Page 24 - June 2018 Disruption Report Flip Book

BLOCKCHAIN ADOPTION
JANJUNAERY20210818
Electronic medical records pilot: Change Healthcare,
Change Healthcare: In Nashville, Change Healthcare, a network of 800,000 physicians, 117,000 dentists and 60,000 pharmacies, rolled out a blockchain system for processing insurance claims. The system provides encrypted data that represents a “single source of truth” that’s provided in real time to providers. Change Healthcare is now exploring other applications that can be run on their system, including automated processing of claims and ways to improve digital verification of the patient. (Blockchain for Dummies, Manav Gupta, 2017; Wall Street Journal, Tomio Geron, 05/28/18)
Healthcare payments pre-authorization
The term “clinical attachments” is a concept surrounding the need for additional clinical information when a payer is adjudicating a healthcare claim. Claims are often submitted without all the required supporting detail, so payer(s) need to request additional detail, which adds costs and delays to the settlement process. Further, matching up the claims with the supporting information is challenging for all parties involved.
Blockchain can simplify this complicated and time-consuming process and automate the collection and sharing of information. Additional benefits include:
• Claims can be reviewed and paid more efficiently and quickly.
• The system can suggest alternative services that have better coverage. Healthcare payments pre-authorization pilot: Coral Health
The healthcare blockchain company, Coral Health, is working with insurance companies to program smart contracts on its blockchain ecosystem that contain all of the insurer’s health plan information needed to assess a request and approve or deny prior authorization. When a provider prescribes a treatment, the provider submits the treatment to the Coral Health platform and receives automatic approval, based upon the insurer’s smart contract. Coral Health is working to establish partnerships with a select group of insurance companies to pilot the automated authorization process for a small set of medical procedures. (Blockchain for Dummies, Manav Gupta, 2017; Medium, 01/08/18)
The Internet of Things (IoT)
As machines interact with one another, any relevant interactions can be reported by the machines
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