Know Your Patient: Safeguarding and Streamlining Healthcare Industry



Identity theft is a cybercrime that has damaged about every sector. Initially, it was seen more in online social media accounts, but now it is everywhere. Financial institutions e.g. banks have suffered huge losses because of it. Fraudsters steal users’ personal details and then disrupt the banking system by creating fake profiles. They can transfer money from that or make illegal transactions by doing so.

After identity theft, another cybercrime is committed by scammers that are known as account takeover. In this, the account’s access is taken over or hacked by stealing user credentials. They get this information by phishing attacks or other social engineering tactics. The reason may be the low-security measures or users’ less attention towards the latest protocols.

Like other industries, healthcare providers haven’t been saved from identity theft. To counter all types of identity fraud in the medical industry, Know Your Patient is introduced.

Know Your Patient

As patients’ data in the healthcare system is very sensitive and crucial. Criminals get access to it by hacking the hospital database or getting it directly from the patients. According to a report, 15 million patient records were hacked in 2018. As reported by HHS 6,40,000 data was breached from Florida Orthopedic Institute in 2020. The attack was Ransomware and proved to be one of the most successful cyberattacks

If in the wrong hands it can be used for many illegal practices:

False Health Insurance Claims

As most patients have medical insurance, this means that the insurance corporation will have to pay some amount as bills for the health services. Patients have to present a record of their medical history for claiming it.

Fraudsters can use patient data to claim fraudulent health insurance. At this step, the insurance corporation should verify the patient records. Scammers steal and alter medical records by changing names and other personal information from them. But they leave medical history unchanged or in some cases, they just change the picture from it. Then they create a fake id card against that altered data. Now it becomes very difficult for the insurance company to spot the fraudulent attempt.

If the fraudster becomes successful and gets the insurance amount, the actual patient will be the most affected one. In the company records, he got the amount. He can sue the company for not verifying the documents.

Employee Benefits

Companies give health allowance to their employees in case of any uncertainty. They can claim their alliance by presenting a health report to the company. In this case, there is no external fraudster but the employee himself. He alters the medical records of some patients and gets a health allowance on that.

The company unknowingly issues the allowance, it is very difficult to spot this scam. The reason is there is no victim except the company. There are very few chances that it came to know about it.

Special Services

Governments or some businesses give special services to a patient of some specific disease, for instance, a discount on an airline ticket. Some education companies give scholarships to students with a disease. Although these cases are not seen as common, they still have a hazard.

Patient Identification

The patient is verified by government-approved identity documents like an identity card or an international passport. There is complete personal information of the person on it. It also has a national identity number on it which can be used cross-matching with the patient records.

Know your patient can solve this problem by verifying the patients’ identities. Here is the quick walkthrough of the process of patient verification:

  • The patient is asked to upload a selfie carrying an identity document in his hands
  • The required data is derived from the image
  • Authenticity checks are performed on the document. It is checked that it is really an original identity document. The possibilities of fake or fraudulent documents are eradicated in this step
  • The results are verified and the data is validated

The perils of fraudulent attempts using medical records can be mitigated by know your patient verification. The process is robust, online, and conducted by online software. It is backed by artificial intelligence that helps in giving more reliable results. Businesses that have the jeopardy of misuse of patient’s data can use know your patient for streaming and safeguarding their operations.


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