Last month Samsung SDS unveiled a new medical insurance claims processing platform powered by blockchain. It primarily addresses the inconvenience to patients of filing health claims and tackles fraud.
Instead of patients having to collect paperwork from hospitals to submit a claim, the platform directly links the insurers to hospitals and digital health providers. As a result, the insurer knows that the health claim is verified and fraud is prevented.
Samsung has empowered patients to submit the claim either at the hospital reception counter, at kiosks or via the KakaoTalk mobile messenger app.
In terms of adoption, so far, Samsung Fire & Marine Insurance and NongHyup Life Insurance are involved with eight other insurers in the pipeline. Kangbuk Samsung Hospital and Hallym University Dongtan Sacred Heart Hospital are the first medical facilities, and by the end of the year, Samsung envisions adding another 30, including the Seoul Medical Center.
Samsung is using its Nexledger enterprise blockchain platform to digitize the receipts and customer documents, thereby reducing costs.
“We will continue expanding the scope of our service to ensure more customers are able to easily file medical claims regardless of the time and place,” said Hunsup Shim, SVP of Samsung SDS.
Samsung’s description focuses on claim initiation. Last year U.S.-based Change Healthcare, which processes more than $1 trillion in claims per year, outlined to Ledger Insights the challenges of automating the matching of claims to policies. The big question is whether a specific treatment is covered or not.
That’s in part because providers often use a similar but inaccurate billing code that is more likely to get paid out. Nonetheless, claims for routine medical checks such as mammograms can be entirely automated with smart contracts.
Ant Financial is also using technology to make it more convenient to file medical claims. It runs a blockchain-based mutual aid platform Xiang Hu Bao with more than 100 million members. It also aims to address fraud and allows patients to submit digitized paperwork using the Alipay app. At this stage, it is not fully integrated with all the hospitals. This week Ant stepped in to fund payouts relating to the death of members that contracted the Coronavirus.