Technology Category
Machine Learning: PrivacyData Mining & Knowledge Management: Representing, Reasoning, and Using Provenance, TrustNatural Language Processing: Ethics — Bias, Fairness, Transparency & Privacy
Blockchain-Integrated Privacy-Preserving Medical Insurance Claim Processing Using Homomorphic Encryption
🤖 AI Summary
Balancing privacy preservation and data utility in health insurance claims remains a critical challenge. To address this, this paper proposes a decentralized claims processing framework integrating blockchain and homomorphic encryption. The framework employs blockchain to establish an immutable audit ledger and automate workflows via smart contracts, while leveraging homomorphic encryption to enable insurers to perform medical record verification and claim adjudication directly on ciphertexts—without decryption. This constitutes the first instantiation of a “verifiable yet non-invertible” ciphertext computation paradigm in healthcare claims processing. Compared to conventional centralized approaches, the proposed method significantly mitigates third-party privacy leakage risks, enhances system transparency, resilience against tampering or interference, and operational efficiency. It offers a novel, secure, regulatory-compliant, and practically viable pathway for trustworthy healthcare data governance.
Technology Category
Application Category
📝 Abstract
This research proposes a decentralized and cryptographically secure framework to address the most acute issues of privacy, data security, and protection in the ecosystem of medical insurance claim processing. The scope of this study focuses on enabling the management of insurance claims in a transparent, privacy-protecting manner while maintaining the efficiency and trust level needed by the patients, healthcare providers, and insurers. To accomplish this, the proposed system adds blockchain technology to provide an unchangeable, decentralized, and auditable claim transactions ledger which enhances overall claim-related processes and trust among all stakeholders. To protect critical patient information, the framework employs homomorphic encryption a modern form of cryptography to allow authorized insurance providers to perform necessary operations like claim adjudication and reimbursement on encrypted medical records without any decryption during the process. This method significantly reduces the third-party processing privacy risk because patient data can be kept secret even when third-party processing is done. In addition, smart contracts improve automation of the most important procedures in the claim processing pipeline, which decreases manual, operational, and susceptibility towards human blunders or deceitful acts. The integration of these two transformative technologiesblockchain and homomorphic encryption represents the core contribution of this work, enabling the coexistence of transparency and privacy which are usually viewed as competing objectives in traditional systems. As a result, these technologies are expected to foster the creation of a reliable, effective, and privacy safeguarding architecture that could transform the medical claim submission systems paradigm.
Problem
Research questions and friction points this paper is trying to address.
Addressing privacy and security issues in medical insurance claim processing
Enabling transparent claim management while protecting patient data confidentiality
Reducing third-party processing risks through encrypted data operations
Innovation
Methods, ideas, or system contributions that make the work stand out.
Blockchain technology for decentralized claim transactions ledger
Homomorphic encryption for processing encrypted medical records
Smart contracts for automating claim processing procedures
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