Problems with Medical Claims that Artificial Intelligence (AI) and Blockchain Can Fix

The challenges in medical claims in the Middle East are significant. The region is witnessing rapid growth in healthcare utilization and expenditures, making it crucial to find effective ways to manage and control medical claims costs. Factors such as an aging population, rising chronic disease burden, and increased demand for healthcare services put pressure on healthcare systems and insurance providers.

In medical insurance, there are both valid and legitimate claims that should be covered by the insurer and fraudulent or inappropriate claims that should not be paid. Problems arise in scenarios when valid claims are not paid and when fraudulent or inappropriate claims are paid. Hospitals and insurers play critical roles in these cases. Artificial Intelligence (AI) and blockchain technologies can play significant roles in addressing the problems associated with medical insurance claims.

Some of the ways in which these technologies can help are using AI algorithms to analyze data stored on the blockchain for fraud detection, and leveraging blockchain’s transparency to improve the accuracy of AI models by providing access to a larger dataset. The author addresses approaches for each scenario.

Want to read on? Head here: https://doi.org/10.30953/bhty.v6.273

• Joe Hawayek | Editor

• Osama AbouElKhir, MD