Abstract

Health insurance fraud is a significant problem affecting insurance providers and policyholders. To address the rising problem of fraudulent activities in the health insurance sector, this paper proposes a pioneering blockchain-based system aimed at increasing transparency and security. Utilizing a hybrid Blockchain architecture, the system incorporates a consensus algorithm influenced by practical byzantine fault tolerance (PBFT) and proof of activity (PoA) to ensure reliability and efficiency in distributing mining power. Developed using Python, extensive testing confirms the system's performance and security metrics. Results show that a block size containing one transaction is 1.63 KB, with 1.2 KB for data and 0.43 KB for identification and hashing. Operational tests demonstrate that a single participant can upload 850 transactions to the transaction pool, with validation completed in just 7.49 seconds. Block appending time for these transactions is a swift 10 seconds. Notably, the system exhibits resilience against data tampering, detecting unauthorized changes within 881.3 milliseconds across 10,000 blocks and identifying irregularities in the transaction pool within 8.78 seconds. Additionally, to enhance data privacy, patient information is accessible only through a unique QR code, providing an extra layer of security; this research represents a significant advancement in combatting fraud and safeguarding data privacy.

Full Text
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