A mobile biometric based patient identification model for medical insurance services access

Kihiko, Augustine
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Strathmore University
Medical insurance fraud has increasingly been on the rise in Kenya. This has thwarted the efforts of the insurance companies to curb the rising fraud cases. A great challenge is insured patient identification who are under individual or corporate medical insurance cover. Currently, the healthcare industry uses photo cards to identify an insured patient. This is vulnerable to fraud, for example, through impersonation whereby an insured patient gives a non-insured patient their medical photo-card so as to fraudulently obtain medical services at various service points within a health facility. Lack of unequivocal identification of insured patients is a major contributing factor to the rising cases of medical insurance fraud. We therefore need an appropriate method to correctly identify the insured patients. In this study, we propose a biometric based solution and develop an appropriate insured patient identification system using biometric fingerprint technology to curb the challenges encountered in identification of insured patients. To achieve this biometric fingerprint identification, the insured patient fingerprints are scanned during the registration exercise and stored on an online database. Subsequent identification is achieved by obtaining a match between the registered fingerprint and the stored fingerprint and associating it with the insured patient records. Lastly, the application is then tested and the findings used to check for its appropriateness.
Submitted in partial fulfillment of the requirements for the Degree of Master of Science in Information Technology
Biometric, Mobile biometric, patient identification model, access control, insurance service, medical insurance, insurance, Fraud, healthcare, Technology, governance, insurance firms, fraud control mechanisms