Insurance claim settlement system and method based on block chain
By introducing blockchain technology into the insurance claims system, the hospital and the institution end and the user end form the same blockchain connection, solving the system docking problems and data transmission security issues in the traditional insurance claims process, and achieving a more efficient and accurate claim process.
Patent Information
- Application Number
- CN202411800187.3
- Authority / Receiving Office
- CN · China
- Patent Type
- Applications(China)
- Current Assignee / Owner
- Filing Date
- 2024-12-06
- Publication Date
- 2025-03-28
AI Technical Summary
During the insurance claims process, it is difficult for the hospital and insurance company systems to be seamlessly connected, resulting in users needing to manually collect and upload proof materials, which takes a long time and is prone to omissions and errors, reducing the timeliness and accuracy of claims.
A blockchain-based insurance claims system is designed. The hospital end, the user end and the institution end are located on the same blockchain. The hospital end generates and sends verifiable credentials based on the user's credential reception request, and the user end forwards it to the institution end. The institution end executes the claim process based on the medical information in the credentials.
It avoids the hassle of users uploading proof materials manually, reduces manual intervention, improves the timeliness and accuracy of insurance claims, and ensures the security and immutability of data through encryption and blockchain technology.
Smart Images
Figure CN119722347A_ABST
Abstract
Description
Technical Field
[0001] The present application relates to the field of data processing technology, and in particular to an insurance claims system and method based on blockchain. Background Art
[0002] In the insurance claims process, the hospital's medical information system and the insurance company's insurance claims system are two independently operated systems. Since the two systems have different data standards, security mechanisms, and business process designs, it is difficult to achieve seamless connection between the two systems.
[0003] At present, in order to make insurance claims, users need to convert various paper-based certification materials such as medical records, examination reports, and expense lists into electronic formats by taking photos or scanning, and then upload them to the insurance claims system provided by the insurance company. After the insurance company receives the user's electronic certification materials, a dedicated claims staff will conduct a manual review on the insurance claims system, including reviewing the authenticity and completeness of the certification materials and whether they meet the claim conditions, so as to make insurance claims for the users corresponding to the approved certification materials.
[0004] However, the above process is not only time-consuming, but also prone to omissions and errors, thereby reducing the timeliness and accuracy of insurance claims. Summary of the invention
[0005] Based on the above problems, the present application provides a blockchain-based insurance claims system and method, which can improve the timeliness and accuracy of insurance claims.
[0006] The embodiments of the present application disclose the following technical solutions:
[0007] In a first aspect, the present application discloses a blockchain-based insurance claims system, the system comprising: a hospital side, a user side, and an institution side, wherein the hospital side, the user side, and the institution side are located on the same blockchain;
[0008] The hospital end is used to, when receiving a credential receiving request sent by the user end, determine the medical information according to the identifier in the credential receiving request; generate a verifiable credential according to the medical information; and send the verifiable credential to the user end;
[0009] The user end is used to, when receiving the verifiable credential issued by the hospital end, send the verifiable credential to the institution end;
[0010] The institution end is used to execute the claim settlement process according to the medical treatment information in the verifiable certificate when receiving the verifiable certificate issued by the user end.
[0011] Optionally, the hospital end is specifically used for: if it is determined that the user end meets the insurance claim conditions based on the medical information and the insurance claim conditions, a verifiable credential is generated, wherein the verifiable credential is a verifiable credential that represents that the user end meets the insurance claim conditions.
[0012] Optionally, the hospital side is specifically used to, when receiving a credential reception request issued by the user side, verify the signature of the credential reception request by determining the public key of the user side from the blockchain; if the verification result indicates that the credential reception request comes from the user side, then determine the medical information according to the identifier in the credential reception request.
[0013] Optionally, the hospital end is specifically used to sign the verifiable credential using the private key of the hospital end to obtain the signed verifiable credential; and send the signed verifiable credential to the user end.
[0014] Optionally, the user end is specifically used to, when receiving the signed verifiable credential issued by the hospital end, encrypt the signed verifiable credential by determining the public key of the institution end from the blockchain to obtain the encrypted verifiable credential; and send the encrypted verifiable credential to the institution end.
[0015] Optionally, the institution end is specifically used to, when receiving the encrypted verifiable credential sent by the user end, use the private key of the institution end to decrypt the encrypted verifiable credential to obtain the decrypted verifiable credential; by determining the public key of the hospital end from the blockchain, verify the decrypted verifiable credential; if the verification result indicates that the medical information in the decrypted verifiable credential comes from the hospital end, then execute the claims process according to the medical information.
