A Blockchain-Based System for Anti-Fraud of Healthcare Insurance

Abstract

The number of healthcare insurance frauds increases year by year, which causes tremendous concern in society. Healthcare insurance fraud exists in various forms, such as falsifying information, concealing third-party liability, falsified electronic bill and so on. The current healthcare insurance system requires a lot of manpower and resources which bears heavily on the system. In this paper, referring to the various forms of healthcare insurance fraud, we propose a healthcare insurance anti-fraud system based on blockchain. The system adopts the architecture based on cloud computing. And organizations such as 120-command centers, public security traffic control departments, judicial organs, healthcare insurance agencies, etc., are included in the blockchain system. And the data of medical expenses, prescriptions, inspection reports, treatment records in the medical process is employed to establish a healthcare insurance blockchain. Based on the blockchain, the system provides medical process inspection service, excessive medical behavior analysis, third-party liability inspection service and medical invoice data review service.