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Combating Health Care Fraud and Abuse: Conceptualization and Prototyping Study of a Blockchain Antifraud Framework.

Timothy K MackeyKen MiyachiDanny FungSamson QianJames Short
Published in: Journal of medical Internet research (2020)
The proposed framework and the initial prototype have the potential to improve the health care claims process by using blockchain technology for secure data storage and consensus mechanisms, which make the claims adjudication process more patient-centric for the purposes of identifying and preventing health care fraud and abuse. Future work will focus on the use of synthetic or historic CMS claims data to assess the real-world viability of the framework.
Keyphrases
  • healthcare
  • health insurance
  • electronic health record
  • affordable care act
  • big data
  • intimate partner violence
  • current status
  • social media
  • climate change
  • artificial intelligence
  • deep learning