[0016] In the second aspect, the present application discloses a blockchain-based insurance claims method, which is applied to the hospital side. The method includes:
[0017] When receiving a credential receiving request from a user terminal, determining the medical information according to an identifier in the credential receiving request, wherein the user terminal and the hospital terminal are located on the same blockchain;
[0018] Generating a verifiable credential based on the medical consultation information;
[0019] The verifiable credential is sent to the client.
[0020] Optionally, generating a verifiable credential based on the medical consultation information includes:
[0021] If it is determined that the user terminal meets the insurance claim conditions based on the medical information and the insurance claim conditions, a verifiable credential is generated, wherein the verifiable credential is a verifiable credential indicating that the user terminal meets the insurance claim conditions.
[0022] Optionally, when receiving a credential receiving request sent by a user terminal, determining the medical information according to an identifier in the credential receiving request includes:
[0023] When receiving a credential receiving request from a user terminal, verifying the signature of the credential receiving request by determining the public key of the user terminal from the blockchain;
[0024] If the signature verification result indicates that the credential receiving request comes from the user end, the medical information is determined according to the identifier in the credential receiving request.
[0025] Optionally, sending the verifiable credential to the user terminal includes:
[0026] Using the private key of the hospital, signing the verifiable credential to obtain the signed verifiable credential;
[0027] The signed verifiable credential is sent to the user terminal.
[0028] In a third aspect, the present application discloses a blockchain-based insurance claims method, which is applied to a user end, and the method includes:
[0029] When the verifiable credential issued by the hospital side is received, the verifiable credential is sent to the institution side, wherein the user side, the hospital side and the institution side are located on the same blockchain.
[0030] Optionally, when receiving the verifiable credential issued by the hospital, sending the verifiable credential to the institution includes:
[0031] When receiving the signed verifiable credential issued by the hospital, encrypting the signed verifiable credential by determining the public key of the institution from the blockchain to obtain an encrypted verifiable credential;
[0032] The encrypted verifiable credential is sent to the institution end.
[0033] In a fourth aspect, the present application discloses a blockchain-based insurance claims method, which is applied to an institutional end, and the method includes:
[0034] When a verifiable credential is received from a user terminal, a claim settlement process is executed according to the medical information in the verifiable credential, wherein the user terminal and the institution terminal are located on the same blockchain.
[0035] Optionally, when receiving the verifiable credential issued by the user terminal, executing the claim settlement process according to the medical information in the verifiable credential, including:
[0036] When receiving the encrypted verifiable credential sent by the user, decrypting the encrypted verifiable credential using the private key of the institution to obtain a decrypted verifiable credential;
[0037] By determining the public key of the hospital from the blockchain, the decrypted verifiable credential is signed;
[0038] If the signature verification result indicates that the medical information in the decrypted verifiable certificate comes from the hospital, the claim settlement process is executed according to the medical information.
[0039] Compared with the prior art, this application has the following beneficial effects:
[0040] The embodiment of the present application provides a blockchain-based insurance claims system and method, wherein the hospital side, user side and institution side of the blockchain-based insurance claims system are located on the same blockchain, wherein the hospital side is used to, when receiving a credential reception request issued by the user side, determine the medical information according to the identifier in the credential reception request; generate a verifiable credential according to the medical information; send the verifiable credential to the user side; the user side is used to, when receiving a verifiable credential issued by the hospital side, send the verifiable credential to the institution side; the institution side is used to, when receiving a verifiable credential issued by the user side, execute the claims process according to the medical information in the verifiable credential. Therefore, in the present application, the hospital side generates and sends a verifiable credential to the user side according to the credential reception request issued by the user side, and then the user side forwards it to the institution side, avoiding the trouble of users having to manually collect and upload various certification materials in the traditional way, which not only reduces manual intervention, but also improves the timeliness and accuracy of insurance claims. BRIEF DESCRIPTION OF THE DRAWINGS
[0041] In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the drawings required for use in the embodiments or the description of the prior art will be briefly introduced below. Obviously, the drawings described below are only some embodiments of the present application. For ordinary technicians in this field, other drawings can be obtained based on these drawings without paying creative labor.
