Artificial intelligence (AI) will assist the National Institute of Social Security (INSS) to detect fraud in health certificates. The federal agency will widely adopt the tool in early 2024 to detect fraudulent documents submitted to claim benefits.
With technology, data will be cross-referenced to map any irregularities. One of the banks used will be Atestmed, which is available on the Meu INSS website and application. This system digitally sends the citizen’s medical documents to the institution.
Artificial intelligence will check doctors’ identities and registrations with Regional Medical Councils (CRM). Moreover, the technology will be able to monitor mass shootings from a single IP address and even doctors’ handwritings.
Behavior analysis will also be integrated. Before applying artificial intelligence, INSS monitors the health certificates of those claiming temporary disability benefit (formerly known as sickness benefit) on a sampling basis.
INSS insured people who prove by medical examination that they cannot operate for more than 15 consecutive days are entitled to benefit from this benefit. The grace period is 12 months of contributions.
Giving a certificate is considered a crime
Exemption from the waiting period includes work-related accidents or diseases and the list of 17 diseases specified in the Inter-Ministerial Regulation MTP/MS n° 22 dated 31.08.2022. Anyone caught submitting a false medical report will face criminal charges.
INSS aims to reduce the queues of pension and benefit claims. According to the Pension Transparency Portal, there are currently more than 1.6 million claims queued. Some of these people, 7.5 percent, wait six months to a year for analysis. The majority, 55%, were there for up to 45 days.
The Ministry of Social Security plans to reduce the waiting period for all insured people to a maximum of one and a half months by the end of this year. The idea is that by December 2024, all requests will be responded to within 30 days.
Source: Tec Mundo
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