Impact Factor (2025): 6.9
DOI Prefix: 10.47001/IRJIET
Healthcare
insurance claim processing traditionally relies on centralized clearinghouses,
creating potential privacy risks through the inadvertent or malicious exposure
of sensitive patient information. To address these vulnerabilities, this paper
proposes a decentralized solution leveraging blockchain technology to replace
the role of clearinghouses in the healthcare insurance claim process. Our
approach enhances patient privacy by implementing a HIPAA-compliant system
designed to secure data exchange and automate the claim process through
distributed, immutable ledgers. We developed specialized data structures to
store patient information, medical service records, insurance payments, and
agreements, all maintained within the blockchain ledger for transparency and
security. Smart contracts are defined to assure privacy and streamline claim
processing, automating key steps while ensuring compliance with regulatory
requirements. The framework was implemented using Hyperledger Fabric and
evaluated for performance and response time, demonstrating a marked improvement
in data integrity, security, and operational efficiency over conventional
systems. This blockchain-based approach offers a scalable, secure, and
privacy-centric solution, advancing the healthcare sector’s capacity for safe
and efficient insurance claims handling.
Country : USA
IRJIET, Volume 8, Issue 1, January 2024 pp. 201-208