[0042] Figure 1 A signaling diagram of a blockchain-based insurance claims system provided in an embodiment of the present application;
[0043] Figure 2A signaling diagram of another blockchain-based insurance claims system provided in an embodiment of the present application;
[0044] Figure 3A A flowchart of the first blockchain-based insurance claims method provided in an embodiment of the present application;
[0045] Figure 3B A flowchart of a second blockchain-based insurance claims method provided in an embodiment of the present application;
[0046] Figure 3C A flowchart of the third blockchain-based insurance claims method proposed in the embodiment of the present application;
[0047] Figure 4 A schematic diagram of a computer-readable medium provided for an embodiment of the present application. DETAILED DESCRIPTION
[0048] As described above, in order to make insurance claims, users need to convert various paper-based certification materials such as medical records, examination reports, and expense lists into electronic formats by taking photos or scanning, and then upload them to the insurance claims system provided by the insurance company. After the insurance company receives the user's electronic certification materials, a dedicated claims personnel will conduct a manual review on the insurance claims system, including reviewing the authenticity and completeness of the certification materials and whether they meet the claim conditions, so as to make insurance claims for the users corresponding to the approved certification materials.
[0049] However, the above process is not only time-consuming, but also prone to omissions and errors, thereby reducing the timeliness and accuracy of insurance claims.
[0050] After research, the inventor has proposed a blockchain-based insurance claims system and method. The hospital side, user side and institution side of the blockchain-based insurance claims system provided by the embodiment of the present application are located on the same blockchain, wherein the hospital side generates and sends a verifiable credential to the user side according to the credential reception request issued by the user side, and then the user side forwards it to the institution side, avoiding the trouble of users manually collecting and uploading various certification materials in the traditional way, which not only reduces manual intervention, but also improves the timeliness and accuracy of insurance claims. In addition, the present application uses encryption technology to ensure the security of the user's medical information during transmission and storage. Only authorized entities with corresponding decryption keys can access the credential content, which effectively prevents unauthorized data access and protects the user's privacy. Furthermore, through the application of blockchain technology, the present application ensures the non-tamperability of medical information, and the institution side can trust the authenticity of the data received from the hospital, thereby speeding up the review of insurance claims.
[0051] In order to enable those skilled in the art to better understand the solution of the present application, the technical solution in the embodiments of the present application will be clearly and completely described below in conjunction with the drawings in the embodiments of the present application. Obviously, the described embodiments are only part of the embodiments of the present application, not all of the embodiments. Based on the embodiments in the present application, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of this application.
[0052] See also Figure 1 , which is a signaling diagram of a blockchain-based insurance claims system provided by an embodiment of the present application. Figure 1 It can be seen that the insurance claim system 10 based on blockchain includes a hospital end 11, a user end 12 and an institutional end 13. Among them, the hospital end 11 can be a hospital server, a medical information system, etc., the user end 12 can be a mobile phone application, a web interface or a self-service terminal, and the institutional end can be an insurance company's server, an insurance claim system, etc. For the specific hospital end 11, user end 12 and institutional end 13, this application does not limit it, as long as it ensures that the hospital end 11, the user end 12 and the institutional end 13 are located in the same blockchain.
[0053] S101: When the hospital receives a credential receiving request from the user, it determines the medical information according to the identifier in the credential receiving request.
[0054] When a user needs to receive some form of credential (such as appointment confirmation, test report, electronic prescription, etc.), the user terminal 12 will send a credential receiving request to the hospital terminal 11. Each credential receiving request contains a unique identifier, such as the user's ID number, appointment number, medical record number, or other identifier that can uniquely identify the user, so as to ensure that the hospital terminal 11 can accurately find the corresponding medical information of the user terminal 12, so as to provide the correct verifiable credential to the user terminal 12 in the subsequent steps.
[0055] Once the hospital end 11 receives the credential receiving request including the identifier, the hospital end 11 will perform a query operation in its database to determine the medical information matching the identifier.
[0056] S102: The hospital generates a verifiable credential based on the medical information.
[0057] First, the hospital end 11 will select a suitable template from the template library of the hospital end 11 according to the voucher type (such as appointment confirmation, test report, electronic prescription, etc.) corresponding to the voucher reception request issued by the user end 12. Each template is designed for a specific voucher type and contains specific fields and layouts. Among them, the fields are used to fill in specific medical information, such as test items, result values, reference ranges, drug names, dosages, usage, etc., and the layout determines the display method of these medical information, including font size, color, alignment, etc.
[0058] Subsequently, the hospital terminal 11 will automatically extract the medical information from the database and fill the medical information into each field of the selected template. It is understandable that the process of filling in the fields is usually automated, which can reduce the errors and time-consuming of manual operations.
