In an era where efficiency, accuracy, and fraud prevention are critical to the success of public assistance programs, traditional eligibility verification methods are struggling to keep up. Manual processes, outdated data, and limited visibility leave agencies vulnerable to fraud, waste, and abuse (FWA).
At CITIZ3N, we developed VERIFY to help agencies modernize eligibility verification, protect taxpayer dollars, and strengthen program integrity. Below, we compare VERIFY’s modern approach with traditional methods and highlight why the shift is necessary.
Traditional Verification Methods: Limitations That Cost Agencies
Traditional eligibility verification often relies on paper documentation, phone calls, and manual data entry. Caseworkers review pay stubs, tax returns, and employer verifications—a time-consuming process prone to human error and delays.
According to The Work Number, relying on outdated wage data or manual verification methods slows down determinations and increases the risk of approving ineligible applicants. This outdated process also struggles to keep up with the complex fraud schemes targeting benefit programs.
For example, the Social Security Administration (SSA) reported significant losses due to fraudulent claims, leading to increased scrutiny and new identity verification rules. Manual systems simply lack the tools to detect sophisticated schemes like identity theft, phantom billing, and coordinated cross-state fraud.
Additionally, manual workloads drain agency resources, reduce efficiency, and result in backlogs—making it harder for agencies to serve eligible families quickly and accurately.
The VERIFY Advantage: Automated, Accurate, and Actionable
VERIFY reimagines the verification process by integrating automation, machine learning, and real-time data from CITIZ3N’s databanks, third-party suppliers, and government databases. It’s designed specifically to solve the problems traditional methods can’t address.
Key advantages of VERIFY include:
Automated Verification: Streamlines eligibility determinations, reducing processing times and human error. Agencies can verify applicant data faster, even during periods of high demand.
Advanced Fraud Detection: Using AI and predictive analytics, VERIFY proactively identifies high-risk activities, including identity theft and duplicate claims—helping agencies stop fraud before it happens. Related: How AI is transforming Medicaid fraud detection
Real-Time Data Integration: Unlike traditional methods reliant on static records, VERIFY pulls the latest data, giving agencies up-to-date insights to make informed decisions quickly.
Risk Scoring & Prioritization: VERIFY assigns color-coded risk scores to each case (Red = High Risk, Yellow = Medium, Green = Low), allowing caseworkers to prioritize their efforts where it matters most.
Post-Payment Fraud Analysis: Not only does VERIFY detect fraud upfront, but it also supports retrospective audits to identify fraudulent claims that may have slipped through initial screens.
Regulatory Compliance: VERIFY meets HIPAA, NIST, and CMS standards, with independent security audits ensuring continued compliance.
Why VERIFY Outperforms Traditional Methods
Switching to VERIFY helps agencies:
Improve Efficiency: Automation drastically reduces manual workload, allowing caseworkers to process more applications in less time. (How VERIFY optimizes resources)
Increase Accuracy: Real-time data checks and AI-driven risk scoring improve accuracy, reducing costly improper payments—like the Medicaid program’s $50.3 billion in improper payments in 2023.
Detect Fraud Proactively: Instead of chasing fraud after payments go out, VERIFY helps agencies prevent it upfront.
Protect Resources: With better tools and data, agencies can focus on supporting truly eligible applicants while preserving public funds.
The Bottom Line
Traditional verification methods simply can’t keep pace with today’s fraud landscape or the demand for efficiency in social service programs. VERIFY gives agencies a smarter, faster, and more secure way to verify eligibility, protect programs from abuse, and better serve the people who rely on these critical benefits.
Learn more about CITIZ3N’s VERIFY platform here.
