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Combating Health Care Fraud and Abuse: Conceptualization and Prototyping Study of a Blockchain Antifraud Framework

https://doi.org/10.2196/18623
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What this work says

Outgoing claims: the papers this work cites, builds on, or argues with.

inferredcites →https://doi.org/10.1001/jama.2019.13978openalex-snapshot
Waste in the US Health Care System
inferredcites →https://doi.org/10.1001/jamainternmed.2019.4771openalex-snapshot
Association Between Treatment by Fraud and Abuse Perpetrators and Health Outcomes Among Medicare Beneficiaries
inferredcites →https://doi.org/10.1007/978-3-319-61446-5_4openalex-snapshot
Patient-Centric Strategies in Digital Health
inferredcites →https://doi.org/10.1007/978-3-319-67262-5_1openalex-snapshot
On or Off the Blockchain? Insights on Off-Chaining Computation and Data
inferredcites →https://doi.org/10.1007/978-3-319-99819-0openalex-snapshot
Service-Oriented and Cloud Computing
inferredcites →https://doi.org/10.1007/s10916-018-0995-5openalex-snapshot
Towards Secure and Privacy-Preserving Data Sharing in e-Health Systems via Consortium Blockchain
inferredcites →https://doi.org/10.1007/s10916-018-0997-3openalex-snapshot
Blockchain-Based Data Preservation System for Medical Data
inferredcites →https://doi.org/10.1007/s10916-018-1121-4openalex-snapshot
Blockchain-Based Medical Records Secure Storage and Medical Service Framework
inferredcites →https://doi.org/10.1016/j.csbj.2018.06.003openalex-snapshot
Blockchain Technology for Healthcare: Facilitating the Transition to Patient-Driven Interoperability
inferredcites →https://doi.org/10.1016/j.tele.2018.11.006openalex-snapshot
A systematic literature review of blockchain-based applications: Current status, classification and open issues
inferredcites →https://doi.org/10.1016/s1361-3723(97)82589-4openalex-snapshot
Takedown
inferredcites →https://doi.org/10.1093/jamia/ocx068openalex-snapshot
Blockchain distributed ledger technologies for biomedical and health care applications
inferredcites →https://doi.org/10.1093/jamia/ocy185openalex-snapshot
Comparison of blockchain platforms: a systematic review and healthcare examples
inferredcites →https://doi.org/10.1093/pm/pny315openalex-snapshot
Can Blockchain technologies help tackle the opioid epidemic: A Narrative Review
inferredcites →https://doi.org/10.1109/cvcbt.2018.00011openalex-snapshot
Do you Need a Blockchain?
inferredcites →https://doi.org/10.1186/s12916-019-1296-7openalex-snapshot
‘Fit-for-purpose?’ – challenges and opportunities for applications of blockchain technology in the future of healthcare
inferredcites →https://doi.org/10.1186/s13063-017-2035-zopenalex-snapshot
Blockchain technology for improving clinical research quality
inferredcites →https://doi.org/10.1186/s40537-018-0138-3openalex-snapshot
Big Data fraud detection using multiple medicare data sources
inferredcites →https://doi.org/10.1377/hlthaff.2018.05499openalex-snapshot
National Health Expenditure Projections, 2018–27: Economic And Demographic Trends Drive Spending And Enrollment Growth
inferredcites →https://doi.org/10.15171/ijhpm.2015.196openalex-snapshot
Improving Fraud and Abuse Detection in General Physician Claims: A Data Mining Study
inferredcites →https://doi.org/10.2196/10163openalex-snapshot
Blockchain Technology for Detecting Falsified and Substandard Drugs in Distribution: Pharmaceutical Supply Chain Intervention
inferredcites →https://doi.org/10.2196/12426openalex-snapshot
Design Choices and Trade-Offs in Health Care Blockchain Implementations: Systematic Review
inferredcites →https://doi.org/10.2196/12439openalex-snapshot
Implementing Blockchains for Efficient Health Care: Systematic Review
inferredcites →https://doi.org/10.2196/13583openalex-snapshot
Accelerating Health Data Sharing: A Solution Based on the Internet of Things and Distributed Ledger Technologies
inferredcites →https://doi.org/10.2196/13592openalex-snapshot
A Blockchain Framework for Patient-Centered Health Records and Exchange (HealthChain): Evaluation and Proof-of-Concept Study
inferredcites →https://doi.org/10.2196/14184openalex-snapshot
The Potential of Blockchain Technology for Health Information Exchange: Experimental Study From Patients’ Perspectives
inferredcites →https://doi.org/10.3390/electronics9010094openalex-snapshot
A Blockchain-Based Smart Contract System for Healthcare Management
inferredcites →https://doi.org/10.3390/healthcare7020056openalex-snapshot
Blockchain Technology in Healthcare: A Systematic Review
inferredcites →https://doi.org/10.3390/s19020326openalex-snapshot
A Decentralized Privacy-Preserving Healthcare Blockchain for IoT
inferredcites →https://doi.org/10.5539/gjhs.v7n1p194openalex-snapshot
Using Data Mining to Detect Health Care Fraud and Abuse: A Review of Literature
inferredcites →https://doi.org/10.7326/0003-4819-149-5-200809020-00009openalex-snapshot
Whistleblower-Initiated Enforcement Actions against Health Care Fraud and Abuse in the United States, 1996 to 2005

