The Benefits of Real-Time Patient Identity Verification

The Benefits of Real-Time Patient Identity Verification

For medical offices, accurately identifying patients is a crucial first step to providing effective care. However, missed or duplicate patient records, fraud, and other errors can undermine quality of care and profitability if not caught early. Implementing real-time identity verification at patient registration is emerging as an important solution. In this post, we’ll explore how instantly verifying patient identities helps doctor's offices improve care coordination, increase revenue, and reduce liability risks.

Improving Care Coordination

One of the biggest benefits of real-time patient identification is enhancing care coordination by maintaining correct patient records. Duplicate or overlapping records in a practice’s EHR system make it difficult for providers to get a comprehensive view of the patient’s medical history, current treatments, and medication list. This fragmentation puts patient safety at risk if important information is missed.

Verifying identities during registration prevents creation of duplicate records for existing patients. It also checks for records at affiliated providers to pull in external patient data. This gives practitioners reliable information to make fully informed care decisions and avoid adverse drug interactions. It also reduces duplicative testing, saving patients time and needless costs.

Increased Revenue

Incorrect patient information can also lead to costly claim rejections and payment delays that hurt revenue and cash flow for the practice. Common claim issues tied to inaccurate patient data include:

  • Claims filed under the wrong insurance policy due to multiple or erroneous records.
  • Inability to validate patient eligibility if demographics don't match payer records.
  • Claims getting flagged for fraud concerns over mismatched identities.
  • Patients unable to pay bills due to billing to incorrect contact info or guarantors.

Real-time verification maps the patient’s ID to the correct corresponding payer information. This prevents these revenue leaks by improving claim accuracy and accelerating reimbursement. It also reduces time-consuming denial management and appeals required when claims initially get rejected or suspended.

Lower Risk

Inaccurate patient identities are a liability risk as well. Wrong patient records may contain another person’s medical history, treatment plans, or test results. Acting on this incorrect data breaches privacy and puts the patient at physical risk of inappropriate care. Providers can be held negligent for any resulting harm.

Confirming identities upfront guards against these mistakes by linking data unambiguously to the presenting patient. Any errors can be addressed before treatment begins. This helps demonstrate the medical office exercised reasonable duty of care in identifying the patient properly from the start.

Deterring Fraud

Identity verification also provides fraud prevention and detection that protects healthcare organizations from illicit use. Criminals may impersonate patients to obtain drugs to abuse or resell illegally on the black market. Stolen or made-up identities are used to obtain services and leave the provider with the unpaid bills.

Validating real identities makes fraud more difficult right from patient intake. Any red flags are caught early before further Illicit activity occurs. This protects against the wasted resources and revenues lost to fraudulent schemes.

Selecting the Right Identity Verification System

To achieve these benefits, medical offices need an identity verification system designed for healthcare’s unique needs. When evaluating solutions, look for the following key capabilities:

  • Real-time data checks against multiple validated sources for accurate corroboration.
  • Integration with registration systems for automated verification at intake.
  • Custom workflows to fit office protocols and systems.
  • Rules-based systems that learn to refine match accuracy over time.
  • Flexible implementation options including cloud-based or on-premises.
  • Fast results in under 10 seconds to avoid slowing patient intake.
  • Security measures compliant with healthcare regulations to protect sensitive data.
  • Intuitive interface requiring minimal training for staff.
  • Identification of deceased patients to prevent identity fraud.
  • Reporting tools to pinpoint areas for workflow improvement.
  • Capability to verify patient household members for customized family billing.
  • Support for verifying guarantors’ identities for accurate claims payment.

Getting Started

Implementing real-time identity verification is a project requiring planning and resources. Follow these steps for a successful deployment:

  1. Define objectives and requirements. What specific issues do you want to address?
  2. Evaluate potential solutions against those requirements.
  3. Develop rollout timeline synchronized with registration system upgrade if needed.
  4. Train registration staff on new verification procedures.
  5. Integrate advanced rules to fine-tune accuracy over initial launch period.
  6. Monitor metrics and feedback on performance. Refine as needed.
  7. Expand use cases like adding guarantor verification for boosted revenue cycle impact.

With smart implementation and adoption across registration workflows, real-time identity verification can transform patient data integrity. The payoff is more coordinated care, greater revenues, and reduced risk for the practice. In today’s complex healthcare environment, deploying this technology is an investment that leading medical offices are making for long-term sustainability.