[0059] For example, for a test report, the hospital end 11 will fill in the patient's name, test items (such as blood routine, urine routine, etc.), specific test result values (such as white blood cell count, red blood cell count, etc.), reference range (i.e., normal value range), etc. For an electronic prescription, the hospital end 11 will fill in the patient's name, drug name, specification, dosage, usage (such as oral, external, etc.), frequency of medication, duration of medication, etc.
[0060] After all fields are filled, the hospital end 11 generates a complete, formatted medical certificate (i.e., a verifiable certificate).
[0061] S103: The hospital sends the verifiable credentials to the user.
[0062] The hospital end 11 usually sends the verifiable credentials to the user end 12 through an encrypted communication protocol, such as HyperText Transfer Protocol Secure (HTTPS), to ensure that the verifiable credentials will not be stolen or tampered with during the transmission process. It should be noted that the specific sending method is not limited in this application.
[0063] S104: When the user end receives the verifiable credential issued by the hospital end, the verifiable credential is sent to the institution end.
[0064] It should be noted that before the user terminal 12 sends the verifiable credential to the institution terminal 13, the user needs to express his or her explicit consent. This is because the verifiable credential may contain personal health information, which involves privacy protection issues.
[0065] S105: When the institution receives the verifiable credential sent by the user, it executes the claim settlement process according to the medical information in the verifiable credential.
[0066] First, the institution end 13 needs to extract the medical information by parsing the verifiable credentials, including the patient's medical treatment date, doctor information, diagnosis results, treatment costs, etc.
[0067] The institution side 13 will then compare the medical information with the internal database of the institution side 13 to confirm the patient's identity and policy status, thereby ensuring that the patient is indeed eligible to apply for a claim. After determining that the patient is eligible to apply for a claim, the claim process can be executed.
[0068] In summary, the embodiment of the present application provides a blockchain-based insurance claims system, in which the hospital side, user side and institution side of the blockchain-based insurance claims system are located on the same blockchain, wherein the hospital side is used to, when receiving a credential reception request issued by the user side, determine the medical information according to the identifier in the credential reception request; generate a verifiable credential according to the medical information; send the verifiable credential to the user side; the user side is used to, when receiving a verifiable credential issued by the hospital side, send the verifiable credential to the institution side; the institution side is used to, when receiving a verifiable credential issued by the user side, execute the claims process according to the medical information in the verifiable credential. Therefore, in the present application, the hospital side generates and sends a verifiable credential to the user side according to the credential reception request issued by the user side, and then forwards it to the institution side by the user side, avoiding the trouble of users having to manually collect and upload various certification materials in the traditional way, which not only reduces manual intervention, but also improves the timeliness and accuracy of insurance claims.
[0069] See also Figure 2 , which is a signaling diagram of another blockchain-based insurance claims system provided by an embodiment of the present application. Figure 2 It can be seen that the blockchain-based insurance claims system 20 includes a hospital end 21, a user end 22 and an institution end 23, and the hospital end 21, the user end 22 and the institution end 23 are located on the same blockchain.
[0070] S201: When the hospital receives a credential receiving request from the user, it verifies the signature of the credential receiving request by determining the public key of the user from the blockchain.
[0071] After receiving the credential receiving request sent by the user terminal 22, the hospital terminal 21 will first check the basic format and integrity of the credential receiving request to ensure that the credential receiving request meets the expected standards.
[0072] After ensuring that the format of the credential receiving request is complete, the hospital end 21 needs to find the public key of the user end 22 from the blockchain according to the identifier in the credential receiving request to perform the signature verification operation. Among them, the user end 22 will record its public key on the blockchain as publicly available information when registering or using the blockchain for the first time. In this way, any third party (such as the hospital end 22) that needs to verify the user's identity or the authenticity of the request can obtain this public key from the blockchain.
[0073] After extracting the public key of the user terminal 22, the hospital terminal 21 can use the public key to decrypt the digital signature attached to the credential receiving request, that is, to verify the signature. The signature verification can not only prove the authenticity of the credential receiving request, but also confirm that the credential receiving request has not been tampered with, because any modification will cause the signature verification to fail.
[0074] It should be noted that if the signature verification fails, it indicates that the credential reception request may be forged or tampered with. The hospital end 21 will reject the credential reception request and may take further security measures, such as notifying the administrator or restricting the operating authority of the relevant account.
