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

Award Information
Agency: National Science Foundation
Branch: N/A
Contract: 1914203
Agency Tracking Number: 1914203
Amount: $225,000.00
Phase: Phase I
Program: STTR
Solicitation Topic Code: OT
Solicitation Number: N/A
Solicitation Year: 2018
Award Year: 2019
Award Start Date (Proposal Award Date): 2019-07-01
Award End Date (Contract End Date): 2020-06-30
Small Business Information
AUSTIN, TX 78704
United States
DUNS: 081244418
HUBZone Owned: No
Woman Owned: No
Socially and Economically Disadvantaged: No
Principal Investigator
 Tejwansh Anand
 (650) 823-4072
Business Contact
 Tejwansh Anand
Phone: (650) 823-4072
Research Institution
 University of Texas at Austin
 Sriram Vishwanath
3925 W Braker Lane, Ste 3.340
Austin, TX 78759
United States

 Nonprofit College or University

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.

* Information listed above is at the time of submission. *

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