MIDAS Helps Health Plans Engage Members in the Healthcare Process; MIDAS is Safe, Secure, and Easy to Use
MIDAS uses real-time text messages and emails to alert members when a healthcare transaction is submitted to their health plan. The alert leads the member to a secure site that displays summary information in plain language. The member can either validate the transaction or mark it as "suspicious." If suspicious, a notification is sent for prompt follow-up by the MIDAS resolution experts. If fraud or medical identity theft has indeed occurred, MIDAS deploys proven resolution processes to diagnose the problem, address the issue, and mitigate any harm.
"Consumers have easy access to their personal financial data yet their medical care transactions are a closed door," said Bob Gregg, CEO of ID Experts. "MIDAS will change this by bringing transparency to healthcare transactions, engaging members as the first line of defense in protecting their identities and uniting health plans with their members to combat fraud."
Reducing Healthcare Fraud by Early Detection
Healthcare fraud is skyrocketing, costing the United States at least
$80 billion annually, according to the FBI, and medical identity theft has affected more than 1.8 million victims, according to the 2013 Survey on Medical Identity Theft. As millions more Americans enter the healthcare insurance market under the Affordable Care Act, fraud and abuse are expected to escalate.
Flagging and resolving suspicious healthcare transactions earlier in the process will aid health plans in reducing healthcare costs. Today, the misuse of a medical identity is typically discovered long after the member's medical record has been compromised. MIDAS streamlines the investigation of fraud and medical identity theft and leverages ID Experts' proven expertise in dispute resolution so that health insurers can better protect members, reduce fraud losses, and lower their costs.
MIDAS Gives Members Control
According to the 2013 Survey on Medical Identity Theft, 54% of patients do not currently check their health records and Explanation of Benefits (EOBs) for inaccuracies because they either don't know how or say it's too difficult. Of those who found unfamiliar claims, 52% did not report them.
Engaging members throughout the healthcare process is also a key compliance component of the Affordable Care Act. MIDAS will engage members to monitor their healthcare transactions and allow them to take control of their medical identities.
"Consistent with our focus on providing innovative member programs, Moda was an early adopter of MIDAS," said Robert Gootee, CEO of Moda Health, one million-member plus health plan servicing Oregon, Washington and Alaska. "In the face of consumer choices resulting from healthcare transformation, we feel this distinguishes us by allowing our members more control of their healthcare transactions."
"We have been talking to a lot of payers. They tell us their members demand simple, timely access to relevant information," said Christine Arevalo, vice president, healthcare fraud solutions at ID Experts.
"MIDAS provides an elegant solution, by communicating to members in plain language, in a way that increases patient engagement."
More information about MIDAS can be found here: www2.idexpertscorp.com/MIDAS.
About ID Experts
ID Experts creates software and delivers services that address the organizational risks associated with regulated personal data. The RADAR&trade data incident management software platform and professional privacy/security and data breach response services, provide organizations with complete data breach care. Newly announced MIDAS&trade (Medical Identity Alert System) addresses the growing national issue of healthcare fraud. ID Experts serves leading healthcare providers, insurance organizations, universities, and government agencies and is exclusively endorsed by the American Hospital Association. Founded in 2003, ID Experts is an advocate for privacy; an active contributor to legislation; a member of IAPP, HIMSS, and HCCA; a founding member of Medical Identity Fraud Alliance (MIFA); chair of PHI Protection Network (PPN); and chair of the ANSI Identity Management Standards Panel PHI Project. For more information on ID Experts, join the LinkedIn All Things HITECH discussion at bit.ly/AllThingsHITECH; All Things Data Breach at http://linkd.in/TsbwgJ; follow ID Experts on Twitter @IDExperts; and visit http://www2.idexpertscorp.com/.