Hardening Healthcare Against Hackers

Stop and think. When was the last time you called your healthcare or health insurance provider? How did that conversation start? In many instances, the voice on the other end of the line asks “May I get your last name and date of birth?”. Then he or she will call up details about you, your history, active prescriptions, upcoming appointments and other medical details, often including home address and method of payment.

All that based on Last Name and Date-of-Birth?!!! Seriously?

No wonder fraudulent access to the records of medical service providers is a persistent threat. According to the FBI, the financial losses due to health care fraud are an estimated at $80 billion each year. in 2019, one government showed that the medical records for over 7 million people were exposed by healthcare workers. Figures from the National Health Care Anti-Fraud Association, show that the incidents of ID theft-based fraud related to Health Care grew by 40% year-over-year. It is almost double the growth reported in the past 3 years and it is a figure that is expected to continue to accelerate, unless, that is, more measures are taken to stem some of the root causes, one of which is lax authentication practices in customer care contact centers.
* (The National Health Care Anti-Fraud Association (NHCAA) and the FBI https://www.fbi.gov/about-us/investigate/white_collar/health-care-fraud)

Healthcare is an irresistible target for fraud because so much money changes hands and the ill-gotten gains are almost immediate. Fraudsters also find that they can accomplish so many of their objectives over the phone, such as providing false billing information, re-directing refunds or gaining access to prescription drugs. The prevailing authentication practices are simply not strong enough. It is an open invitation for bad actors.

Here’s What Must be Done

Biometrics hold the answer to a number of the security challenges confronted by healthcare organizations. It is easy for both security and customer care executives to perceive the value of using voice biometrics to make it harder for imposters who are calling into contact centers.

As a matter of fact, one of the largest healthcare providers in the world suffered repeated fraud attacks. The challenge was to find those fraudsters who kept attacking before they cause more damage. For that they deployed NICE Real Time Authentication and fraud prevention voice biometrics solution. In the very first week of operation they managed to block 46 different fraudsters who were attacking them constantly, because they had recording of their voices. Those voices were added to the fraudster blacklist and the fraudsters were caught in real time, saving the company $1.2 million in the first week of operation. But more impressively, using NICE’s unique proactive fraudster exposure capabilities, they exposed 132 other fraudsters that they were not aware of. Further investigation revealed that those fraudsters caused them losses of $112 million.

Other healthcare providers know that fraudsters are already waiting in the wings. Adding a layer of security that includes voice authentication and fraud prevention has the dual positive outcomes of thwarting repeat offenders by assembling and maintaining a “blacklist” of known criminals while creating an almost effortless way for legitimate patients to authenticate themselves and carry out legitimate and sometimes life-saving tasks. Opus Research expects this domain to be one of the fastest growing verticals for the implementation of voice biometrics to reduce fraud loss dramatically and to improve patient satisfaction.