[0075] S202: If the signature verification result indicates that the credential receiving request comes from the user end, the hospital end determines the medical information according to the identifier in the credential receiving request.
[0076] If the signature verification result indicates that the credential reception request does come from the user end 22 (that is, the credential reception request is authentic and has not been tampered with), the hospital end 21 will perform a query operation in the internal system or related system of the hospital end 21 based on the identifier in the credential acceptance request to find the medical information that matches the identifier.
[0077] It is understandable that, since the signature verification has ensured the authenticity of the credential receiving request, the hospital end 21 can be sure that the queried medical information is associated with the real user end 22, which helps to avoid the risk of information leakage or misoperation.
[0078] S203: The hospital generates a verifiable credential based on the medical information.
[0079] This step is similar to step S102 and will not be described again here.
[0080] In a specific implementation, in order to avoid unnecessary processing steps and waste of resources, the hospital end 21 can pre-evaluate whether the user end 22 meets the insurance claim requirements based on the medical information and insurance claim conditions before generating a verifiable credential. These requirements include but are not limited to the types of diseases covered by the insurance, the reimbursement ratio of treatment items, deductibles, maximum compensation limits, specific drug restrictions, and treatment method restrictions. The hospital end 21 needs to carefully review the medical information to ensure that the treatment and expenses of the user end 22 comply with the provisions of the insurance contract. If all requirements are met, the hospital end 21 can automatically determine that the user end 22 meets the claim conditions, and then the hospital end 21 can generate a verifiable credential.
[0081] S204: The hospital uses its private key to sign the verifiable credential to obtain the signed verifiable credential.
[0082] In order to ensure the authenticity and validity of the verifiable credential, the hospital end 21 will use the private key of the hospital end 21 to sign the verifiable credential. It should be noted that the private key of the hospital end 21 is strictly confidential and can only be accessed by the internal authorization system of the hospital end 21. This is to ensure that the private key is not obtained by unauthorized personnel, thereby protecting the information security of the hospital end 21.
[0083] The hospital end 21 uses the private key of the hospital end 21 to encrypt the verifiable credential and generate a "digital signature" (i.e., the signed verifiable credential). It is understandable that due to the uniqueness and confidentiality of the private key, the generated signed verifiable credential is also unique. Only the entity that holds the public key corresponding to the private key (such as the institution end 23 or the user end 22) can decrypt the signed verifiable credential.
[0084] S205: The hospital sends the signed verifiable certificate to the user.
[0085] This step is similar to step S103 and will not be described again here.
[0086] S206: When the user receives the signed verifiable credential issued by the hospital, the signed verifiable credential is encrypted by determining the public key of the institution from the blockchain to obtain the encrypted verifiable credential.
[0087] When the client 22 receives the signed verifiable credential issued by the hospital 21 through a secure communication channel (such as HTTPS), the client 22 will first perform a preliminary verification on the signed credential to ensure its integrity and authenticity.
[0088] After the initial verification is passed, in order to ensure the security of subsequent encryption, the user terminal 22 needs to obtain the public key of the institution terminal 23 (such as an insurance company) by accessing the blockchain. It can be understood that due to the immutability of the blockchain, the public key of the institution terminal 23 stored on the blockchain is reliable, and the user terminal 22 can safely use it for encryption operations.
[0089] Subsequently, the user terminal 22 uses the signed verifiable credential as input and encrypts the signed verifiable credential using the public key of the institution terminal 23 to obtain the encrypted verifiable credential. This encryption process ensures that only the institution terminal 23 holding the corresponding private key can decrypt and view the encrypted verifiable credential.
[0090] S207: The user terminal sends the encrypted verifiable credential to the institution terminal.
[0091] S208: When the institution receives the encrypted verifiable credential sent by the user, the institution uses the private key of the institution to decrypt the encrypted verifiable credential to obtain the decrypted verifiable credential.
[0092] In order to be able to decrypt the encrypted verifiable credentials, the institution end 23 needs to access the private key of the institution end 23. The private key of the institution end 23 is usually stored in a secure location, such as a hardware security module (HSM) or a cryptographic key management service (KMS) to ensure its security and availability.
[0093] Subsequently, the institution end 23 uses the private key of the institution end 23 to decrypt the encrypted verifiable credential and obtain the decrypted verifiable credential.
[0094] S209: The institution verifies the decrypted verifiable certificate by determining the public key of the hospital from the blockchain.
