Five Blockchain Use Cases for Healthcare Payers, Providers

Five Blockchain Use Cases for Healthcare Payers, Providers

This is a technology I am really excited about. The common wisdom and current case uses are an underpinning of cryptocurrencies, such as Bitcoin and Ethereum. While this is important, only secondary to the technology highlighted below and from the base article.


Blockchain may offer a solution to these issues by keeping all members of the community instantly updated on where a provider is allowed to practice, whether or not she is accepting new patients, and what new affiliations she has formed.

This is important, because of current mHealth initiatives, such as CMC Virtual Visit, requires you to physically be in North Carolina, though the system servers both Carolinas. That has to change.

Administrative tasks such as claims processing and underwriting may also benefit from a blockchain approach, since managed permissions make it easier for payers to assess the validity of a claim, manage pre-authorizations, and ensure that providers are meeting the criteria laid out in their value-based contracts.

“Smart contracts could automate these processes and decrease the time and resources needed to execute the terms and conditions [of value-based contracting],” the report says.  “And because smart contracts are decentralized and cannot be changed, all parties can be confident that terms will be consistently executed.”

Pages from CMC Mercy Wound Care 10062017_Redacted_Page_1I continue to get notice of bill payments, similar to an actual bill image to the left, despite my plan being straightforward, at least as I know about it. Possibility to save much headaches and time wasting.

Blockchain would nearly eliminate this as rules can be set; such as “only render services covered under Medicare” to a particular patient. This removes the doubts about all parties getting compensated.


Enhanced security and transparency may also drastically reduce the amount of fraud that slips through the defenses of public and private payers.  When entities must have current and authenticated identities before a transaction is approved, the ability to push suspect claims through the reimbursement process is diminished.

Payers with access to a patient’s complete medical record and all of the individual’s approved providers would be more able to identify suspect claims or payment requests that do not match the patient’s documented conditions or normal care habits, explains Deloitte.

Source: Five Blockchain Use Cases for Healthcare Payers, Providers


Leave a Reply


You are commenting using your account. Log Out /  Change )

Google photo


Twitter picture


Facebook photo


Connecting to %s