Transforming Health Insurance Claims Adjudication with Blockchain-based Solutions

Abstract

Over the past decade, the blockchain technology has gained a significant traction with the introduction of the “bitcoin”, the first cryptocurrency back in 2008. The rapid growth of “bitcoin” as a currency and the Bitcoin as a protocol has served as a wake-up call to the IT community which began to realize the real potential of blockchain technology. Blockchain technology is capable of filling many gaps that traditional IT solutions struggle to address. In the other hand the increasing complexity of adjudicating health insurance claims is an urge to introduce more secure and efficient claims adjudication system. Blockchain technology has the potential to reshape the claims adjudication process not only due to its decentralized and tamper-proof features but to its consensus protocols and much more other characteristics. This article studies some of the most recent researches on blockchain solution for health insurance claim adjudication, evaluates the its feasibility and identifies areas where blockchain technology could be applied to improve efficiency and accuracy. This study will also examine the potential benefits and challenges of implementing a blockchain-based system, like reducing administrative costs and improving fraud detection.