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

A system, comprising:

• at least one processor 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 prompt from the insurance provider system for at least one proof of a patient identity;
• receive the at least one proof of the patient identity from the mobile device of a user;
• in response to validating the at least one proof, communicate a validation token to the mobile device;
• receive a secondary patient authorization request from the medical provider computing device, the secondary patient authorization request comprising the validation token;
• generate, using the identification risk assessment model and based at least partly on the secondary patient authorization request, a new authenticity score;
• communicate the new authenticity score to the insurance provider system to cause the insurance provider system to approve or decline the secondary patient authorization request;
• receive a secondary insurance provider response from the insurance provider system;
• and
• communicate at least a portion of the secondary insurance provider response to the medical provider computing device, the secondary insurance provider response based on the new authenticity score.

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 prompt from the insurance provider system for at least one proof of a patient identity;
• receive the at least one proof of the patient identity from the mobile device of a user;
• in response to validating the at least one proof, communicate a validation token to the mobile device;
• receive a secondary patient authorization request from the medical provider computing device, the secondary patient authorization request comprising the validation token;
• generate, using the identification risk assessment model and based at least partly on the secondary patient authorization request, a new authenticity score;
• communicate the new authenticity score to the insurance provider system to cause the insurance provider system to approve or decline the secondary patient authorization request;
• receive a secondary insurance provider response from the insurance provider system;
• and
• communicate at least a portion of the secondary insurance provider response to the medical provider computing device, the secondary insurance provider response based on the new authenticity score.