System and method for implementing healthcare fraud countermeasures
First Claim
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1. A method of discouraging healthcare fraud comprising:
- causing a patient to provide a biometric signature on a date and at a location where the health care service is provided;
capturing said biometric signature;
creating a record that records said patient was at said location at a particular time and/or date, said record comprising a patient identifier, said biometric signature, location information indicating said particular location at which said biometric signature is obtained;
storing said record in a computerized data store, wherein said record corresponds to reimbursement information and said location information in said record provides evidence that a particular patient was at a suitable location for providing said healthcare services;
providing an interface to said computerized data store wherein said interface receives said reimbursement information and determines whether a record in said computerized data store matches said reimbursement information;
determining whether said record corresponds to said reimbursement information wherein the absence of a positive match indicates a phantom bill;
indicating to a payer entity whether said particular patient was at a suitable location for providing said healthcare services based on said determination.
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Abstract
A method of discouraging healthcare fraud in conjunction with providing a health care service to a patient in which the patient provides a biometric signature. An event record is created where the event record creates an association between the biometric signature, a patient identifier, and location information indicating a location at which the biometric signature is obtained. The event record is stored in a central data store and can be later retrieved to verify the patient was present at the location.
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Citations
15 Claims
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1. A method of discouraging healthcare fraud comprising:
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causing a patient to provide a biometric signature on a date and at a location where the health care service is provided; capturing said biometric signature; creating a record that records said patient was at said location at a particular time and/or date, said record comprising a patient identifier, said biometric signature, location information indicating said particular location at which said biometric signature is obtained; storing said record in a computerized data store, wherein said record corresponds to reimbursement information and said location information in said record provides evidence that a particular patient was at a suitable location for providing said healthcare services; providing an interface to said computerized data store wherein said interface receives said reimbursement information and determines whether a record in said computerized data store matches said reimbursement information; determining whether said record corresponds to said reimbursement information wherein the absence of a positive match indicates a phantom bill; indicating to a payer entity whether said particular patient was at a suitable location for providing said healthcare services based on said determination. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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Specification