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SYSTEM AND METHOD FOR PREVENTING HEALTH CARE FRAUD

  • US 20100228563A1
  • Filed: 03/08/2010
  • Published: 09/09/2010
  • Est. Priority Date: 03/08/2009
  • Status: Abandoned Application
First Claim
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1. A method for preventing health care fraud, comprising the steps of:

  • (a) storing, in a central repository, a first biometric signature received from an insurance recipient during an enrollment period;

    (b) storing, in said central repository, a first set of demographic information received from said insurance recipient during said enrollment period and associating said first set of demographic information with said first biometric signature;

    (c) receiving, during a visit to a health care provider, a second biometric signature and a second set of demographic information from a patient, wherein said visit to said health care provider occurs after said enrollment period;

    (d) retrieving said first biometric signature and said first set of demographic information from said central repository;

    (e) comparing said first biometric signature to said second biometric signature, and comparing at least a portion of said first set demographic information to at least a portion of said second set of demographic information; and

    (f) creating an encounter record in said central repository, wherein said encounter records comprises a flag indicating the results the comparisons made in step (e);

    whereas the identity of said patient as said insurance recipient and eligibility to receive health care from said health care provider may be verified prior to an insurance claim related to said visit is processed.

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