Patent Application Titled “Distributed Ledger System For Automated Claim Adjudication” Published Online (USPTO 20230368136): Synchrony Bank

2023 DEC 04 (NewsRx) -- By a News Reporter-Staff News Editor at Computers, Networks & Communications Daily Daily -- According to news reporting originating from Washington, D.C., by NewsRx journalists, a patent application by the inventors Hang, Cheng (Stamford, CT, US); Patel, Ujjval (Stamford, CT, US); Ruan, Justin (Stamford, CT, US), filed on May 23, 2023, was made available online on November 16, 2023.

The assignee for this patent application is Synchrony Bank (Stamford, Connecticut, United States).

Reporters obtained the following quote from the background information supplied by the inventors: “

“Field of the Disclosure

“The present disclosure relates to a secure system for automated claim adjudication and more specifically, to a secure and tamper proof distributed ledger architecture for recording, monitoring and processing of claims between users, service providers and/or any intermediary broker node.

“Description of the Related Art

“Adjudication of claims particularly claims arising from interactions and dealings between a user and a service provider, often involve multiple intermediary parties that result in the processing of such claims become time consuming and costly adding significant overhead administrative costs.

“Further, deficiencies of legacy systems used in recording, monitoring and processing of such claims present significant risk of breach of privacy of parties involved. This is evidenced by the multi billion dollars insurance fraud that exist, which in turn consumes a lot of law enforcement resources to track and prevent such insurance frauds.

“Accordingly, what is needed is a more secure, uniform and cost effective systems for adjudication of claims.”

In addition to obtaining background information on this patent application, NewsRx editors also obtained the inventors’ summary information for this patent application: “To address the deficiencies in the existing legacy systems used for recording, monitoring and processing of claims between users, service providers and intermediary brokers as well as to improve the time consuming and costly adjudication process, the present disclosure provides a unique and novel distributed ledger system that detects initiation of a claim adjudication process, extracts necessary information from various sources necessary for creating smart contracts based on which the underlying claim is being adjudicated (using novel and unique APIs and compatible record extraction and conversion codes), and processing the claims. The distributed ledger system and the smart contract provides a secure unified claim adjudication system that can prevent attempted unauthorized access to private user information and resulting fraud.

“One aspect of the present disclosure is a distributed ledger system. The distributed ledger system includes a first network node including one or more memories having computer-readable instructions stored therein and one or more processors configured to execute the computer-readable instructions to detect a triggering condition for processing a claim; collect user and broker information for processing the claim; convert the information from a first computer-readable format to a second computer-readable format to yield converted information; validate the converted information based on corresponding digital signatures associated with the converted information to yield validated information; generate claim state objects based on the validated information, the claim state objects being used by each node of the distributed ledger system to execute a smart contract for processing the claim; receive one or more updated claim state objects from a second network node reflecting updated processing status of the claim, the one or more updated claim state objects being used by each node of the distributed ledger system to execute the smart contract for processing the claim; and process the claim based on results of execution of the smart contract using the one or more updated claim state objects.

“One aspect of the present disclosure includes one or more non-transitory computer-readable media comprising computer-readable instructions, which when executed by one or more processors of a first node on a distributed ledger system, cause the first node to detect a triggering condition for processing a claim; collect user and broker information for processing the claim; convert the information from a first computer-readable format to a second computer-readable format to yield converted information; validate the converted information based on corresponding digital signatures associated with the converted information to yield validated information; generate claim state objects based on the validated information, the claim state objects being used by each node of the distributed ledger system to execute a smart contract for processing the claim; receive one or more updated claim state objects from a second network node reflecting updated processing status of the claim, the one or more updated claim state objects being used by each node of the distributed ledger system to execute the smart contract for processing the claim; and process the claim based on results of execution of the smart contract using the one or more updated claim state objects.

“One aspect of the present disclosure includes a method of automated adjudication of claims on a distributed ledger system. The method includes a method of automated adjudication of claims on a distributed ledger system includes detecting, at a first node of the distributed ledger system, a triggering condition for processing a claim; collecting user and broker information for processing the claim; converting the information from a first computer-readable format to a second computer-readable format to yield converted information; validating the converted information based on corresponding digital signatures associated with the converted information to yield validated information; generating claim state objects based on the validated information, the claim state objects being used by each node of the distributed ledger system to execute a smart contract for processing the claim; receiving one or more updated claim state objects from a second network node reflecting updated processing status of the claim, the one or more updated claim state objects being used by each node of the distributed ledger system to execute the smart contract for processing the claim; and processing the claim based on results of execution of the smart contract using the one or more updated claim state objects.”

The claims supplied by the inventors are:

“1. (canceled)

“2. A method comprising: accessing user information associated with a user and a smart contract, wherein accessing is based on a proximity of end user equipment associated with the user and a premises of a service provider; accessing broker information associated with the smart contract and a broker for processing a claim, wherein the claim is associated with the service provider; processing the user information and the broker information into a converted computer-readable format to yield converted information compatible with a smart contract format and a distributed ledger network; processing the converted information to generate corresponding digital signatures using a cryptographic key known to each node of a blockchain associated with the user, the service provider, and the broker; generating a claim state object associated with the converted information and the corresponding digital signatures; communicating the claim state object to a first network node; receiving an updated claim state object as an updated version of the claim state object, wherein when the updated claim state object is received from a second network node associated with the broker reflecting updated processing status of the claim, the updated claim state object facilitates execution of the smart contract for processing the claim in the distributed ledger network; confirming completion of a distributed verification of execution of the smart contract, wherein the distributed verification is performed separately by the first network node, the second network node, and the end user equipment.

