The Difference Between MIDAS & Your EOB

One of the questions we’re asked frequently when we’re out talking about MIDAS (Medical Identity Alert System) is how it’s different from the Explanation of Benefits (EOB) forms that insurers already provide to their patients after they receive covered treatment(s). This is a great question and one that really gets to the heart of the value that MIDAS brings to payers, providers and consumers.

For this discussion, it’s worth diving a bit more into what EOBs are and how they were designed to be used. EOB’s originally came into being largely because they were mandated by federal legislation. Insurers have spent a lot of time and money over the years working to make these forms more useful to their customers. Modern EOBs are better and more useful than the documents consumers received back in the managed care days in the 1990s.

However, when the Ponemon Institute surveyed consumers last year on medical fraud issues, they found that only 21 percent of people opened their EOBs every time they received them. The majority of people reported they never looked at their EOBs. And more than half of the people who reported they’d seen an inaccuracy on their EOB never reported it to their insurance company.

EOBs provide a range of important information. They notify consumers of claims made against their accounts, but more importantly – for many people – they explain what was covered and what the consumer now must pay out-of-pocket. They can be used to help detect fraudulent claims, but that’s not their primary purpose or how most consumers have been educated to view them.

In contrast, MIDAS was purpose-built for fraud detection. The entire context of the service is medical identity protection, so consumers are primed for that view. The alerts are timely, giving consumers a better chance to remember the treatment they received. And they are presented in clear, easy-to-understand text that makes it a lot easier for consumers to digest.

Uber and Lyft toppled the taxicab model by breaking down transaction barriers and providing a seamless, mobile app-driven experience. MIDAS does the exact same thing. Alerts hit consumers on the devices they use every day; transactions easily can be flagged if suspicious; and perhaps the coolest part is that in the unlucky event the consumer spots something suspicious, ID Experts moves right into action to help consumers deal with the nightmare!

Medical identity theft and fraud are uniquely damaging crimes. Unlike a stolen credit card – which can be quickly replaced and have its charges reversed – medical identity fraud can have lifetime impacts. When someone pretends to be you to receive health care, your lifetime medical records become mixed with incorrect information.

This can eventually lead to a prescription mistake with a medication to which you’re allergic or other dangerous/inappropriate treatment. ID Experts’ trained identity recovery team works with victims to “decontaminate” their records to help ensure proper treatment in the future.

In summary, MIDAS is not intended to be a replacement for EOBs. Rather, it was purposely designed to sit alongside them to provide actionable, noticeable and comprehensible alerts that can help identify and resolve suspicious transactions well before payer reviews or law enforcement investigations.