequences associated with compromised medical records

Medical records that may have been compromised include name, addresses, phone numbers, email addresses, dates of birth, religion, race/ethnicity, Social Security numbers, medical record numbers, primary care providers, dates of services, appointment notes, hospital account numbers, department names, provider names, account numbers, and health plan names.  

Nevertheless, accidental disclosure of sensitive personal information may lead to severe consequences, and lead to medical identity theft or even worse. If it falls into the wrong hands, this information can be used for theft or personal gains. The culprit may also fraudulently obtain medical benefits or sell this information to third parties, who may then misuse them.  

Healthcare organizations plagued by patient data breaches have had a sustained impact. Patient-trust is the driving force for effective and quality clinical practice. When an incident similar to Hawaii Pacific Health occurs, it will cause financial and reputational losses to medical service providers. On the bright side, Hawaii Pacific Health will provide the affected patients with free credit monitoring and identity restoration services for one full year. However, as data breaches make hospitals more vulnerable to identity theft, hospitals will again face an increasing administrative burden.

What can the healthcare providers do to protect patient data?

Currently, Hawaii Pacific Health is looking for alternatives and is willing to invest in technology. Technology can help prevent repercussions, such as medical identity theft. Nonetheless, compromised data can be easily safeguarded with a biometric patient identification platform that prevents unauthorized access. 

RightPatient – Biometric Patient Identification Platform

RightPatient has been serving several healthcare providers and medical institutions to avert repercussions like illegal access to patient data, and ultimately preventing medical identity theft. RightPatient is the most advanced biometric patient identification platform that can protect patient data by preventing inappropriate access to patient medical records.

How does it work?

During registration, patients will need to provide their biometric information (facial photos, irises, fingerprints) to the hospital. With the help of biometric encryption technology, patients’ medical data will be kept locked and secured. The next time patients come to receive medical services,  all they need to do is look at the camera or perform a fingerprint scan to unlock their data in seconds. This technology automatically prevents illegal access to medical records,  as to access the data, you will need the patient’s authentication. 

When all is said and done

There is no doubt that the patient’s medical record should be kept confidential, but the crux of the matter is human errors are inevitable. Hospitals should be aware and willing to invest in technologies that can prevent more damage and open the door to more opportunities for quality health service.

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Hospital data breach results in an expensive lawsuit – Is yours next?

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Hospital data breaches have been rampant for quite some years now. Last year’s figures alone are quite frightening – one states that 41 million patient records were exposed, essentially making the patients potential victims of medical identity theft. Thus, both data breaches and medical identity theft has been in the limelight. These unwanted nuisances have turned the attention towards healthcare providers who are suffering from these events. One such provider is the University of Missouri Health Care (MU Health), who suffered a data breach of 14 thousand records and also were hit by a lawsuit by the impacted patients.

This happened back in 2019. The provider was sued by patients who were affected by the breach in question. The patients reasoned that the breach had made their sensitive records prone to medical identity theft – their fear was not irrational.

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The actual story

On the first day of May 2019, the healthcare provider found out that an outsider somehow accessed email accounts of two employees for more than a week. Following the incident, the concerned officials said that they took the necessary steps to secure both accounts. 

It was not disclosed how the hacker got access and whether it was a phishing incident or not. However, the healthcare provider revealed that the affected account had sensitive patient data stored, such as names, DOB, medical record numbers, insurance details, as well as treatment details. The hospital data breach even consisted of the Social Security Numbers of some unlucky patients.

The data breach, fortunately, did not affect all the patients of MU Health. However, it did affect around 14,400 patients, which is no small number. As soon as the provider’s inquiry ended regarding the breach on the twenty-seventh day of July, it started to inform the patients regarding the breach. Oddly, the organization notified the patients after the required timeframe of 60 days as per HIPAA regulations.

The aftermath

Within the same week of notifying the patients, one of them filed a lawsuit, followed by 19 others. Their reason was very simple – the data breach would likely result in medical identity theft and lead to lower-quality care. The patients also believed that they were paying quite an amount of money, and thus, MU Health should add stringent security with their services.

Hospital data breaches can arm hackers with enough information to obtain medical services assigned to the patients. The hackers could either expose the data, sell it, or use it for themselves. These could lead to the patients paying for healthcare services they did not avail. These could also become denied claims for healthcare providers. Whichever way one looks at it, data breaches and medical identity theft is extremely undesirable. 

How do hospitals prevent medical identity theft?

Although it is quite prevalent nowadays, medical identity theft can actually be prevented. One way to make sure that the medical records are safe is by locking them with a key that hackers cannot forge. That is exactly what RightPatient does. It is a biometric patient identification platform that locks the patient records with their biometric data. Once the platform attaches the medical record with the data during enrollment, a third party cannot come and claim that record, preventing medical identity theft and ensuring accurate patient identification. RightPatient has been preventing medical identity theft for leading hospitals such as University Health Care System and Grady Health System.

