Brazil’s supplemental healthcare sector has been facing a series of crises. The sharp increase in fraud involving medical and dental plans has had a direct impact on beneficiaries’ wallets. In 2023 alone, reports of irregularities rose by 66% compared to the previous year, according to FenaSaúde.
Private healthcare providers, commonly known as health plans, operate under a mutualism model. In this system, monthly payments made by individuals and companies are pooled into a collective fund. The organization uses these funds to cover the medical services outlined in contracts and legislation, ensuring care for those who need it.
For this reason, fraud and resource waste — such as unnecessary consultations and exams or duplicate requests — directly threaten the sustainability of this model. Unauthorized use of the plan by third parties or billing for procedures that were never performed undermines the financial balance of providers and leads to price increases. Implementing effective solutions to control these losses not only ensures quality care but also prevents beneficiaries’ own money from being wasted. Biometrics, for example, is a technology that allows precise identification of service users.
In this article, we will show how biometric technology can be applied in supplemental healthcare to prevent unnecessary expenses, protect provider resources, and guarantee beneficiaries’ right to safe and efficient care.
Keep reading!
Main types of waste in supplemental healthcare
The constant rise in healthcare and administrative costs has largely been driven by various forms of inefficiency throughout the care chain. According to the Guide to Best Practices in Supplemental Healthcare (CNseg, 2018), these excesses can account for up to 25% of the sector’s total expenses.
Below are the main types:
Fraud and abuse
Fraud, improper conduct, and opportunistic use of health plans include undue charges, billing for procedures that were not performed, overbilling, and excessive requests for materials or medications without real clinical need.
Overtreatment
Overtreatment refers to subjecting patients to care that does not provide real health benefits, such as the indiscriminate use of antibiotics, unnecessary surgeries, and excessive ordering of tests.
Administrative bureaucracy
Administrative bureaucracy involves the imposition of standardized or inadequate rules, often created by market agents or the government, which hinder process efficiency.
Lack of care coordination
A lack of care coordination is characterized by fragmented assistance with no focus on the patient. This leads to high hospital readmission rates, loss of autonomy, and increased dependency, especially among patients with chronic diseases.
Service failures
Service failures involve poor execution or the absence of processes to improve patient care, as well as the lack of safety systems and preventive practices.
Overpricing
Overpricing occurs when prices charged deviate significantly from those expected in efficient markets. In Brazil, for example, the prices of medical-hospital items such as Orthoses, Prostheses, and Special Materials (OPSM) can vary up to 3,000 times between different states, and are often higher than those seen in other countries.
The inclusion of biometrics in supplemental healthcare has proven to be highly effective. By enabling precise identification of both patients and professionals, this technology helps prevent fraud and brings greater security to everyone involved. With less bureaucratic processes, care becomes more efficient and integrated, reducing errors and waste along the way. In this way, biometrics protect sector resources and contribute to a more transparent and trustworthy experience for both users and healthcare workers.
Causes of waste in supplemental healthcare
In addition to increasing costs and compromising the sustainability of the healthcare sector, inefficient use of resources directly impacts the quality of care. For this reason, identifying the main causes of this problem is essential to promote more efficient management and ensure that resources are used appropriately. Below are the key factors that contribute to waste in supplemental healthcare:
- Alteration of information to obtain undue reimbursement and use of false documents.
- Administrative failures, incorrect data entry, and duplicate billing.
- Requesting or performing unnecessary exams and procedures, prolonged hospitalizations without clinical justification, and excessive prescription of medications.
- Lack of beneficiary knowledge about proper plan usage and lack of professional awareness regarding clinical protocols.
- Inefficient processes, lack of integration between systems, and inadequate resource management.
- Absence or non-adoption of technological solutions to reduce human error, which hinders error prevention, compromises efficient resource use, and reduces transaction transparency.
By understanding these causes, it is possible to adopt smarter solutions to reduce waste and move towards building a sustainable and fair supplemental healthcare system. Platforms like BioPass ID assist providers, clinics, and hospitals in reducing costs, preventing fraud, improving patient experience, and strengthening the sector’s sustainability. With the use of biometrics, there is greater accuracy, fewer human errors, and better management of supplies and processes. Next, we will explain more about this technology.
How to use biometric recognition to monitor and identify waste
Aiming to promote greater control, security, and efficiency in processes, BioPass ID offers biometric solutions designed to reduce waste in supplemental healthcare. With easy-to-integrate APIs, this technology enables intelligent resource management, allowing providers to optimize their operations.
Here’s how BioPass ID contributes to this scenario:
Accurate authentication of patients and professionals
Biometric validation prevents duplicate consultations and procedures while precisely authenticating the identity of patients and staff. BioPass ID ensures that care is delivered to the right person, eliminates identification errors, and optimizes the use of healthcare services.
Automated control of supplies and medications
The system tracks the lifecycle of medications and hospital materials, monitoring the entry, distribution, and usage of resources. Biometric technology allows for tracking each stage, preventing waste caused by expiration or improper use.
Security in online care
For telemedicine services, biometric validation ensures the correct identification of both patients and professionals, guaranteeing the proper use of virtual resources.
Prevention of financial fraud
Reduces costs by preventing improper requests for reimbursements and procedure authorizations. With BioPass ID, providers can avoid overbilling and fraudulent claims.
Efficient management of the care cycle
Each step of the care process is monitored, providing complete visibility. This makes it easier to identify operational failures and contributes to more agile, waste-free workflows.
Through robust APIs that easily integrate with different systems, biometric solutions provide total control over processes, reinforce security, and ensure appropriate use of resources. With BioPass ID, supplemental healthcare providers have a comprehensive solution to enhance the patient experience.
Biometric recognition in resource optimization
In this article, we have explored the main causes of waste in supplemental healthcare and understood how biometrics can help control costs in the sector. To address this issue, it is essential for healthcare providers to adopt biometric solutions that ensure efficiency, accuracy, and security. With cutting-edge technology, BioPass ID helps tackle these challenges. Through APIs such as Multibiometrics and Quality, it is possible to identify operational inefficiencies, optimize processes, and ensure that resources are used more strategically and effectively.
Implementing biometrics provides greater accuracy in records, reduces administrative errors, optimizes resources, and enables monitoring of supply and medication usage. Now that you are familiar with BioPass ID’s biometric solutions, contact one of our specialists and request a demonstration. If you prefer, you can purchase the solution directly here.
