How can we create a secure way to tie patient identity to insurance to reduce healthcare fraud and abuse? [Dev Bharel]
October 3, 2016
Dev Bharel’s Challenge
Dev is the CTO and cofounder of DistributedID, a blockchain-based identity verification and authentication service. He also serves as the Chicago Region Head for the Blockchain Education Network, a global nonprofit dedicated to educating their peers about blockchain technology.
In his free time, he gives talks and hosts hacknights and hackathons featuring smart contracts and other blockchain technologies. He works with Chicago entrepreneurs, bankers, and regulators to educate them about the volatile cryptocurrency space and is advocate for pro-blockchain policy.
How can we create a secure way to tie patient identity to insurance to reduce healthcare fraud and abuse?
Why This Is Important
The National Healthcare Anti-Fraud Association (NHCAA) estimates that the financial losses due to health care fraud and abuse are in the tens of billions of dollars each year. A significant amount of these claims come from victims whose medical records are compromised or whose legitimate insurance information is used to submit false claims.
One of the most common types of fraud and abuse is billing for services that were never rendered-either by using genuine patient information, sometimes obtained through identity theft, to fabricate entire claims or by padding claims with charges for procedures or services that didn’t take place.
When a person’s name or other identifying information is used without that person’s knowledge or consent to obtain medical services or goods, or to submit false insurance claims for payment, that’s medical identity theft. Medical identity theft frequently results in erroneous information being added to a person’s medical record, or even the creation of an entirely fictitious medical record in the victim’s name.
Victims of medical identity theft may receive the wrong medical treatment, find that their health insurance benefits have been exhausted, and could become uninsurable for both life and health insurance coverage.
An individual subscriber can also commit health care fraud by allowing someone else to use his or her identity and insurance information to obtain health care services or using benefits to pay for prescriptions that were not prescribed by his or her doctor.
Office Hours: Thurs: 2 – 3PM CST & Friday: 4 – 5PM CST
Contact Information: dev [at] diid [dot] today
Additional appointments available via schedule: https://calendly.com/devbharel