Medical Billing

How To Implement Blockchain Technology For Medical Billing

In the present era, every institute implements technological innovations to improve the system with total efficiency and potential. Healthcare institutes also need technology to be implemented to make the system error-free. Medical billing is a very hectic and complex process with several steps.

There are always many chances for mistakes and errors to happen, which alters the end outcomes. Therefore, it is the need of the hour to use blockchain as medical billing technology to streamline the whole process. Blockchain technology is gaining popularity because of its wonderful features, which lead to positive results.

Blockchain technology in the medical billing system makes life easy for medical billers, insurance companies, and patients. Blockchain has the potential, through its ledger and decentralized system, to make the medical billing process easy and smooth.

In this article, we will learn the basic features of blockchain technology and the importance of blockchain in the medical billing process. We will also learn about the process of implementation of it as medical billing technology.

What is Blockchain?

What is Blockchain?

Blockchain is a system of decentralized networks in which the information is saved in blocks in different computers located at different locations. When we put any information on the blockchain or make any transaction, this information is grouped as a block. Many blocks are linked chronologically without any central system of authority. This is the blockchain’s unique feature, making it a strong and fraud-free network. As the information is saved in multiple systems, it becomes difficult for hackers to locate it. The information recorded can only be altered and available to multiple departments with any change. This brings transparency.

Features of Blockchain

Following are the features of the blockchain that are used as medical billing technology to bring the desired results with fewer errors:

1.      Decentralization

Blockchain is a ledger technology without any central source of information. Although, many computer systems are linked together to hold the records or information. This improves the security system and resolves all concerns about data leaks. Hackers need to know which computer they should hack to get the desired information.

2.  Immutability and Transparency

When the transaction or piece of information is uploaded on the blockchain as a block, changing the information in the block is nearly impossible. Blockchain connects multiple systems, and each system has 24/7 access to the information. In the medical billing process, the patients, medical billers, hospital administration, and insurance companies can view the information, enhancing the system’s transparency. All the members can deny the information in case of error or fraud.

3.  Security

Data sharing is a major concern for many institutes, but blockchain secures the data using its cryptographic techniques. There remains no risk of data tempering and leaks. It gives a sense of security and safety to the healthcare institutes.

Implementation of Blockchain in Medical Billing

Implementation of Blockchain in Medical Billing

The ways to implement the blockchain as medical billing technology are described below, making the medical billing process fast and fraud-free.

●          Identify the Sector of Use

First, there is a need to identify the field of medical billing where you want to use blockchain technology. Selection of a field or sector for blockchain is very important as blockchain is good with specific tasks, and using it in other departments is useless and costly. It is best with claim processing, data verification, data records, prior authorizations, and data sharing between healthcare institutes and insurance companies.

●          Develop a Secure Network.

It is wise to choose the members with whom you want to share the information, like hospital administration, insurance companies, and patients, to keep the records and information private. A secure network only allows authorized members to access the data anytime, and unauthorized sources can’t claim any right to view the information. A secure networking system is achieved through controls, encryption, authorization, and authentication mechanisms.

●          Data Standardization

There comes a problem known as data incompatibility among the authorized members because each member has their own system, and there is a need to standardize the information or data in a specific universal format and style for all the members across the blockchain network. This step is significant in using this medical billing technology. Arrange or standardizing the data in the specific format and structures smoothens the integration process in the blockchain system. Otherwise, data will be recorded as raw files without any information available to the members.

●          Smart Contracts

To make medical billing fast and automatic, there is a need to develop smart contracts for the execution of medical billing tasks like claim submission, verification, and reimbursement. These steps will be complemented automatically if smart contracts are already developed. It reduces the operating time and administration burden of doing these tasks manually.

●          Integration and Training

 Integrating blockchain with medical billing systems like electronic health records, insurance software, billing software, and insurance platforms is vital for medical billing. Integration of all systems streamlines the whole process of blockchain. The flow of information from these healthcare systems and blockchain becomes smooth.

The important and last step for efficiently working on this medical billing technology is staff training. There should be workshops for the staff to learn about the new system. This is essential to escape the errors or problems that can be faced due to a lack of knowledge and training in blockchain technology.

Benefits of using Blockchain Technology

Benefits of using Blockchain Technology

●          Enhanced Claim Processing

The present medical billing process is overloaded with the chances of errors, which can lead to the denial of claims and late release of payments. Blockchain technology enhances the efficiency of claim processing by reducing the paperwork, submitting claims automatically, and enabling the correction of objections on time. The reimbursement process becomes fast, and it is beneficial for both parties.

●          Reduction of Fraud

The immutability of data from the blockchain increases the transparency in the medical billing process. Using blockchain technology decreases the data leak chances, which can reduce fraud and hacking. All information remains available for all the authorized members, like insurance companies and hospital administration. Every step of medical billing remains clear in front of members, and there is no fear of fraud.

●          Enhanced Interoperability

Electronic health record technology is present in the healthcare system, which allows all the stakeholders to seek information. Still, problems need to be solved, like the electronic health system sometimes needs to provide the correct information due to overlapping large data sets. But now, blockchain has each transaction in a different block, and there is no chance of overlapping. Standardizing the data formats also plays a vital role in providing the same right information to the payers, providers, and patients. This allows better communication between all parties to work smoothly.

●          Reduced Administrative Burden and Costs

Blockchain has taken many steps from manual to digital route, reducing the cost of paperwork and recruiting many medical billers and coders. Resources of healthcare institutes can be saved and spent on patients’ health thanks to blockchain technology. It is an ideal and superb medical billing technology.


Blockchain has the potential to revolutionize the medical billing process with the help of its features like decentralization, security, transparency, and immutability. The ledger technology records information from different sources without a central system. It enhances the claims’ security, efficiency, submission, and reimbursement. It can be implemented as medical billing technology, identifying the best sector, developing secure networks, and integration with other healthcare systems. There is also a need for data standardization and staff training to take the work from the blockchain without any glitches. Using blockchain technology to streamline the medical billing process is highly recommended.