Online Identity Proofing Using Eligibility Transaction Data
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Solution Overview
Problem
Traditional identity proofing in healthcare settings is time-intensive and costly, often requiring face-to-face or phone interactions, which are inefficient and not scalable for secure online access to healthcare services.
Innovation Solution
A system that leverages standard eligibility request/response transactions between organizations and payors to authenticate organizations in near real-time by comparing patient-specific attributes, allowing secure online access to healthcare services while reducing costs and time.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional face-to-face or phone identity proofing is used, then security verification is achieved, but the process becomes time-intensive and costly
Solution Approach 1:
The patent uses eligibility transaction data (a copy of existing verified information) from payor-organization transactions to perform identity proofing, eliminating the need for time-consuming face-to-face or phone verification while maintaining security. The system retrieves and compares patient attributes from these existing transaction records to verify organizational identity.
Solution Approach 2:
The patent replaces the mechanical human interaction process (face-to-face or phone verification) with an automated electronic system that queries payor databases and compares eligibility transaction data. This substitution eliminates manual verification steps and enables near real-time automated identity proofing.
2Reliability
If traditional face-to-face or phone identity proofing is used, then security verification is achieved, but the process becomes expensive
Solution Approach 1:
The system leverages existing eligibility transaction data that is already generated during normal payor-organization interactions. By reusing this existing data for identity proofing purposes, the system avoids the additional cost of separate verification processes while maintaining security requirements.
Solution Approach 2:
The eligibility transaction data serves multiple functions: it performs both the original eligibility verification and simultaneously provides the basis for identity proofing. This multi-functionality eliminates redundant processes and reduces overall system cost while maintaining security verification.
3Productivity
If automated online identity proofing is implemented, then efficiency and scalability are improved, but system complexity increases
Solution Approach 1:
The patent introduces an authentication service as an intermediary layer between organizations and payors. This service handles the complexity of querying eligibility transactions, comparing attributes, and determining authenticity, while presenting a simple interface to organizations. The intermediary absorbs system complexity rather than exposing it to users.
Solution Approach 2:
The patent extracts the identity proofing logic into a separate, standalone authentication service that operates independently from the core eligibility processing systems. This extraction allows the complex verification logic to be developed and maintained separately while maintaining simple integration points with existing systems.
Data Source
AI summary
Methods, computer systems and computer readable media for online authentication of an organization are provided. Authentication is accomplished by receiving a first set of patient specific attributes from an organization. This first set of attributes is obtained from an eligibility transaction between the organization and a payor for the patient. The first set of attributes is compared to a second set of attributes involving the same patient, where the second set of attributes is obtained from an eligibility transaction between the online service provider and the payor. If the first set of attributes matches the second set of attributes, the secure online service provider will be notified that the organization is authentic.