System, method, and computer program product for patient authentication and identity risk assessment

A system comprising a server comprising at least one processor, the server being programmed and/or configured to:

• receive an initial patient authorization request from a medical provider computing device, the initial patient authorization request comprising a patient identifier communicated by a mobile device of a user to the medical provider computing device;
• generate, using an identification risk assessment model and based at least partly on the initial patient authorization request, an authenticity score;
• communicate the authenticity score to an insurance provider system to cause the insurance provider system to approve or decline the initial patient authorization request;
• receive a primary insurance provider response from the insurance provider system comprising a prompt for the mobile device to initiate a patient identification response to prove a patient identity;
• communicate at least a portion of the primary insurance provider response to the medical provider computing device;
• receive the patient identification response from the mobile device, the patient identification response comprising the patient identifier and at least one proof of the patient identity;
• in response to validating the at least one proof, communicate an identification evaluation response to the mobile device, the identification evaluation response comprising a validation token;
• receive a secondary patient authorization request from the medical provider computing device via an electronic payment processing network, the secondary patient authorization request comprising the patient identifier and the validation token;
• and
• communicate at least a portion of a secondary insurance provider response to the medical provider computing device, the secondary insurance provider response based on a new authenticity score based at least partly on the secondary patient authorization request.

A computer program product comprising at least one non-transitory computer-readable medium including program instructions that, when executed by at least one processor, cause the at least one processor to:

• receive an initial patient authorization request from a medical provider computing device, the initial patient authorization request comprising a patient identifier communicated by a mobile device of a user to the medical provider computing device;
• generate, using an identification risk assessment model and based at least partly on the initial patient authorization request, an authenticity score;
• communicate the authenticity score to an insurance provider system to cause the insurance provider system to approve or decline the initial patient authorization request;
• receive a primary insurance provider response from the insurance provider system comprising a prompt for the mobile device to initiate a patient identification response to prove a patient identity;
• communicate at least a portion of the primary insurance provider response to the medical provider computing device;
• receive the patient identification response from the mobile device, the patient identification response comprising the patient identifier and at least one proof of the patient identity;
• in response to validating the at least one proof, communicate an identification evaluation response to the mobile device, the identification evaluation response comprising a validation token;
• receive a secondary patient authorization request from the medical provider computing device via an electronic payment processing network, the secondary patient authorization request comprising the patient identifier and the validation token;
• and
• communicate at least a portion of a secondary insurance provider response to the medical provider computing device, the secondary insurance provider response based on a new authenticity score based at least partly on the secondary patient authorization request.