Keeping medical records safe is critical

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As the health care industry further embraces digital transformation, fraudulent attacks on both organizations and consumers continue to increase in volume and complexity. Digital health care is an ongoing balancing act between patient experience and fraud prevention, but the massive volume of health care transactions makes fraud detection challenging. In fact, the demand for health care data has increased from bad actors: stolen health information is 20-50 times more valuable than financial data. The incredible volume of information and transactions in health care leaves many opportunities for first-party and third-party fraud – false claims and billing fraud, payment fraud, medical identity theft – all impact system vulnerability.

While digitization is reshaping the future of health care, identity theft remains one of the biggest threats to the industry. In the United States, health care providers today battle an average of 1,410 weekly cyberattacks per organization, up 86% from last year. Correspondingly, annual health care fraud loss in the U.S. reached $68 billion in 2022, according to the National Health Care Anti-Fraud Association. As such, data breaches are the leading cause of medical identity fraud, impacting the health care sector on a larger scale, as many online systems are vulnerable to and defenseless against massive attacks.

What is medical identity fraud?

Medical identity fraud – or theft – is when fraudsters target medical records and steal someone’s identity to acquire unauthorized medical care or submit fraudulent claims to health insurers. Scammers do this by obtaining patients' personal data – such as their name, birth date, and social security number – and other identifying information. This type of fraud is arguably one of the most dangerous as it can alter an individual’s medical records and care, possibly putting their health in jeopardy.

To combat medical identity fraud, identity-proofing will remain a critical piece of the fraud-prevention puzzle.

Know your enemy

Identity theft is one of the oldest and most common types of cyber crimes, and it continues to advance just as technology has advanced. Fraudulent attacks come from a variety of bad actors with diverse sets of tactics. Identity thieves and cyber criminals come from various backgrounds, and operate as a larger group or a “side hustle” for sole operators.

In any case, identity theft will continue to grow due to the significant financial gain available, and it's up to organizations to leverage identity-proofing solutions to combat bad actors and protect their patients.

Fraud solutions in health care

Important data shared with physicians and providers are oftentimes kept in health care apps or online portals. With sensitive information out in the ether, we must ensure everything is protected – which is why digital identity management is such a crucial component in health care, and our everyday lives. Right now, most methods we have for protecting online data aren't enough; improving password hygiene or adding a one-time passcode can only do so much to fight off bad actors.

Here are two solutions physicians and medical providers can implement to ensure sensitive information is safeguarded from harm:

1. Facial biometric technology
   High-level facial biometric technology can provide fast, simple methods to authenticate an individual by matching a patient’s selfie to the photo on a government-issued ID, profile picture, or any other image of a person’s face with complete accuracy.
2. ID verification
   An identity verification service ensures that users provide information that is associated with a real person. Artificial intelligence and machine learning technology can detect the most advanced fraudulent documents to verify an ID’s authenticity.

By implementing robust identity verifications, the health care sector can improve security, clinical productivity and boost their bottom line.

Protect your patient’s identities

Health care and patient collaboration is often a type of fraud that is sophisticated and difficult to track, but preventing it and taking back control of medical data should be a top priority for health care institutions. Some examples include filing false Medicare or Medicaid claims, payment for unnecessary, unperformed elective procedures activities and purchasing medical equipment with the intention of selling it for personal gain.

It’s important to remember, while medical identity fraud is on the rise, there are protection measures to fight against medical identity theft. Organizations and providers can scale fraud detection efforts while meeting consumer demand for safe, secure account and records access. By doing so, physicians who operate their own practices as well as larger health care organizations ensure their patients are protected.

The health care industry can leverage advanced AI identity verification and machine learning models to detect dubious or unusual behavior that might indicate a data breach. These tools help detect crooked activity in real time, with added defenses and mechanisms like fraud detection software, which allow for counter fraud attacks to ensure security for the industry and their patients.

The significant increase in identity fraud prompts a sense of urgency for the health care sector to enable themselves with the tools needed to resist the most complex fraudsters. Select fraud detection and identity verification providers can help health care organizations get ahead of scammers, which is important now more than ever with digital transformation evolving so rapidly in this industry.

Blair Cohen is the founder and president of AuthenticID an identity proofing and fraud prevention technology company.