Patient Verification Solutions: Supporting the Healthcare Sector in Fighting Fraud


Digitization has revolutionized industries all over the world. However, there are still some sectors where advancement is required such healthcare industry. As per HIPAA journal, on average 2 hospitals experienced data privacy violations out of 500. Cybercriminals want access to sensitive patient data from databases of hospitals. In this light, the healthcare sector must implement Know Your Patient (KYP) service to achieve its objectives of safety from ransomware and other cyberattacks. Patient verification works for hospitals and pharmacies whereas KYC system facilitates the banking industry. 

KYP service is an AI-based system that fights medical fraud, reduces insurance scams, and controls the prevalence of illicit drugs. Users must ensure data security according to GDPR standards. 

Importance of Patient Verification System 

The implementation of know your customer service in the banking industry has supported financial organizations in dealing with identity theft and other online scams. The additional security measures have minimized money laundering and terrorism financing incidents effectively. Similarly, in the healthcare sector, there is a huge demand for digital solutions that can deter cybercriminals from violating security protocols. These steps are crucial in controlling prescription fraud and data breach cases in the healthcare sector. 

Patient verification checks must be performed during the onboarding process so that only genuine patient identities can receive medical services and get medical results. Ensuring peace of mind for the staff members that they are providing treatment to only real patients and not hackers, is a huge benefit of KYP solution. 

The execution of know your patient solution means that patients’ data will remain safe even though hackers want access to their information. Consequently, the administration in the healthcare sector must upgrade their security protocols at regular intervals. 

Working Mechanism Behind the Patient Verification Solutions

Top management in hospitals must know that patient verification service is easily accessible for the users. The general outlook of the digital KYP is as follows.

  • During the registration process, the software guides the patient to display their ID card/passport/driving license for the purpose of authentication. The latest selfie is a must for cross-checking data during the verification process
  • The software uses a facial verification system that is supported by AI & ML technologies. Only in the case of original information, the software shows final verification results. If a patient tries to fool the system, technology immediately rejects the application and notifies hospital management to take action
  • The software also performs age verification checks on new patients in case minors do not have access to age-restricted drugs. Medicine prescriptions intended for adults can harm underage patients in various ways
  • The advanced OCR technology captures data from patients’ documents. It also evaluates information against various sanction lists to discourage high-risk clients
  • In case the documents are manipulation free, the patient will have the account with all rights reserved for data security and access to medical services

Best Use Cases of Patient Verification in the Healthcare Sector

  • The digital data privacy violation cases leave a long-term impact on patient’s well-being. Hackers can get their hands on critical information. The application of KYP system can facilitate hospitals and patients in protecting crucial data from cyberattacks
  • The age verification feature in KYP service guarantees that patients receive their prescriptions as per their age. Execution of know your patient solution promotes transparency for medical professionals and promotes trust

Global Regulations for Patient Verification

KYP is critical in safeguarding hospitals and patient identities from insurance and prescription scams. However, old patient verification techniques only gave poor experience because of more time-consumption, and incorrect prescription allocations. 

The Healthcare industry must opt for a balanced approach to verify identities of patients. This is according to global regulations such as HIPAA and HITECH. The guidelines enforce patient verification to safeguard them and provide a positive experience. The patient verification service providers must ensure convenient API and SDK integrations to streamline the process. Providing personalized KYP solutions guarantees positive experiences for the users. 

Wrapping Up

Patient security is a crucial matter in the healthcare industry. The administration has to ensure that the patients are who they claim to be. Application of know your patient services protects databases of hospitals from cyberheists. Maintaining the security of patients’ data requires correct data from users. Nowadays, the application of patient verification is as crucial as know your customer services in the banking industry. Such progressive measures are crucial in reducing patient identity theft and data privacy violations. 

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