siliconindia

With trillions of dollars being spent on health insurance claims, billions are processed each year. This also includes billing errors and fraudulent claims that have their significant share in the healthcare sector. Though billing errors are unintentionally made with providers entering wrong codes, one question that strikes us is ‘what is Medicare fraud and abuse?' Anything from false diagnosis to treatments that were never administered to avail high insurance amounts falls under it. In addition, as these frauds are committed by certain healthcare institutions and providers, firms like Healthereum are coming to the rescue. A platform targeting micro-level inefficiencies in provider-patient encounters, Healthereum has set out to improve patient accountability, care delivery, and interactions with insurers.

A global platform to improve the quality of care, Healthereum utilizes blockchain technology to address critical healthcare needs. It first captures provider-patient and hospital-patient encounters into smart contracts, which aim at incentivizing healthy behavior, improving accountability, creating two-way interactions, and verifying health services. The firm’s blockchain technology ensures all encounters are verifiable and patient-specific activities are indisputable. This approach lowers the no-show rate, and every appointment confirmed on the blockchain, assures immediate deployment of healthy behavior and care quality survey.

“We have gamified encounters to reward attendance to appointments or penalize the no-show,” states Prasad Kothapalli, Co-Founder of Healthereum. With its decentralized applications (dapps)—the reward dapp that recognizes people who show up for appointments, penalizing the no-shows, and the core measures dapp that helps focus on checklist during a patient’s treatment—the firm helps in better patient-provider engagement. In addition, with the survey dapp that helps patients rate their experience with providers and hospitals and the verification dapp that enables patients to confirm the accuracy of items on insurance bills, the firm brings stability in the healthcare sector. These dapps assure a connection between the provider, the insurance company, and the patient. “With the involvement of the patient now, there is proof of the visit due to the verification of services provided by them, and we ensure it is recorded in the blockchain,” mentions Kothapalli. As a result of this approach, insurance companies can be convinced easily.

Moreover, this ethereum blockchain Patient Engagement Management platform enables providers to deliver tokens (health token)—through HELIO Syndicate—to patients who exhibit responsibility for their health and take time out to complete tasks.

Besides, for a blockchain transaction, the utility is the critical aspect; hence, Healthereum enables providers to take the tokens back for the services provided to the patient. “Our platform assures a full cycle healthcare blockchain experience," adds Kothapalli.

Currently, Healthereum is predominantly focused on the healthcare ecosystem of the United States because it believes that problems are much clearer there, and hence, plans for geographic expansion sometime in the future. The firm wants to test its solutions in the US market first, understand the problems and how it can add value to healthcare providers before going global. Moreover, since the loss of revenue and reputation are the major hurdles, Healthereum is majorly focusing on these two aspects before planning to expand on their existing solutions. “We aim to eliminate the process of implicit trust and establish explicit trust,” concludes Kothapalli.