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As an IT professional working in the healthcare sphere, it is imperative that you not only help to protect your organization but also your patients, especially when it comes to medical fraud. The sad fact is that the issue of medical fraud is a growing concern within the healthcare industry, with some reporting that the issue results in over $100 billion in unnecessary prescriptions and procedures.

Needless to say, it is a situation that requires attention, and as an IT professional, you can help. With proper planning, smart data collection procedures, and attention to detail, you can do your part to ensure the security and safety of company data and the information of your patients.

Properly Manage Data

If you are an IT expert with knowledge of the systems within your organization, then you can do your part to keep an eye out for suspicious activity. Work with the accounting and management teams to set up a system where the appropriate parties are notified if anything strange occurs during billing or treatment. On top of that, IT should verify that every employee only has access to the patient data that they need.

While watching the data is essential, so is properly disposing of what is no longer needed because failure to do so could result in more scams, including identity theft. Digital data that is no longer needed should be backed up and secured on protected servers and physical paperwork should be shredded.

The best way to go about this is to implement a scheduled shredding program both in your department and throughout the office where paperwork is shredded regularly, so unnecessary information isn’t lying around for too long. Locked bins should be placed throughout the office so medical personnel can easily drop in their paperwork, and the bins should be collected daily. When the paperwork is shredded, it should be done so with a micro-cut shredder which will cut the paper so small that it cannot be reconstructed.

Spread the Word

One of the reasons why medical fraud is so common is because it can come in many different forms that can be hard to trace. In some cases, fraud can occur when doctors or coders intentionally overcharge patients for services they didn’t receive. It can also occur when a doctor performs unnecessary treatments that the patient doesn’t need just for the sake of bringing in more money. There are even cases of doctors taking kickbacks for patient referrals.

The point is that medical fraud can come from all angles, so while your IT team may be able to watch for some unlawful practices, it is important that you also try to build a sense of community within your organization where everyone watches out for one another, and there is an easy way to report fraud if it is suspected.

Since you are likely more aware of the many types of medical fraud, it is also a wise idea to have meetings with the other employees where you talk about different scams, the red flags, and how these issues can be avoided. It is also a great idea to create literature and informative emails that you can send out to the team. Not only will these emails educate folks at your clinic, but if someone there is committing fraud, they may be less likely to continue if they realize that the IT team is watching.

Patient Safety

While we often focus on how we should prevent healthcare employees from committing medical fraud, we often forget about how these scams impact the patients. If paperwork and digital data are not properly managed, then both employees and cybercriminals can use that old information to target patients, which they often do through phishing scams and by spreading malware.

Older patients are often targeted because they lack the knowledge of cybersecurity, and they often don’t know what hackers are capable of doing, like impersonating healthcare professionals. An example of this is when criminals call older customers, lie and state that they work with a Medicare agency, and then con the patient into providing their Medicare number, birth date, and financial information, which they either use illegally or sell on the black market.

As an IT professional with knowledge of this information, you can create literature that doctors can hand out to their patients to warn them of the dangers, or the information can be posted on your website. Information should also be posted about what patients should do if they do fall victim to fraud.

In the end, IT experts can do more than they may realize when it comes to preventing medical fraud. While you may not be able to prevent every crime, by doing your part, you will better serve your practice and the patients.