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How RightPatient Benefits Medical Identity Theft and the Healthcare Red Flags Rule

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It’s no secret that medical identity theft is on the rise. Over 2 million Americans each year become victims of medical identity theft, and, unfortunately, that number only continues to grow.

It’s growing for a number of reasons. First of all, there were more healthcare data breaches in 2019 than the previous three years combined. These breaches compromised the medical records of over 40 million Americans. 

Let’s consider this in light of rising healthcare costs and a worsening opioid epidemic. These facts create a ripe market for medical identity theft. Patient identity data is readily available on the black market and there is a ton of demand for it.

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When medical identity theft is perpetrated, patients and healthcare providers suffer. Victims can face bills for services they never received, incorrect treatment data mixed into their medical record can affect future outcomes and quality of care, and the costs to restore their identity can be prohibitive. 

Healthcare providers lose millions of dollars for services that will never be paid for. Increasingly, they also face litigation costs from patient lawsuits for failing to protect their information. 

Providers also face another burden. In 2009, the FTC started to enforce the Red Flags Rule, which requires healthcare providers to develop programs that can help to detect and address situations that are “red flag” indicators of medical identity theft. The goal is to ensure vigilance and reduce the potential costs associated with medical identity theft.

However, implementing red flag processes, keeping them current, and ensuring compliance can be expensive and time consuming for healthcare providers. These processes must also be administered by front-line staff members, typically patient access employees that handle registration. 

This is an enormous responsibility for these employees when considering the potential consequences of medical identity theft. Compliance with red flag rules also places a substantial burden on registrars who are already buried with additional duties such as verifying insurance, collecting payment, and processing patients as efficiently as possible to reduce wait times and improve margins. 

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Now, against the backdrop of these market realities, imagine if the risk of medical identity theft could be substantially mitigated, if not eliminated altogether. This is where RightPatient comes into play. 

RightPatient validates that patients are who they claim to be when scheduling appointments by comparing a patient’s selfie photo to the photo on her driver’s license or other ID cards. When patients show up for visits, RightPatient accurately identifies them during registration and other points along the care continuum. 

RightPatient creates a closed-loop platform to prevent medical identity theft and other errors that can impact patient safety, revenue cycle, and data quality. This saves a lot of time, money, and hassle for patients and healthcare providers.

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How Do Progressive Hospitals Prevent Medical Identity Theft?

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There are many things we need to be concerned about to avoid any identity theft and lose a significant amount of money. Social Security Numbers, bank accounts, credit cards, insurance, and even driver’s license need to be monitored continuously to make sure these are safe and sound. Another kind of theft has been increasing rapidly in numbers – medical identity theft. However, what are the problems associated with medical identity theft, and what can hospitals do to ensure that their patient data is safe and secure from such events? Let’s explore.

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What is medical identity theft?

As a refresher, medical identity theft occurs whenever an unauthorized person takes the credentials of a patient without the latter’s knowledge and uses it for personal gain. It can be used to obtain healthcare services such as prescription drugs, treatment, as well as medical equipment. Also, as we can see in the recent news, criminals are actively targeting medical data of patients, which has contributed to the meteoric rise of medical identity theft. These cause the patients to receive medical bills with shocking numbers – tens of thousands of dollars’ worth of services can be used or stolen by the criminals. One hundred seventy-one million patient records were exposed online, according to the Identity Theft Resource Center. On the other hand, the reputed Ponemon Institute estimates that patients pay around $13,500 either for the fixes or for the services used by the culprits.

How does it affect patients and hospitals?

Other than the previously mentioned financial impacts medical identity theft has on patients, it affects them in different ways as well. According to the Ponemon Institute, 3% of the patients were fired, 19% lost potential jobs. In contrast, a considerable number of patients faced embarrassment due to the exposure of sensitive healthcare data – all of which happened due to medical identity theft. It can also cause the medical data of the culprits to be embedded into the patient record. For instance, when a victim goes to their providers for healthcare services, the patient might be given treatment based on the culprit’s preferences, interfering with the preferences of the actual patient.

For hospitals, medical identity theft is equally damaging, if not worse. Half of the patients will switch their healthcare providers if their medical identities are stolen, according to the Ponemon Institute. Such an event would also impact their reputation, cause losses in millions due to denied claims, and so on. All in all, medical identity theft is a problem for everyone involved and can be very costly to fix.

How do hospitals prevent medical identity theft?

Many safeguards can prevent medical identity theft, but none are as effective as RightPatient. It is a biometric patient identification platform that ensures that the medical records are locked with the biometric data of the patients. The platform takes the biometric data such as fingerprints or irises of the patients and attaches them with the medical records. Without biometric verification, the records cannot be accessed by unauthorized parties, ensuring no medical identity theft takes place. RightPatient also ensures patient safety – the platform provides accurate medical records within seconds of scanning the patients’ biometric data. It reduces denied claims, improves revenue cycle, and saves hospitals and patients from unnecessary costs. Several pioneering healthcare providers like Terrebonne General Medical Center and Novant Health are using RightPatient. They are reducing denied claims, preventing medical identity theft, improving revenue cycle, and enhancing patient safety.