Healthcare Fraud, Patient Identification, Patient Tracking | Locaid ®

Research shows that 9 in 10 US adults own a mobile device and most carry it with them everywhere they go. The mobile device tends to “ride together” with your patient, making it the single best proxy for the patient’s physical presence at the time of receiving medical services. What if you knew the location of patient’s device when his Medicare, Medicaid, or private health insurance is accessed by the medical provider? You could dramatically reduce incidence of patient identity theft and fraudulent billing due to upcoding, unbundling, and “phantom” services. Investing in technology to detect and prevent fraud before claims are paid could mean hundreds of millions of dollars in savings each year for your company. Locaid®, the world’s largest LaaS (Location-as-a-Service) company, delivers network location data for over 350 million subscribers to healthcare insurance providers, governmental regulatory agencies, and HIPAA compliance technology partners.
 

Here’s what mobile location data from Locaid can do for you:

Prevent Fraudulent Claims

Healthcare is one of the top five industries most frequently plagued by fraudulent claims. The National Health Care Anti-Fraud Association and the FBI estimate that up to 10 % of total US healthcare spending – that is, $260 billion – is lost due to healthcare fraudulent activities each year. The “pay and chase” model is no longer tenable as the primary method to combat fraud. What is proving to be effective is using technology to prevent fraud on the front-end, before the claims are paid. Consider real-time location technology. Locaid works on 100% of the mobile devices-- smartphones, feature phones, connected devices, or even just SIM cards-- on the Tier 1 wireless carrier networks including AT&T, Verizon, Sprint, T Mobile, Rogers. The patient’s location data can be retrieved real-time, indoors or outdoors, all without requiring the patient to download an app on the device. Because you connect directly to the carriers’ network via Locaid, you have access to real-time network data that cannot be cheated, spoofed, or hidden. With Locaid, you can authenticate patient’s mobile device location whenever healthcare insurance is accessed anytime, anywhere. That is ubiquity at its best.

Preventative measures help hedge against the high cost of doing business under the “pay and chase” model. This is especially true managing high volume cases of low-dollar frauds where the cost of recovery doesn’t justify the individual claim amounts often less than $50.

Authenticate Services and Billing

Overbilling by falsifying patient identity and medical services is one of the most prevalent healthcare frauds. With Locaid’s privacy-protected and permission-based location data, patient’s real-time location can be verified whenever Medicaid, Medicare, and private health insurance are accessed. By comparing patient’s mobile device location to that of the medical provider billing, you can determine if the subscriber was present when services are delivered. Claims for services that are authenticated with location can be accepted and claims without validation can be rejected with requests for additional proof of delivery. “Phantom” medical providers can be identified and denied.

By integrating mobile location data into your overall fraud-prevention platform, tools, analyses infrastructure, even if 1% to 10% of the frauds can be prevent before-hand, a significant cost-savings can be realized each year.

Many Americans believe that healthcare fraud is one of the most significant causes for rising healthcare costs. This is more reason why your patients demand vigilance when it comes to protecting their medical identity and preventing fraud.