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Published: November 21, 2025 by Adam.Lewis@experian.com

3-effects-of-rising-healthcare-costs-blog-2024

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Solving the patient identity problem with universal identifiers

Solving the patient identity problem and ensuring that each patient record is accurate and airtight is a top priority. Healthcare providers want to be 100% confident in answering “yes” to the following questions: Is the patient who they say they are? Is the right medication being administered to the right person? Is the correct bill being sent to the patient’s current address? By validating patient identities, providers can secure patient trust, deliver high-quality care, and avoid losing revenue to identity errors and fraud. Unfortunately, patient identity management is only becoming more complex. While telehealth and remote patient access are opening healthcare’s digital front door to meet changing consumer needs and expectations, a mountain of sensitive patient data is piling up. This data is a gold mine for fraudsters who steal and sell patients’ personal information or use it to access services and prescriptions without paying. It’s distressing for patients and creates a major financial and administrative burden for healthcare staff. A nationwide patient identification system may still be some way off. However, providers can optimize patient matching in their own health systems by working to reduce vulnerabilities and adopting cutting-edge interoperable patient matching technology. Better patient matching means better patient care and protected profits The human cost of incorrect, incomplete or outdated patient medical records is significant. Patients could be given the wrong medication or diagnostic procedures. Allergy information can be missed. Patient test results can be mislabeled or mixed up. In Experian Health’s State of Patient Access 2.0 survey, almost half of providers said inaccurate and incomplete patient data was an obstacle to proactive follow-up, which could cause gaps in care and avoidable complications – which are critical to value-based care compensation. Duplicate and mismatched patient records also create massive inefficiencies that can threaten an organization’s financial health too. With telehealth claim lines climbing by 2817% between December 2019 and December 2020, reliably authenticating patient identities in both existing and new services will be critical to future financial performance. Resolve, protect and enrich patient identities with universal identifiers Having the right technology to resolve and secure a patient’s information when they log on to patient portals and telehealth systems is the first step. Automating patient enrollment with Experian Health’s PreciseID® ensures the patient is who they say they are. This solution utilizes best practices in identity-proofing, fraud management and device recognition. But this system only works if the records being matched are accurate. A universal patient identifier provides a single, accurate, 360° view of each patient throughout their healthcare journey. An interoperable format allows systems to talk to each other and protects against duplicates, errors, inefficiencies and fraudulent activity. Universal identifiers aren’t available nationwide yet, though there has been some encouraging movement. Congress is working to remove the ban on funding for such measures, while the Centers for Medicare and Medicaid Services are taking steps to promote data standardization. For health systems that want to maintain a golden record for each patient within the bounds of their own operations, Experian Health’s Universal Patient Identifier allows staff to connect, verify and protect patient information. Choosing the right patient matching technology Traditional matching technology relies on demographic data and uses deterministic or probabilistic methods to link records with identical identification information. However, relying on a single source of data means that previous errors are inherited by new versions of a patient’s record. Demographic data isn’t unique to individual patients, which can lead to mismatched records and create extra manual work to fix. Experian Health uses referential matching technology to build a complete view of patients from reliable health, credit, and consumer data sources. The universal patient identifier connects disparate datasets and instantly updates the master index of patient records with new data points. Referential matching can only ever be as good as the data that is being matched and Experian is a global leader in data accuracy, across numerous sources, and is continually updated. Victoria Dames, VP of Product Management at Experian Health, says, "With Experian’s reference data, we’re able to create a longitudinal record of each individual and reconcile their data as they change names, addresses and see different providers. You need to know that it’s the same person, especially with the pandemic acting as a catalyst for digital technologies such as telehealth. It also helps organizations bring data together and ensure data integrity through mergers and acquisitions. Dealing with large volumes of data is a big hill to climb, but with the right technologies it can be that much faster.” As telehealth and digital patient access services gain traction, solving the patient identity problem becomes increasingly urgent. Universal Identity Manager combines industry-leading consumer demographic information with the highest quality reference data and powerful unique patient identifiers to create a single view of each patient. With better patient identity management, providers can protect against errors and fraud, and reassure patients that their personal information is safe. Find out more about Experian Health’s identity management solutions.

