4 Key Methods to Reduce the Impact of Healthcare Scam Calls
Laura Fitzgerald
May 22, 2025 (UPDATED ON 05/22/2025)
6 minute read time
Healthcare contact centers often serve as the frontline for patient support, scheduling appointments, confirming insurance details, and addressing a wide range of inquiries. These contact centers are vital for patient care; but the discussion of sensitive data makes them a target for fraudsters.
When fraudsters pose as patients, insurance companies, or government agencies, they can manipulate agents into revealing personal information, transferring funds, or altering patient records.
This can impact an organization’s bottom line, leading to potential fraud and legal liabilities. If personal or financial records are compromised, it can also erode the confidence of patients and healthcare centers.
Combined with emerging methods like deepfake attacks, detailed in deepfake attacks: what you need to know, the stakes for healthcare contact centers have never been higher.
This article examines four key strategies for verifying caller identities, better protecting patient information, and enhancing overall trust to counter these threats.
How healthcare scam calls work
Fraudsters often start by gathering details about a target organization or patient list. They might acquire stolen data, such as policy numbers or Medicare IDs, from data breaches, then call the contact center claiming to be a patient or an insurance representative.
By posing as the owner, the fraudster may try to persuade agents to divulge more information or change account details. Alternatively, they could impersonate an official from a government agency, leveraging caller ID spoofing to make the phone number appear legitimate.
Fraudsters can also use texts or automated robocalls to direct unsuspecting agents to dial a suspicious number or visit a website, effectively bypassing standard authentication protocols.
Modern fraudsters even apply deepfake technology to replicate voices and request urgent changes. These sophisticated calls require more advanced defenses than basic scripts or cursory identity checks.
1. Verify caller identity
Properly verifying caller identity is your first line of defense in combating healthcare scam calls. This extends beyond simply requesting a phone number or personal information.
Contact center agents should rely on multilayered verification methods, such as voice analysis or device intelligence, to confirm a caller is who they claim to be. Traditional knowledge-based questions and one-time passwords can be easily bypassed if criminals have already stolen the necessary data.
As our guide on how AI can improve healthcare fraud protection explains, advanced authentication solutions help detect anomalies in real time. This is especially relevant for highly regulated contexts involving health insurance or Medicare details.
Quick tip: Implement a step-by-step process for verifying identity. For instance, voice analysis can be used, and then a second factor may be required, such as a confirmation code sent to an authorized device.
If any discrepancy arises, agents should follow escalation protocols. Read about how you can better protect patient privacy with voice biometric authentication.
2. Recognize red flags
Well-trained agents can identify phone scams early by recognizing behaviors that deviate from standard caller patterns. Even so, training alone doesn’t always suffice. Fraudsters are no longer confined to traditional methods; they utilize advanced tools to appear more convincing.
Voice phishing, for example, is one of the most prevalent scam call tactics. Fraudsters use a deceptive technique to trick individuals into providing personal and sensitive information over the phone. They pressure for immediate action, claiming the matter is time-sensitive, such as a crucial insurance lapse or a “government agency” needing an immediate callback.
Today, it’s more essential than ever for agents to recognize red flags. Below are some common signs to watch for:
The caller claims an urgent deadline or severe consequences (e.g., insurance lapses) but refuses standard verification steps.
The caller asks for information that isn’t typically required, such as full Social Security numbers or complete credit card details.
The caller’s phone number or caller ID appears legitimate but doesn’t match official records, or the caller seems overly defensive when asked basic identity questions.
The caller’s voice sounds oddly inconsistent—either robotic in tone, unusually distorted, or noticeably different from verified previous calls.
Voice phishing and other deceptive tactics are rapidly increasing, driven by the widespread availability of AI deepfake technologies that enable fraudsters to expand their operations. Discover how voice security can combat deepfake AI.
3. Guard personal information
Frontline contact center agents and managers must understand the value of the data they handle. Any slip can provide fraudsters with an opening.
Limit data exposure: Ensure staff access or disclose only the minimal patient data necessary for each call. Store sensitive information—like Social Security numbers—in secure, access-controlled systems.
Establish clear protocols: Staff should never share or request unnecessary details, such as entire credit card numbers or fully spelled-out account information, unless absolutely needed to complete a transaction.
Training and policies: Outline how and when staff can disclose certain pieces of data. For a deeper dive, check out best practices in our healthcare identity theft resource.
4. Report and block scam calls
If your contact center repeatedly encounters suspicious calls, sharing that information with internal teams and relevant authorities can help you prevent future attacks. The faster you can detect and block scam attempts, the better you can protect your organization’s data and reputation.
Network-level blocking: Work with your telecom provider to blocklist known malicious phone numbers or IP addresses.
Escalation procedure: Clearly outline whom staff should notify—IT security, compliance officers, or supervisors—if a call raises suspicions.
Collaborative intelligence: Leverage industry forums that track healthcare scams. Sharing data can improve detection across the broader healthcare ecosystem.
Proactive reporting doesn’t just safeguard your operation—it also assists other organizations by identifying shared threat patterns, including phony claims and caller IDs. Now you may be wondering, how can you catch and stop these calls in the first place?
Use Pindrop® Protect for comprehensive call risk assessment
While network blocking and escalation policies are crucial, voice analysis and AI-powered tools can offer immediate insights into suspicious callers. Pindrop® Protect provides a single, real-time risk score for each call, available from the Interactive Voice Response (IVR) stage through to the agent interaction.
By combining multiple data signals—device characteristics, behavior, and potential anomalies—Pindrop® Protect helps your organization:
Identify fraud more quickly: Near real-time alerts on high-risk calls allow staff to intervene or terminate the interaction before data is compromised.
Reduce reliance on manual checks: An automated, data-driven risk score can help you avoid asking lengthy security questions that inconvenience genuine callers.
Build trust: Show stakeholders that you’re proactively managing fraud risks with an advanced approach.
Learn more about Pindrop® Protect and how it can help safeguard your contact center from old vulnerabilities and new threats, such as deepfake voices. Plus, learn how you can modernize the patient experience without compromising security.