Artificial Intelligence is right now the hottest tech trend with multiple industries benefiting from it, in one form or another. E-commerce is utilizing it to launch conversational chat bots for better customer service while banks are using it to deter account takeover practices but it is not the money-making enterprises that stand to benefit from Artificial Intelligence. There are various aspects of Artificial Intelligence that can help to improve medical care not only when it comes to surgical procedures but also in medical service delivery practices as well.
Most people consider and view AI specifically in the light of technically smart medical procedures that it can introduce in order to make the medical care more efficient. Smart medical procedures are not only effective at introducing robotics or innovative tools for medical procedures but also making the entire Medicare process free of fraud and cost-effective, benefiting both medical revenue streams for healthcare service providers and better service delivery for patients as well.
Artificial Intelligence solutions are programmed in order to smooth the service delivery funnel for patients and remove hindrances for medical service providers to collect funds for the provided services.
The 3 most pressing ones are discussed below:
Deter Identity fraud
More often then medical institutes would like to admit, they come across employees and medical assistance staff that uses fake credentials to land a job in the medical care industry. Identity documents tampering and fake medical degrees are more common than one would expect in a profession such as medical care. Some authentic and qualified doctors and medical personnel are also found guilty of forging their letters of recommendation and experience certificates.
There are several KYC service providers that are offering identity verification with effortless customer experience. They can check the authenticity of a submitted identity document as well as use that document to vet the authenticity of the submitted credentials by a potential job candidate in the medical industry. By using techniques such as machine learning algorithms all possible scenarios of doctoring an educational document or medical certification can be detected in nearly real-time by smart verification tools provided by companies such as Onfido, Shufti Pro and Mitek Systems. Such smart authentication tools have the ability to check the educational and professional credentials of medical service individuals through a wide range of supporting documents. Not only that, but these third-party AI-powered service providers also implement template matching techniques to enhance their document support facility by integrating customized documents such as medical degrees and certifications issued by other reputable medical governing bodies.
End Fake Medical Insurance claims
Most of the medical insurance firms have accepted a certain percentage of their revenue being lost to fake medical insurance claims. Some of the fraudsters use insurance cards of original users while others apply for new insurance cards with the help of fake identity details. Both types of these scams can now be deterred by using Artificial Intelligence. Smart identity verification services can check the authenticity of a claimed identity by asking the claiming person to showcase their face along with a photo ID.
First, the authenticity of the submitted document is checked through various security features as well as by checking for photo shopped elements and tampered information check. Afterward, the face present on the authentic identity document is compared with that of the user through distinct bio metric and facial parameters and only after an exact cross-match of these features, the insurance claim is further processed in order to pay for the medical expenses incurred during a genuine medical procedure. Sometimes, the billing document submitted by a insurance policyholder or the medical reports admitted as proof of medical procedure also vetted by the medical insurance provider.
Credit Card Fraud prevention
Credit card fraud is something that is not only an issue for medical service industry locations such as medical centers, hospitals, and health clinics but even the pharmaceutical industry, as well as medical labs operating outside the hospitals, also have to suffer from cash back requests and payment scams because of stolen or fake credit cards. Although there is no sure shot way to tell the difference between a fake and original credit card by a customary manual review but now AI has developed several solutions for both online and physical examination of a credit card’s authenticity. There are solutions available that can track the last transaction, its geographical location and amount used to pay with the help of provided credit cards.
Card-not-present transactions that were considered the bane of online transactions and financial payments industry is now no longer an issue for the service providers as document verification services are available that require end-users to showcase their original credit cards before every transaction. It means that even the different sections of the medical care industry that provide online services to their clients can also be made secure against credit card frauds and online payment scams.
When put under a microscope, AI-supported solutions discussed in the above lines are not just necessary for those in need of medical assistance or those who are providing that medical care but all the above services are crucial for protecting the individual interests of the users as well whose identity details have been compromised as well.
In some cases, financial information or actual credit cards are stolen by scammers in order to pay for these medical services or even worse defraud insurance companies who end up paying a substantial amount for medical care and health care that was never actually provided to these scamming individuals at any cost.