Overview

A worldwide leader in healthcare was challenged with providing a common view of accumulators (such as deductible and out-of-pocket maximums) in both medical and pharmacy claims processing systems. The systems could be out of synchronization for as long as 24 hours, risking inaccurate charges. Reconciling the two systems was very tedious and time-consuming, lowering customer satisfaction as a result. The client needed a secure, reliable, and auditable way for medical and pharmacy systems to share and update real-time accumulators.
• Luxoft technology and healthcare experts consulted with the client to map business needs to blockchain technology, via daily Scrum meetings and using an Agile iterative process
• Tested for throughput of Hyperledger Fabric and R3 Corda
• Implemented an accumulator blockchain solution on AWS using Hyperledger Fabric
• Used Fabric Channels to isolate and secure data across medical and pharmacy benefit partnerships
• Developed REST interfaces to accelerate integration with legacy systems
• Created a highly secure solution that guarantees accuracy
• Enabled new partnership opportunities across competitors
• Increases customer satisfaction due to having accurate billing amounts, avoiding time-consuming adjustments and delays on invoices and inaccurate expenses
• This solution is a step toward moving enrollment, claim adjudication, and payment logic into smart contracts, which will eliminate the need for institutions to do benefits administration

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