“3. The method of claim 2, wherein accessing the user information and the broker information is initiated by a triggering condition; and wherein the triggering condition includes detection of a user terminal within a facility associated with the first network node at a first time and a determination that the user terminal is no longer present at the facility at a second time that is after the first time.

“4. The method of claim 2, wherein the user information or the broker information is in an Electronic Data Interchange (EDI) format.

“5. The method of claim 2, wherein the converted information compatible with a smart contract forma is a Javascript Object Notation (JSON) format.

“6. The method of claim 2, wherein the user information includes user identifying information and user insurance information.

“7. The method of claim 2, wherein the first network node is associated with a service provider for which the claim is being processed.

“8. The method of claim 2, further comprising processing the claim by completing a cardless transaction using a financial account of a provider associated with the first network node and at least one of a financial account of an insurance provider associated with the second network node and a financial account of a user who is a party to the claim.

“9. The method of claim 2, wherein processing the claim results in a claim status that a complete payment or partial payment for the claim by an entity associated with the second network node.

“10. A system comprising: a memory; and one or more processors coupled to the memory and configured to perform operations including: accessing user information associated with a user and a smart contract, wherein accessing is based on a proximity of end user equipment associated with the user and a premises of a service provider; accessing broker information associated with the smart contract and a broker for processing a claim, wherein the claim is associated with the service provider; processing the user information and the broker information into a converted computer-readable format to yield converted information compatible with a smart contract format and a distributed ledger network; processing the converted information to generate corresponding digital signatures using a cryptographic key known to each node of a blockchain associated with the user, the service provider, and the broker; generating a claim state object associated with the converted information and the corresponding digital signatures; communicating the claim state object to a first network node; receiving an updated claim state object as an updated version of the claim state object, wherein when the updated claim state object is received from a second network node associated with the broker reflecting updated processing status of the claim, the updated claim state object facilitates execution of the smart contract for processing the claim in the distributed ledger network; confirming completion of a distributed verification of execution of the smart contract, wherein the distributed verification is performed separately by the first network node, the second network node, and the end user equipment.

“11. The system of claim 10, wherein accessing the user information and the broker information is initiated by a triggering condition; and wherein the triggering condition includes detection of a user terminal within a facility associated with the first network node at a first time and a determination that the user terminal is no longer present at the facility at a second time that is after the first time.

“12. The system of claim 10, wherein the user information or the broker information is in an Electronic Data Interchange (EDI) format.

“13. The system of claim 10, wherein the converted information compatible with a smart contract forma is a Javascript Object Notation (JSON) format.

“14. The system of claim 10, wherein the user information includes user identifying information and user insurance information.

“15. The system of claim 10, wherein the first network node is associated with a service provider for which the claim is being processed.

“16. The system of claim 10, wherein the one or more processors are configured for operations further comprising processing the claim by completing a cardless transaction using a financial account of a provider associated with the first network node and at least one of a financial account of an insurance provider associated with the second network node and a financial account of a user who is a party to the claim.

“17. The system of claim 10, wherein processing the claim results in a claim status that a complete payment or partial payment for the claim by an entity associated with the second network node.

“18. A non-transitory computer readable storage medium comprising instructions that, when executed by one or more processors of a device, cause the device to perform operations comprising: accessing user information associated with a user and a smart contract, wherein accessing is based on a proximity of end user equipment associated with the user and a premises of a service provider; accessing broker information associated with the smart contract and a broker for processing a claim, wherein the claim is associated with the service provider; processing the user information and the broker information into a converted computer-readable format to yield converted information compatible with a smart contract format and a distributed ledger network; processing the converted information to generate corresponding digital signatures using a cryptographic key known to each node of a blockchain associated with the user, the service provider, and the broker; generating a claim state object associated with the converted information and the corresponding digital signatures; communicating the claim state object to a first network node; receiving an updated claim state object as an updated version of the claim state object, wherein when the updated claim state object is received from a second network node associated with the broker reflecting updated processing status of the claim, the updated claim state object facilitates execution of the smart contract for processing the claim in the distributed ledger network; confirming completion of a distributed verification of execution of the smart contract, wherein the distributed verification is performed separately by the first network node, the second network node, and the end user equipment.

“19. The non-transitory computer readable storage medium of claim 18, wherein accessing the user information and the broker information is initiated by a triggering condition; and wherein the triggering condition includes detection of a user terminal within a facility associated with the first network node at a first time and a determination that the user terminal is no longer present at the facility at a second time that is after the first time.

“20. The non-transitory computer readable storage medium of claim 18, wherein the user information or the broker information is in an Electronic Data Interchange (EDI) format.

“21. The non-transitory computer readable storage medium of claim 18, wherein the converted information compatible with a smart contract forma is a Javascript Object Notation (JSON) format.

“22. The non-transitory computer readable storage medium of claim 18, wherein the user information includes user identifying information and user insurance information.

“23. The non-transitory computer readable storage medium of claim 18, wherein the first network node is associated with a service provider for which the claim is being processed.

“24. The non-transitory computer readable storage medium of claim 18, further comprising processing the claim by completing a cardless transaction using a financial account of a provider associated with the first network node and at least one of a financial account of an insurance provider associated with the second network node and a financial account of a user who is a party to the claim.

“25. The non-transitory computer readable storage medium of claim 18, wherein processing the claim results in a claim status that a complete payment or partial payment for the claim by an entity associated with the second network node.”

For more information, see this patent application: Hang, Cheng; Patel, Ujjval; Ruan, Justin. Distributed Ledger System For Automated Claim Adjudication. U.S. Patent Application Number 20230368136, filed May 23, 2023 and posted November 16, 2023. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20230368136)&db=US-PGPUB&type=ids

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