Mar 02,2022 by Experian Health

Protecting patient identities as QR codes open up new cybersecurity risks

QR codes made an unexpected comeback during the pandemic. They offered a contactless gateway for individuals to check in to venues, log COVID-19 test results, help trace the virus spread and more. Restaurants and retailers embraced the technology as a way to welcome back consumers with touch-free access to online menus and digital payments. Previously seen as gimmicky and hindered by dependence on specific apps, these scannable squares can now be read using most smartphone cameras. With new use cases emerging during the pandemic, “quick response” codes are suddenly relevant again. However, the growing popularity of QR code technology opened the door to new cybersecurity risks, so providers must remain proactive with protecting patient identities. A 2020 survey found that almost half of consumers said they’d noticed an increase in QR codes since the first shelter-in-place orders. Online payment provider PayPal reported that a new merchant was added to its QR code payment option every 28 seconds in the first quarter of 2021.  Cybercriminals are capitalizing on consumer trust in QR codes to harvest personal data or install malware on devices. This leaves healthcare organizations and their patients vulnerable to fraud, especially given the increased adoption of digital healthcare technology during the pandemic. Providers must remain vigilant with protecting patient identities from QR code cybersecurity risks. How do QR codes threaten patient identities? QR codes hold far more data than traditional barcodes. They can be easily generated and fixed to any surface, ready for users to scan with their smartphones. They are primarily used to store URLs, which take the user directly to a website. But while savvy consumers are aware of the risks associated with clicking on a suspicious link in an email, QR codes are intrinsically trusted. It’s much harder to tell if a QR code is legitimate or not. Scanning a QR code is essentially the same as clicking on an unknown link. A study by MobileIron found that while 67% of consumers say they can identify a suspicious URL, less than 30% can identify a malicious QR code. Mike Bruemmer, VP of Experian Data Breach Resolution and Consumer Protection, says that "QR codes are the new stealth threat vector. Regardless of their application, no one can tell a fake code that launches malware on your device from a legitimate one." There are two main risks for patients. Firstly, they may click on a QR code that takes them to a web page that appears legitimate, prompting them to share personal data or log-in details. This information is then harvested by cybercriminals. This form of QR code phishing, known as “quishing,” puts the user at risk for spam, adware and identity theft. Secondly, the user may scan a QR code that takes them to a malicious site that installs malware on their device, which will then steal and package the user’s personal and financial data. The QR code can even be used to generate actions that appear to come from the user, such as making payments, sending emails, sharing locations or following social media accounts. In January 2022, the FBI issued a warning about cybercriminals using QR codes to redirect victims to malicious sites that steal login and financial information. Users are urged to practice caution when entering personal information after scanning a QR code. How can healthcare organizations help with protecting patient identities against QR code cybersecurity threats? For healthcare organizations, the concern is that if patients fall victim to a QR code scam, bad actors can steal personal identification data to access patient portals and other digital services. This information can be used to access medical services without paying, obtain medications illegally, or submit false health insurance claims, creating ongoing financial and administrative stress for patients. Or, if cybercriminals use captured information to log on as staff members there’s an added risk of further data breaches from inside the provider’s network. Healthcare organizations have a few options to help patients protect themselves from QR code scams: Targeted awareness-raising campaigns are a simple way to encourage patients to make sure their devices are updated with the latest security patches. Patients can be warned to watch out for suspicious activity, such as when a QR code redirects to a page that asks for personal details. They might also choose to ask for a direct URL, instead of using the QR code. Securing access to patient portals and verifying patient identities are practical measures to ensure that the person accessing the account is who they say they are. Another best practice in patient portal security is to take a multi-layered approach. This includes two-factor authentication, device recognition and additional checks on risky requests. By securing patient portals, providers can be proactive at protecting patient identities and reduce the risk of fraud during enrollment. Integrating patient identity management tools can also help verify the patient’s identity from the very first registration touchpoint all the way through their healthcare journey. Automated identity checks and algorithmic matching based on Experian Health’s unrivaled reference data can help ensure that the patient’s record is accurate and complete. Offering alternative secure methods for contactless patient payments and patient access are other options to make the patient experience more secure. For example, providing patients with their own mobile payment option means they can pay bills securely and access payment plans right from their phone. Experian Health also offers various safe and secure registration and scheduling solutions that will give patients a seamless patient access experience and help protect them from identity theft. Victoria Dames, VP of Product Management at Experian Health, says that patients have come to expect a smooth and secure digital experience: "Providers are focused on patient data security in adherence to multiple health policies, like HIPAA, but also to maintain confidence with patients. They [patients] are embracing digital solutions and expecting appropriate security measures are in place." Find out more about how Experian Health can help healthcare providers with protecting patient identities and close the door to QR code scammers. Experian Health can also help prevent other identity theft and fraud, verify that patients are who they say are, and provide safe, secure and convenient ways for patients to get the care they need.

Feb 22,2022 by Experian Health

Success at a glance: automating healthcare collections

“The patient can have a wonderful clinical experience but face a financial experience that falls short of expectations. We wanted a dedicated consultant who would recommend best practices and provide valuable industry insights. We wanted a system with proven results in back-end automation, operational improvement and analytical performance. We were looking to propel our patient experience to the next level and that’s why we partnered with Experian Health.” – Director of Patient Finance at Novant Health Delivering remarkable patient experiences is at the heart of Novant Health’s organizational vision. With a growing consumer base – the North Carolina health system logged over 5.8 million medical encounters in 2020 –  they turned to automated patient collections to ensure a better financial journey for their growing patient population. They also looked to automated workflows as a way to ease pressure on staff, who were managing 21 different collections agencies. The objective was to find a partner that could help to elevate agency performance while driving operational efficiency. With new facilities coming online, it was important to find a system that would integrate with Epic® and provide real-time reporting. Novant Health partnered with Experian Health to implement Collections Optimization Manager, which produces robust accounts receivable insights to determine each patient’s propensity to pay and scrub uncollectable accounts. The product also provides real-time reporting and agency scorecard, so providers like Novant Health can optimize their processes and forecast future performance. Predictive patient segmentation allows Novant Health to quickly identify the patients with the highest propensity to pay and prioritize accounts accordingly. Patients in need of financial assistance or charitable support can be directed to the right resources. Collections are faster, more efficient and more compassionate. With support from a designated Experian Health Collections Consultant, Novant Health can also monitor agency performance and keep agency costs in check. Improved patient segmentation, better allocation of staff resources and more efficient agency management has led to the following results: 8% increase in unit yield year-over-year 5% recovery rate a rolling average return on investment of 8.5:1. Discover how Collections Optimization Manager can help your organization improve collections recovery rates and deliver an improved patient financial experience.

Feb 16,2022 by Experian Health

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