Whether you have employer-sponsored health insurance or you purchase your own insurance policy through HealthCare.gov, a state marketplace or the individual market, health care fraud inevitably translates into higher premiums and out-of-pocket expenses for consumers, as well as reduced benefits or coverage. For employers—private and government alike—health care fraud increases the cost of providing insurance benefits to employees which, in turn, increases the overall cost of doing business. For many Americans, the increased expense resulting from fraud could mean the difference between making health insurance a reality or not.
However, financial losses caused by health care fraud are only part of the story. Health care fraud has a human face too. Individual victims of health care fraud are sadly easy to find. These are people who are exploited and subjected to unnecessary or unsafe medical procedures. Or whose medical records are compromised or whose legitimate insurance information is used to submit falsified claims.
There is no doubt that health care fraud can have devastating effects. Learn more about what Health Care fraud looks like by visiting the National Health Care Ant-Fraud Association .
A-Medicare’s server-based processes will be hosted on a cloud Infrastructure as a Service (IaaS). Singular databases and Data Warehouses are PostgreSQL-based services and blockchain based distributed ledger technology (DLT). These databases securely store HIPAA mandated PHI and PII data, patient, provider, diagnosis, research, financial, advertisement, insurance, and related healthcare data.
Thousands of software web services and other processes based on SQL and machine learning algorithms drive A-Medicare platform hosting healthcare data managed by PostgreSQL.
Medical Records, Diagnosis Data, and Charts
A-Medicare implements the cybersecurity CIA triad of Confidentiality, Integrity, and Availability. CIA protects patient’s PII, PHI, diagnostics, insurance, and financial data and make this data available when needed.
Personal medical records, charts, history archives, and documentation of doctor’s visit of patient are kept securely in singular and blockchain databases both at-rest and in-transit using machine learning algorithms. This confidential data can only be accessed with 2-step authentication on top of A-Medicare ironclad designed encryption techniques on top of cybersecurity policy and other government mandated policy such as HIPAA to protect the patients PHI and PII.
Before clear data is saved into the applicable database it is masked with A-Medicare machine learning designed algorithm. Translation code is similar to SALT in encryption to masked clear data. This process will be impossible to hijack or intercept while the data is on transit to its final destination.
Client Web Browser and Smartphone App
1. The client master ‘engine’ will be developed around a patient-centered interface using a combination of server-, browser-, and machine learning-based algorithmic software using Python, SQL, node.js, react.js, and the Smartphone device’s native operating system such as Android and Apple iOS.
2. Providers, patients, insurers, pharmacists, administrators and other users will have access to a secure browser-based web client and Smartphone native apps implementing A-Medicare’s unique artificial intelligence-based architecture and services. Signing in to a strategically designed rule-based panel system, a patient or administrator can manage doctor’s appointments, verify the patient’s medical records and providers, choose the best and cheaper health care insurance, hospital services, surgeries, doctors’ visits, medications, doctor specialist, and pharmacy.
3. Using custom cryptographic hash algorithms, the client engine encrypts sensitive transactional data such as insurance, diagnosis, financial, Personally Identifiable Information (PII) and Protected Health Information (PHI) as it is used by the A-Medicare web service in the various page navigation by the user. The client engine randomly updates the encryption keys at various times to prevent Hackers from knowing the exact key in those random times.
4. Depending on how the user navigates or use the A-Medicare web service or Smartphone app, hundreds of autonomous micro services (like ‘daemons’ in Unix) or micro robots (bots) will continuously work in the background doing household tasks such as searching or detecting unusual cybersecurity activity like ransomware, DDoS, and phishing software about to ‘knock’ off, kill or hijack windows client services or inject itself in the various services of the host operating system and other application software of the device.
5. Embed cognitive technology into the client ‘engine’ as the user navigates various pages of the A-Medicare web service applications or Smartphone app in concert with the server-based services and processes. The client ‘engine’ will detect and collect context sensitive words and phrases on the current page of the web or app into a local cache then destroys or updates this cache at random when specific tasks of the web service is completed.
6. At user’s pre-agreed consent (via a pop op dialog box) or smart contract, A-Medicare platform collects this information into a singular data warehouse using locally developed cryptographic and hash techniques. This data can be collected and presented for user insights, audits, and outcomes in large display or iPad type devices for further analysis by doctors and decision makers.
7. Using custom hashing and cryptographic techniques, securely query a singular and blockchain validation database clusters based on thousands of pre-created scripts and micro services that are machine learning-based, well documented and easy to use for any type of users.
8. For performance, database queries are redirected by the Federated master agent against the partitioned singular and blockchain database regional location (as an example Sydney) where the web service client or Smartphone device being used based on its location.
For questions, comments, or other concerns not addressed here, please send an email to firstname.lastname@example.org We may not be able to respond directly to every inquiry but will take every raised concern seriously and will inquire more details as appropriate.