Impact on the Health Care System due to fraud medical bill claims

One of the areas where fraud is rampant and can have serious consequences is healthcare. Normally this manipulation of information is done for specific monetary gains — e.g inflating the bills for claiming a larger amount from insurance or medical reimbursement or even generating fictitious bills for procedures never carried out. There are also cases where doctors have been practicing impudently for years on the back of fake credentials and caused material damage to unsuspecting patients.

http://nationalpost.com/health/fake-neurosurgeon-ordered-to-pay-300000-for-botched-treatment-but-allowed-to-pose-as-doctor-for-years

These are not stray cases. Such instances keep surfacing with regular frequency and contrary to popular perception, are not just confined to developing countries. Some of the cases involve high profile and public figures and the amounts in question could be substantial.

http://www.bbc.com/news/world-australia-41563660

In addition, there is also an issue of productivity in case of medical claims processing. It involves a lot of paperwork especially in case of reimbursement of bills and it would help if there could be automated capture of the information into the processor’s system with zero or little manual intervention to eliminate errors and reduce the processing time.

In essence, it would make everyone’s task easier if they could a) trust the documents that they see with a quick and elegant way of verifying the details and then b) automate the transfer of this information into the processing system.

Fortunately with Qryptal’s secure QR code technology it is possible to generate a QR code which can capture the key details of any medical bill or invoice at the time of production and digitally sign it with the private key of the issuer. See an example of such a bill below

Once the details are stored inside the QR code , they can’t be tampered or manipulated given the technology and security involved in the generation. Subsequently this information can be verified using a trusted smartphone app or even a server side validation software for bulk verification. Further, with proper one time integration, the details can be extracted in a structured form to be used by the processing systems of the insurer or administrator.

Using technology like this can help increase trust and improve efficiency and effectiveness of healthcare delivery by preventing myriad instances of fraud. The good part is that it is already available and ready to use. So what are we waiting for ?