What points at this work

Incoming claims: where this work appears in other papers’ reference lists and arguments.

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Smart h‐Chain: A blockchain based healthcare framework with insurance fraud detection
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Detecting Fraudulent Wallets in Ethereum Blockchain Combining Supervised and Unsupervised Techniques - Using Autoencoders and XGboost
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Applicability and Integration of Blockchain in Healthcare
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Bridging Data–Policy Gap in Universal Health Coverage: A Governance-Embedded Reference Architecture for Data-Driven Health Systems
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Cybersecurity Considerations in Blockchain-Based Solutions
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An extended lightweight blockchain based collaborative healthcare system for fraud prevention
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Blockchain-Enabled Healthcare: Critical Analysis of Applications, Limitations, and Technical Solutions
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Blockchain-assisted healthcare insurance fraud detection framework using ensemble learning
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Prioritization of health distributed ledger technology use cases using fuzzy sine trigonometric based decision-making model
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2024 Chinese guideline on the construction and application of medical blockchain
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A survey of blockchain-based IoT eHealthcare: Applications, research issues, and challenges
inferred← citeshttps://doi.org/10.1016/j.japh.2024.102081openalex-snapshot
Prospective systematic risk analysis of the digital technology use within pharmaceutical care
inferred← citeshttps://doi.org/10.1016/j.jbusres.2023.113646openalex-snapshot
Smart contract diffusion in the pharmaceutical blockchain: the battle of counterfeit drugs
inferred← citeshttps://doi.org/10.1016/j.procs.2023.03.060openalex-snapshot
An Adaptive Decision-Making Approach for Better Selection of Blockchain Platform for Health Insurance Frauds Detection with Smart Contracts: Development and Performance Evaluation
inferred← citeshttps://doi.org/10.1016/j.procs.2023.09.022openalex-snapshot
Transforming Health Insurance Claims Adjudication with Blockchain-based Solutions
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AI -Driven Data Aggregation Level Smart Contracts for Blockchain Healthcare Insurance Claims Adjudication
inferred← citeshttps://doi.org/10.1016/s2589-7500(21)00210-7openalex-snapshot
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Using large language models for enhanced fraud analysis and detection in blockchain based health insurance claims
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inferred← citeshttps://doi.org/10.1108/978-1-80455-566-820231003openalex-snapshot
Checking the Effectiveness of Blockchain Application in Fraud Detection with A Systematic Literature Review Approach
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Classification of Health Insurance Fraud Risk with Machine Learning
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QFBN: Quorum-Based Federated Blockchain Network for Healthcare System to Avoid Multiple Benefits and Data Breaches
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Blockchain and Clinical Trials for Health Informatics
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Architectural Design of a Blockchain-Enabled, Federated Learning Platform for Algorithmic Fairness in Predictive Health Care: Design Science Study
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