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How effective are blockchain-based smart contracts in detecting and preventing insurance fraud in the healthcare sector?

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Blockchain-based smart contracts have shown effectiveness in detecting and preventing insurance fraud in the healthcare sector. These smart contracts leverage blockchain technology to ensure data integrity, privacy, and security, making it challenging for fraudulent activities to go unnoticed. By utilizing machine learning techniques like Support Vector Machine (SVM) and logistic regression, along with deep learning methods, these smart contracts can automatically identify suspicious medical records, leading to sustainable execution of insurance payments and reducing the workload of insurance workers. Additionally, the use of consortium blockchain for medical record storage enhances data security, immutability, traceability, and auditability, further strengthening fraud detection mechanisms in healthcare insurance.

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Proceedings Article•DOI Medical Insurance Fraud Detection Based on Block Chain and Machine Learning Approach 26 Dec 2022	Blockchain-based smart contracts, combined with machine learning, enhance medical insurance fraud detection by automating suspicious record identification, ensuring data security, and improving efficiency in healthcare insurance evaluations.
Open access•Posted Content•DOI An Adaptive Decision-Making Approach for Better Selection of a Blockchain Platform for Health Insurance Frauds Detection with Smart Contracts: Development and Performance Evaluation 13 Mar 2023	Blockchain-based smart contracts are highly effective in detecting healthcare insurance frauds, with Hyperledger Fabric outperforming Neo in all metrics, making it the best platform for fraud detection.
Open access•Posted Content•DOI Blockchain Technology for Preventing Counterfeit in Health Insurance 25 Mar 2023	Blockchain technology in health insurance prevents counterfeiting effectively by ensuring data integrity and privacy. Smart contracts enhance fraud detection and prevention through consensus algorithms, reducing validation time.
Journal Article•DOI Managing health insurance using blockchain technology Tajkia Nuri Ananna, Munshi Saifuzzaman, Mohammad Jabed Morshed Chowdhury, Md. Sadek Ferdous - Show less +3 more 17 Jun 2023-arXiv.org	Blockchain-based smart contracts are effective in detecting and preventing insurance fraud in healthcare by enhancing transparency, reducing human error, and ensuring data privacy, as outlined in the paper.

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