Blockchain Health Token System for Expedited Healthcare Payments
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Solution Overview
Problem
The traditional claims-based insurance model in healthcare leads to delayed and unpredictable payments for healthcare services, resulting in slow revenue flow for providers and increased administrative costs, with a lack of transparency for patients and providers regarding cost shares.
Innovation Solution
A blockchain-backed health token system that issues cryptocurrency tokens to patients for pre-authorized healthcare services, allowing for transparent cost sharing and direct payment processing, eliminating the need for post-service claim adjudication and facilitating data exchange between providers and payers.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If a traditional claims-based retrospective insurance payment model is used, then comprehensive claims adjudication and error checking can be performed, but payment processing is delayed and revenue flow to healthcare providers is slow
Solution Approach 1:
The system performs preliminary actions by requiring patients to pay the full cost of healthcare services upfront using health tokens before receiving care. This eliminates the need for post-service claims adjudication and retroactive payment processing, as all payments are settled in advance. The health token system pre-authorized services and pre-collected payments, resolving the contradiction between thorough adjudication and fast payment.
2Reliability
If a traditional claims-based insurance model is used, then comprehensive billing and cost sharing can be managed, but administrative overhead costs increase
Solution Approach 1:
The system implements self-service by using blockchain-based health tokens that automatically track and manage patient cost-sharing obligations. Patients independently purchase and hold their own health tokens, eliminating the need for complex administrative billing systems. The blockchain network automatically validates and processes payments without human intervention, reducing administrative overhead while maintaining billing accuracy.
3Reliability
If a traditional claims-based insurance model is used, then post-service billing and debt collection processes can be implemented, but patient debt and collection costs increase
Solution Approach 1:
The system applies preliminary anti-action by requiring patients to purchase and pre-pay for their healthcare services before receiving care. This upfront payment structure prevents the accumulation of patient debt entirely, as all financial obligations are settled in advance. The health token system acts as a pre-payment mechanism that eliminates the need for post-service billing and debt collection processes.
4Reliability
If a traditional claims-based insurance model is used, then comprehensive claims processing can be performed, but revenue flow to healthcare providers is slow
Solution Approach 1:
The system performs all payment processing actions preliminarily, before healthcare services are rendered. Patients purchase health tokens and pre-pay for services in advance, eliminating post-service claims processing entirely. This preliminary payment structure ensures complete and accurate payment processing while simultaneously accelerating revenue flow to healthcare providers, as payments are settled immediately rather than months later.
Data Source
AI summary
A computer-implemented method for expediting processing of a payment for a patient's healthcare service with a healthcare provider includes displaying an out-of-pocket cost for a patient for a healthcare service at a display interface of a computer device prior to the healthcare service being rendered. After patient selection of the healthcare service and payment of any out-of-pocket costs, a health token is issued to the patient as cryptocurrency for payment of the healthcare service. The health token is received from the healthcare provider after the healthcare provider renders the healthcare service, receives the health token from the patient for payment of the healthcare service, and embeds data pertaining to the healthcare service into the health token. Based on the data embedded in the health token, the healthcare service is approved or disapproved. If the healthcare service is approved, a payment for the healthcare service is issued to the healthcare provider.