DokChain Use Case
Medical claims processing is notoriously complicated, and represents a significant percentage of the business overhead for providers. Traditional intermediaries like clearinghouses and third party administrators tend to just increase the complexity and reduce the transparency of conducting business, and current auto-adjudication software still falls short.
PokitDok and our DokChain Alliance members have agreed that an artificially intelligent, smart contract mediated claims adjudication protocol is a highly desirable use case to pursue. Such a system will allow for near real-time adjudication and remittance of submitted claims. In turn, this will save time and money for payers and providers, and reduce the uncertainty and latency of out-of-pocket expenses for consumers. And because the system will run within the DokChain distributed network, updated rules and optimal payment schemes can be learned in real-time over a broad range of plans and health systems.