[0095] The institution side 23 has successfully used the private key of the institution side 23 to decrypt the encrypted verifiable credential sent by the user side 22, and obtained the decrypted verifiable credential. The decrypted verifiable credential usually contains a digital signature part. The digital signature is a means used by the hospital side 21 to ensure the integrity and authenticity of the verifiable credential. It ensures that the verifiable content has not been tampered with during the process of transmitting the verifiable credential from the hospital side 21 to the user side 22 and then to the institution side 23. In order to verify the authenticity of the digital signature, the institution side 23 uses the public key of the hospital side 21 extracted from the blockchain to verify the digital signature in the decrypted verifiable credential.
[0096] Specifically, the institution end 23 applies the public key of the hospital end 21 to the digital signature and checks whether the generated hash value matches the original hash value in the verifiable credential. If the hash values match, it means that the digital signature is valid, the decrypted verifiable credential is indeed generated by the hospital end 21, and the content has not been tampered with. If the hash values do not match, it means that the digital signature is invalid, and the decrypted verifiable credential may have been tampered with or not generated by the hospital end 21.
[0097] S210: If the signature verification result indicates that the medical information in the decrypted verifiable certificate comes from the hospital, the claim settlement process is executed according to the medical information.
[0098] If the verification result indicates that the digital signature is valid, the decrypted verifiable certificate is indeed generated by the hospital end 21, and the content has not been tampered with, then the institution end 23 can execute the corresponding business process based on the medical information in the verifiable certificate, such as processing insurance claims, updating patient medical records, etc. Taking insurance claims as an example, the institution end 23 may need to check the patient's insurance information, medical expense details, diagnosis results, etc. in the medical information to determine whether the claim conditions are met. If the patient's medical information and insurance conditions are consistent, the institution end 23 can decide to approve the claim request and pay the corresponding medical expense compensation to the patient.
[0099] In summary, the present application discloses a blockchain-based insurance claims system. The hospital side, user side and institutional side of the blockchain-based insurance claims system provided by the embodiment of the present application are located on the same blockchain, wherein the hospital side generates and sends a verifiable credential to the user side according to the credential reception request issued by the user side, and then the user side forwards it to the institutional side, avoiding the trouble of users manually collecting and uploading various certification materials in the traditional way, which not only reduces manual intervention, but also improves the timeliness and accuracy of insurance claims. In addition, the present application uses encryption technology to ensure the security of the user's medical information during transmission and storage. Only authorized entities with corresponding decryption keys can access the credential content, which effectively prevents unauthorized data access and protects the user's privacy. Furthermore, through the application of blockchain technology, the present application ensures the non-tamperability of medical information, and the institutional side can trust the authenticity of the data received from the hospital, thereby speeding up the review of insurance claims.
[0100] See also Figure 3A , which is a flow chart of the first blockchain-based insurance claims method provided in the embodiment of the present application. The method is applied to the hospital side and includes:
[0101] S301: When a credential receiving request is received from a user terminal, the medical information is determined according to an identifier in the credential receiving request, wherein the user terminal and the hospital terminal are located on the same blockchain.
[0102] In some specific implementations, when a credential receiving request sent by a user terminal is received, the medical information is determined according to an identifier in the credential receiving request, including:
[0103] When a credential reception request is received from a user, the credential reception request is verified by determining the user's public key from the blockchain; if the verification result indicates that the credential reception request comes from the user, the medical information is determined based on the identifier in the credential reception request.
[0104] S302: Generate a verifiable credential based on the medical consultation information.
[0105] In some specific implementations, verifiable credentials are generated based on the medical information, including:
[0106] If it is determined that the user terminal meets the insurance claim conditions based on the medical information and the insurance claim conditions, a verifiable credential is generated, wherein the verifiable credential is a verifiable credential that indicates that the user terminal meets the insurance claim conditions.
[0107] S303: Send the verifiable credential to the user.
[0108] In some specific implementations, sending the verifiable credential to the user terminal includes:
[0109] The private key of the hospital is used to sign the verifiable credential to obtain the signed verifiable credential; the signed verifiable credential is sent to the user end.
[0110] See also Figure 3B , which is a flow chart of a second blockchain-based insurance claims method provided in an embodiment of the present application. The method is applied to the user end and includes:
[0111] S304: When a verifiable credential is received from the hospital, the verifiable credential is sent to the institution, wherein the user, hospital and institution are located on the same blockchain.
