Fraud Prevention

Stop Abuse and Fraud in the Healthcare Industry to Save Precious Lives

October, 23, 20205 min Read

Abuse and fraud in the healthcare industry are multifaceted—from stealing patient data to account takeover and new fake account generation—which causes losses worth billions of dollars every year. Attackers use automation to scale the attacks and increase monetary exploits. Fighting fraud in the healthcare industry is, therefore, important not only to arrest financial losses but also to minimize exposure of patient data that can possibly endanger their lives.

Digitization in the healthcare industry is helping create digital patient histories that improve co-ordination between patients and healthcare providers. This also allows for proactive diagnosis and timely medical interventions that help save precious lives. Perhaps, the biggest benefit that digitization brings to the healthcare industry is in automating the otherwise time-consuming administrative tasks.

Larger window of opportunities for fraud in the healthcare industry

Although digitization is making access to healthcare convenient, there is also a flip side to it. Fraudsters abuse the digital platforms to steal patient data, which they can either sell on the dark web or use it to fuel many types of fraud. The stolen credentials are used for account takeover and fake new account registration that provide fraudsters with the ability to orchestrate attacks over a longer period of time. To achieve scale and improve economic returns, fraudsters often use bots and automation.

In a country like the United States, which is a global leader in terms of healthcare spending per individual, the healthcare sector was worth $2,487 billion in 2019. The country also spends twice on healthcare service as the other countries. Therefore, online abuse and fraud in the healthcare industry can lead to losses worth billions of dollars every year. As more and more health tech companies make access to healthcare services easier, fraudsters are exploiting these platforms for financial gain.


Recommended Event: Bankrupting Fraud Virtual Summit


Attacks cause financial losses, disrupt user experience, and endanger lives

One of our clients, in the health tech space, was the target of frequent bot attacks. Being a leading health tech company with invaluable customer data and an all-digital nature of operations, it was facing a barrage of bot-driven account takeover attacks that sought to compromise customer data. The company tried to deflect the attacks by blocking users and rate-limiting. However, that resulted in good users getting locked out and degradation of user experience.

The company is known for its superlative user experience; however, when users began experiencing disruption due to inadequate protection from relentless bot attacks, the company realized the need for a robust fraud defense solution. It could no longer afford to sacrifice user experience, as it is important in attracting and retaining customers. Therefore, the company wanted a fraud solution that would effectively protect against online abuse and fraud, while keeping user experience at the forefront.

Since the company had not engaged with a fraud defense vendor earlier, it examined several vendors before finally deciding to partner with Arkose Labs. It deployed the Arkose Labs solution at the login and new account registration stages; and, within a few days, there was a marked reduction in the attacks per day. This saved the company thousands of dollars every single day. Although the attackers continued with their attack attempts, the Arkose Labs solution helped the company thwart these attempts accurately, and most importantly, continue to offer the seamless user experience it was known for.

Intelligent risk-decisioning powers targeted friction

To effectively fight fraud in the healthcare industry, Arkose Labs platform uses continuous intelligence to ascertain the underlying intent of each user. Instead of blocking any user, it screens them on the basis of their risk profiles. To this end, the dynamic risk engine, Arkose Detect, analyzes hundreds of parameters to segregate risky users. This real-time risk-decisioning informs the adaptive challenge-response mechanism—Arkose Enforce—which then presents targeted friction to suspicious users in the form of adaptive, step-up enforcement challenges.

Authentic users, often, do not even see the challenges. In the event they do come across these challenges, they can clear them with no difficulty, whatsoever. This reduces false positives and prevents degradation of user experience. Bots and automated scripts, however, stand no chance of clearing the challenges, as they fail instantly. This is because our proprietary 3D challenges are designed and trained to defeat even the most sophisticated automatic solvers that may use advanced machine vision technology.

One of the critical concerns of our client was in compliance with the HIPAA statutes, as healthcare companies are regulated by stringent laws around sharing customer data. Since Arkose Labs does not collect any user data, except for the IP address, this concern of the client was adequately addressed. Further, we share robust data analysis and customized actionable insights into the attack patterns that help their fraud teams to remediate evolving issues with confidence.

To learn how Arkose Labs helps fight abuse and fraud in the healthcare industry and empowers health tech companies to defeat attackers at their own game, read the case study here.