This project proposes the conceptualization and prototyping of a healthcare fraud and abuse prevention blockchain. Different from other proposals, our work will focus on adding the patient as a participant and potential validating node to a public and consortium based blockchain design. In traditional healthcare claims certification and reimbursement, the healthcare provider (e.g. hospital, clinic, group practice, individual practitioner) submits a claim after rendering health services to a payor. The payor then verifies patient eligibility, and reimburses for the claim. In our model, we will add the patient as a node on the blockchain and determine whether a process of patient-centric claims verification can be built into a blockchain consensus mechanism and smart contract. Our model will include the use of tokens to incentivize patient participation on the blockchain to self-report and validate claims on the blockchain.
npm i ganache-cli
npm i truffle
npm i web3
MetaMask Chrome Extension: https://metamask.io/
ganache-cli
(In a separate terminal)
truffle compile
truffle migrate
npm run start
This is the login page, it will require only a username. The password can be any characters.
Any changes made to the Ethereum blockchain will evoke a Metamask call, requesting your confirmation of payment.
Login with "UCSD Medical" as username.
Select the green button "Create Service Claim" on the patient Ken. Fill in the fields.
Click on the drop down menu of the patient you have created a claim for and select the claim.
Login with "Ken" as username.
The green button on the bottom of the claim will verify the claim, whether the patient confirms or disputes the claim is up to them.
Login with "CMS" as username.
While insurers cannot modify claims, they can see their provenance as well as their statuses of verification.