STTR Phase I: CLEAR: Reducing Claims Denials in Healthcare Through Blockchain and Machine Learning

STTR 第一阶段：明确：通过区块链和机器学习减少医疗保健领域的索赔拒绝

• 批准号: 1914203
• 负责人: Sarah Brown
• 金额: $ 22.5万
• 依托单位: BRILLIANTMD, LLC
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-07-01 至 2021-06-30
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1914203&HistoricalAwards=false
• 关键词: STTR; Phase; CLEAR; Reducing; Claims

The broader impact/commercial potential of this Small Business Innovation Research (SBIR) project is to create transparency around the business logic used by stakeholders in the healthcare system to make transactional decisions as well as create alignment around the current status of healthcare transactions that are part of the work in process. To most people who interact with the healthcare system, it functions more or less as a "black box" with decisions that sometimes defy logic and common sense. Our goal is to use Blockchain and Machine Learning technology to convert this "black box" into a "glass box." The commercial impact of this project could be an up to 25% reduction in claims processing costs for healthcare providers by the elimination of redundant work, re-work and errors. This STTR Phase 1 project proposes two innovations: 1) claims transaction and reason codes managed through a Blockchain so that Providers and Payers can confidently know the accurate status of a claim, and 2) sophisticated statistical and deep learning algorithms for predicting the likelihood of a claim denial with natural language processing of associated notes and appeals. Our product is a mathematically driven software service that utilizes and innovates with multiple technologies: Blockchain distributed ledgers, smart contracts and tokens, and prediction, recommendation, forecasting, non-linear optimization and natural language processing engines within a privacy-preserving data management system.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.

这项小型企业创新研究（SBIR）项目的更广泛的影响/商业潜力是，围绕医疗保健系统中利益相关者使用的业务逻辑创造透明度，以做出交易决策，并围绕医疗保健交易的当前状态建立一致性，这些交易是在工作中是工作中一部分的一部分。对于大多数与医疗保健系统互动的人，它或多或少地作为“黑匣子”，有时会违背逻辑和常识的决定。我们的目标是使用区块链和机器学习技术将此“黑匣子”转换为“玻璃盒子”。该项目的商业影响可能会通过消除冗余工作，重新工作和错误来减少医疗保健提供者的索赔处理成本25％。该STTR阶段1项目提出了两项​​创新：1）要求通过区块链管理的交易和原因代码，以便提供者和付款人可以自信地了解索赔的准确地位，2）复杂的统计和深度学习算法，以预测拒绝自然语言处理的主张和呼吁和呼吁的索赔的可能性。 Our product is a mathematically driven software service that utilizes and innovates with multiple technologies: Blockchain distributed ledgers, smart contracts and tokens, and prediction, recommendation, forecasting, non-linear optimization and natural language processing engines within a privacy-preserving data management system.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader影响审查标准。