Latest / CareTalk: Healthcare. Unfiltered. / Defending Your Medical Data & Wallet From Fraud w/ HealthLock CEO, Scott Speranza | HealthBiz Briefs

Transcript

Defending Your Medical Data & Wallet From Fraud w/ HealthLock CEO, Scott Speranza | HealthBiz Briefs · CareTalk: Healthcare. Unfiltered.

• 0:00
  Medical bills are complex and expensive, and they often contain errors or even outright fraud.
• 0:06
  How is an overwhelmed consumer who's not a medical billing specialist supposed to keep up?
• 0:12
  Well, today's guest has the answer.
• 0:17
  Welcome to Health Business Briefs.
• 0:22
  I'm David Williams, president of Health Business Group here with Scott Speranza, founder and CEO of HealthBlock.
• 0:27
  The company analyzes claims for fraud and overbilling and helps people get their money back.
• 0:33
  Welcome, Scott.
• 0:34
  Hello, David.
• 0:36
  I want to know, how common are medical billing errors and what are the typical issues that you find?
• 0:43
  Well, actually, over half of all medical bills contain errors.
• 0:47
  Sometimes it's even higher depending upon the system, the carrier and so forth.
• 0:51
  So these are third party statistics.
• 0:53
  They've been around for a while now.
• 0:55
  And nearly, you know, one in four Americans have medical debt.
• 1:00
  You know, 53 % of all credit issues are medical related.
• 1:04
  66 % of all bankruptcies are due to medical bills.
• 1:08
  So it's actually very common from a denied claim.
• 1:11
  20 % of Americans are going to receive a denial of benefit this year to balance billing.
• 1:17
  Something you don't owe is billed to you.
• 1:18
  Upcoding duplicate services, overcharges that could be two, 300 % higher than market average.
• 1:26
  It's a $350 billion problem according to third party statistics.
• 1:32
  You know, I saw on your website that you have now an agreement with MasterCard, which is a pretty big deal.
• 1:38
  And I wonder why did MasterCard agree to work with you?
• 1:42
  You know, what's in it for them and for their card holders?
• 1:45
  Again, the statistics for MasterCard were overwhelming.
• 1:48
  Data breaches.
• 1:49
  And of course, we've heard the news, UHC and Change Healthcare recently, and their fraud division saw our platform and services and used it and started to save money and understood the privacy protection.
• 2:02
  and said, our, our 60 million card holders can use this as a benefit.
• 2:06
  And so our press release, uh, just a couple of weeks ago, uh, had MasterCard announcing that we've now been approved from a standpoint of security, uh, scalability and value for all 60 million card holders.
• 2:18
  And so now each issuer, you know, like a city bank and so forth would make a decision to add health lock as a feature.
• 2:25
  But if you do have a MasterCard and go to our site, you get a discount.
• 2:29
  And then also you get a free service, which would be a fraud remediation for life as a MasterCard user.
• 2:35
  So please take advantage of that.
• 2:37
  Nice.
• 2:37
  Well, I actually checked it out and I have a Citibank card and that was accepted.
• 2:42
  So it seems like some of the big names are signing up.
• 2:44
  So congratulations on that.
• 2:46
  Thank you.
• 2:46
  It was a great win for us and MasterCard is a phenomenal brand and they've been a great partner.
• 2:52
  How concerned should consumers be about their medical privacy and data security?
• 2:57
  You certainly hear, you know, hear about all these breaches and get letters and you sort of just shrug it off or, you know, is this something that actually matters?
• 3:05
  Yeah, you know, it's, it's hard because we've been conditioned as Americans that, you know, everybody has my data and there's a breach a day, which there, there is, um, what can I do about it?
• 3:14
  What should I do about it?
• 3:15
  Should I care?
• 3:16
  And, um, you know, again, you go through the statistics, you know, pre COVID.
• 3:21
  There were a few million data breaches, patient record data breaches.
• 3:25
  Last year there was 171 million, year prior 50 million.
• 3:31
  The old social security number was your big identity theft that you wanted to protect.
• 3:37
  Well, your medical data is now 40 times more valuable to organize crime than your social security number.
• 3:44
  Why?
• 3:45
  Because there's so much fraud happening and it does affect us.
• 3:49
  Uh, a company sets up a fake billing company and they use your group member, your medical records, your patient data to go get paid fraudulently.
• 3:58
  Well, that could affect your credit.
• 3:59
  That could affect your actual benefits.
• 4:01
  A lot of folks will go in two years later, get a service, uh, and they'll be denied because it was something that they'd already paid out and that was fraud and we remediate those.
• 4:12
  So, you know, you certainly want to go to doctors that do not have HIPAA violations.
• 4:17
  It certainly feels secure.
• 4:18
  We monitor those 24 seven so that you know about these.
• 4:21
  And then also just the ability to say, protect my privacy for any third party, HIPAA doesn't protect all of our data.
• 4:28
  And then let's have somebody out there that can help remediate issues when that fraud does happen, because it's happening a lot now.
• 4:35
  Well, that's it for the latest episode of Health Biz Briefs.
• 4:39
  If you like what you hear, check out my full Health Biz podcast to hear about Scott and his life and career.
• 4:46
  Scott Speranza, CEO of HealthLock, Thank you for joining me today on Health Biz Briefs.
• 4:50
  Thank you, David.