[0112] In some specific implementations, when a verifiable credential is received from a hospital, the verifiable credential is sent to an institution, including:
[0113] When receiving the signed verifiable credential from the hospital, the signed verifiable credential is encrypted by determining the public key of the institution from the blockchain to obtain the encrypted verifiable credential;
[0114] Send the encrypted verifiable credentials to the institution.
[0115] See also Figure 3C, which is a flowchart of the third blockchain-based insurance claims method provided in the embodiment of this application. The method is applied to the institution side and includes:
[0116] S305: When a verifiable credential is received from a user terminal, the claim settlement process is executed according to the medical information in the verifiable credential, wherein the user terminal and the institution terminal are located on the same blockchain.
[0117] In some specific implementations, when a verifiable credential is received from a user, a claim settlement process is executed according to the medical information in the verifiable credential, including:
[0118] When the encrypted verifiable credential sent by the user is received, the encrypted verifiable credential is decrypted using the private key of the institution to obtain the decrypted verifiable credential; the decrypted verifiable credential is verified by determining the public key of the hospital from the blockchain; if the verification result indicates that the medical information in the decrypted verifiable credential comes from the hospital, the claims process is executed based on the medical information.
[0119] In summary, the present application discloses an insurance claim method based on blockchain, wherein the hospital side, user side and institutional side of the insurance claim method based on blockchain are located on the same blockchain, wherein the hospital side generates and sends a verifiable credential to the user side according to the credential reception request issued by the user side, and then the user side forwards it to the institutional side, thereby avoiding the trouble of users manually collecting and uploading various certification materials in the traditional way, which not only reduces manual intervention, but also improves the timeliness and accuracy of insurance claims. In addition, the present application uses encryption technology to ensure the security of the user's medical information during transmission and storage. Only authorized entities with corresponding decryption keys can access the credential content, which effectively prevents unauthorized data access and protects the user's privacy. Furthermore, through the application of blockchain technology, the present application ensures the non-tamperability of medical information, and the institutional side can trust the authenticity of the data received from the hospital, thereby speeding up the review of insurance claims.
[0120] The embodiments of the present application also provide a corresponding blockchain-based insurance claims device and a computer-readable medium for implementing the blockchain-based insurance claims method provided in the embodiments of the present application.
[0121] Among them, the blockchain-based insurance claims device includes a memory and a processor, the memory is used to store instructions or codes, and the processor is used to execute instructions or codes so that the device executes a blockchain-based insurance claims method of any embodiment of the present application.
[0122] See also Figure 4, which is a schematic diagram of a computer-readable medium provided in an embodiment of the present application. The computer-readable medium 400 stores a computer program 411, which implements the above-mentioned Figure 1 Steps for a blockchain-based insurance claims approach.
[0123] It should be noted that in the context of the present application, a machine-readable medium may be a tangible medium that may contain or store a program for use by or in conjunction with an instruction execution system, device or equipment. A machine-readable medium may be a machine-readable signal medium or a machine-readable storage medium. A machine-readable medium may include, but is not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, device or equipment, or any suitable combination of the foregoing. A more specific example of a machine-readable storage medium may include an electrical connection based on one or more lines, a portable computer disk, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), an optical fiber, a portable compact disk read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the foregoing.
[0124] It should be noted that the machine-readable medium mentioned above in the present application may be a computer-readable signal medium or a computer-readable storage medium or any combination of the above two. The computer-readable storage medium may be, for example, but not limited to, an electrical, magnetic, optical, electromagnetic, infrared, or semiconductor system, device or device, or any combination of the above. More specific examples of computer-readable storage media may include, but are not limited to: an electrical connection with one or more wires, a portable computer disk, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or flash memory), an optical fiber, a portable compact disk read-only memory (CD-ROM), an optical storage device, a magnetic storage device, or any suitable combination of the above. In the present application, a computer-readable storage medium may be any tangible medium containing or storing a program that can be used by or in combination with an instruction execution system, device or device. In the present application, a computer-readable signal medium may include a data signal propagated in a baseband or as part of a carrier wave, which carries a computer-readable program code. This propagated data signal may take a variety of forms, including but not limited to electromagnetic signals, optical signals, or any suitable combination of the above. The computer readable signal medium may also be any computer readable medium other than a computer readable storage medium, which may send, propagate or transmit a program for use by or in conjunction with an instruction execution system, apparatus or device. The program code contained on the computer readable medium may be transmitted using any suitable medium, including but not limited to: wires, optical cables, RF (radio frequency), etc., or any suitable combination of the above.
[0125] The computer-readable medium may be included in the electronic device, or may exist independently without being incorporated into the electronic device.
