Health Information Management

Patient involvement in healthcare fraud detection

HIM-HIPAA Insider, March 24, 2014

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The healthcare industry is taking lessons from the credit card and financial industry when it comes to preventing fraud. The FBI estimated that healthcare fraud costs the United States at least $80 billion annually. It has affected 1.84 million people, according to the 2013 Survey on Medical Identify Theft conducted by the Ponemon Institute. And just as credit card companies are alerting consumers to potential fraudulent purchases, ID Experts in Portland, Ore., is giving patients the ability to ensure the accuracy of their billings for medical services that come to their health plans.
With medical identity theft and patient engagement such hot topics, ID Experts has come up with a solution for insurance companies to help prevent healthcare fraud.
For health plans that opt in to the new product, patients will be alerted to bills that come in and be able to monitor those healthcare transactions to help put a stop to medical identity theft.
"We're filling a hole we've identified. This is the first member-focused healthcare fraud solution for payers," says Christine Arevalo, ID Experts' vice president of healthcare fraud solutions.
Continue reading "Patient involvement in healthcare fraud detection" on the HCPro website. Subscribers to Briefings on HIPAA have free access to this article in the March issue.

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