As Records Go Digital, Biometrics Integrates into Healthcare Sector

Biometrics is ready for primetime in the healthcare sector. That's the word from Victor Lee, a senior consultant with International Biometric Group, a Manhattan-based biometrics consultancy, integrator and research firm.

Lee, who presented his viewpoint on biometrics and healthcare via a live IBG audio program this afternoon, said that issues of fraud and compliance are the driving factors behind adoption of biometrics in the healthcare industry.

In his presentation, Lee said that today's healthcare organizations are finding four key ways to use biometric identity matches. The first, he said, is in the combating of insurance and billing abuses.

"The National Healthcare Anti-Fraud Association estimated that in the United States alone, at least $51 billion -- which is about 3 percent of the nation's healthcare outlay for calendar year 2003 -- was lost to outright fraud," explained Lee, who added that the 3 percent number may be conservative, and that some put the number closer to 10 percent.

From issues of phantom billing and "upcoding", Lee says fraud can come from the providers themselves. Audit data that is stamped with a biometric approval, he says, makes this process much more secure, and links the different parties involved with the submission so there's less a chance of fraudulent claims and billing.

Lee noted that in Texas, the Medicaid Integrity Pilot (MIP) was put in place in 2004. The pilot program uses both smart cards and biometric authentication, and was designed for "recipient verification at the point of service." The program has since transformed out of the pilot stage and into the so-called "MAC" program, a mandatory program of a similar design which requires healthcare users to check in with smart card or biometrics when they sign in at some providers. To meet concerns of privacy, the program uses a match-on-card approach where the fingerprint scan was matched to the data on the card, not to a provider-housed fingerprint database.

Lee noted that biometrics had also been used in the South African healthcare system that to prevent recipient fraud. The challenge, he says is that South Africa has been plagued by healthcare users who would claim to be many different people to get added benefits.