[0126] Although the subject matter has been described in language specific to structural features and / or methodological logical actions, it should be understood that the subject matter defined in the appended claims is not necessarily limited to the specific features or actions described above. On the contrary, the specific features and actions described above are merely example forms of implementing the claims.
[0127] Although several specific implementation details are included in the above discussion, these should not be interpreted as limiting the scope of the present application. Certain features described in the context of a separate embodiment can also be implemented in a single embodiment in combination. On the contrary, the various features described in the context of a single embodiment can also be implemented in multiple embodiments individually or in any suitable sub-combination.
[0128] The above description is only a preferred embodiment of the present application and an explanation of the technical principles used. Those skilled in the art should understand that the scope of disclosure involved in the present application is not limited to the technical solution formed by a specific combination of the above technical features, but should also cover other technical solutions formed by any combination of the above technical features or their equivalent features without departing from the above disclosed concept. For example, the above features are replaced with the technical features with similar functions disclosed in this application (but not limited to) by each other to form a technical solution.
Claims
1. An insurance claims system based on blockchain, characterized in that: The system includes: a hospital side, a user side and an institution side, wherein the hospital side, the user side and the institution side are located on the same blockchain; The hospital end is used to, when receiving a credential receiving request sent by the user end, determine the medical information according to the identifier in the credential receiving request; generate a verifiable credential according to the medical information; and send the verifiable credential to the user end; The user end is used to, when receiving the verifiable credential issued by the hospital end, send the verifiable credential to the institution end; The institution end is used to execute the claim settlement process according to the medical treatment information in the verifiable certificate when receiving the verifiable certificate issued by the user end.
2. The method according to claim 1, characterized in that The hospital end is specifically used for: if it is determined that the user end meets the insurance claim conditions based on the medical information and the insurance claim conditions, a verifiable credential is generated, wherein the verifiable credential is a verifiable credential that indicates that the user end meets the insurance claim conditions.
3. The system according to claim 1, characterized in that The hospital end is specifically used to, when receiving a credential reception request issued by the user end, verify the signature of the credential reception request by determining the public key of the user end from the blockchain; if the verification result indicates that the credential reception request comes from the user end, determine the medical information according to the identifier in the credential reception request.
4. The system according to claim 3, characterized in that The hospital end is specifically used to sign the verifiable credential using the private key of the hospital end to obtain the signed verifiable credential; and send the signed verifiable credential to the user end.
5. The system according to claim 4, characterized in that The user end is specifically used to, when receiving the signed verifiable credential issued by the hospital end, encrypt the signed verifiable credential by determining the public key of the institution end from the blockchain to obtain the encrypted verifiable credential; and send the encrypted verifiable credential to the institution end.
6. The system according to claim 5, characterized in that The institution end is specifically used to, when receiving the encrypted verifiable credential sent by the user end, use the private key of the institution end to decrypt the encrypted verifiable credential to obtain the decrypted verifiable credential; by determining the public key of the hospital end from the blockchain, verify the decrypted verifiable credential; if the verification result indicates that the medical information in the decrypted verifiable credential comes from the hospital end, execute the claim process according to the medical information.
7. A blockchain-based insurance claims method, characterized in that: Applied to the hospital side, the method includes: When receiving a credential receiving request from a user terminal, determining the medical information according to an identifier in the credential receiving request, wherein the user terminal and the hospital terminal are located on the same blockchain; Generating a verifiable credential based on the medical consultation information; The verifiable credential is sent to the client.
8. The method according to claim 7, characterized in that The step of generating a verifiable credential based on the medical consultation information includes: If it is determined that the user terminal meets the insurance claim conditions based on the medical information and the insurance claim conditions, a verifiable credential is generated, wherein the verifiable credential is a verifiable credential indicating that the user terminal meets the insurance claim conditions.
9. The method according to claim 7, characterized in that: When receiving the credential receiving request sent by the user terminal, determining the medical information according to the identifier in the credential receiving request includes: When receiving a credential receiving request from a user terminal, verifying the signature of the credential receiving request by determining the public key of the user terminal from the blockchain; If the signature verification result indicates that the credential receiving request comes from the user end, the medical information is determined according to the identifier in the credential receiving request.
10. A blockchain-based insurance claims method, characterized in that: Applied to the institution side, the method includes: When a verifiable credential is received from a user terminal, a claim settlement process is executed according to the medical information in the verifiable credential, wherein the user terminal and the institution terminal are located on the same blockchain.