New Engineering Findings from Nirma University Published (Blockchain and AI-Empowered Healthcare Insurance Fraud Detection: an Analysis, Architecture, and Future Prospects): Engineering

Health Policy and Law Daily

2022 AUG 19 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Research findings on engineering are discussed in a new report. According to news reporting out of Gujarat, India, by NewsRx editors, research stated, “Nowadays, health insurance has become an essential part of people’s lives as the number of health issues increases. Healthcare emergencies can be troublesome for people who can’t afford huge expenses.”

The news journalists obtained a quote from the research from Nirma University: “Health insurance helps people cover healthcare services expenses in case of a medical emergency and provides financial backup against indebtedness risk. Health insurance and its several benefits can face many security, privacy, and fraud issues. For the past few years, fraud has been a sensitive issue in the health insurance domain as it incurs high losses for individuals, private firms, and governments. So, it is essential for national authorities and private firms to develop systems to detect fraudulent cases and payments. A high volume of health insurance data in electronic form is generated, which is highly sensitive and attracts malicious users. Motivated by these facts, we present a systematic survey for Artificial Intelligence (AI) and blockchain-enabled secure health insurance fraud detection in this paper. This paper presents a taxonomy of various security issues in health insurance. We proposed a blockchain and AI-based secure and intelligent system to detect health insurance fraud.”

According to the news reporters, the research concluded: “Then, a case study related to health insurance fraud is presented. Finally, the open issues and research challenges in implementing the blockchain and an AI-empowered health insurance fraud detection system is presented.”

For more information on this research see: Blockchain and AI-Empowered Healthcare Insurance Fraud Detection: an Analysis, Architecture, and Future Prospects. IEEE Access, 2022,10():79606-79627. (IEEE Access - http://ieeexplore.ieee.org/servlet/opac?punumber=6287639). The publisher for IEEE Access is IEEE.

A free version of this journal article is available at https://doi.org/10.1109/ACCESS.2022.3194569.

Our news editors report that additional information may be obtained by contacting Khyati Kapadiya, Department of Computer Science and Engineering, Institute of Technology, Nirma University, Ahmedabad, Gujarat, India. Additional authors for this research include Usha Patel, Rajesh Gupta, Mohammad Dahman Alshehri, Sudeep Tanwar, Gulshan Sharma, Pitshou N. Bokoro.