Blockchain-enabled tokenization for health insurance claims: trends, challenges, and future directions

The vaccine of blockchain technology has quickly altered the processing, validation, and settlement of health insurance claims by bringing transparency, automation, and tamper-proof data exchange. The traditional insurance claims systems continue to suffer from fragmented workflows, inconsistent data standards and high risk of fraud. This paper provides a detailed survey of the issues currently affecting claim management and the increasing importance of blockchain as a trust-enhancing technology. The present advancements in healthcare insurance blockchain research are established through a review of current literature that identifies required research areas. To enhance understanding of frauds, we organize healthcare insurance fraud into a framework that shows different attack methods that tokenization can protect. The fundamental principles of blockchain and data tokenization as healthcare assets are explained which led to the development of a complex survey system that operates on blockchain-based tokenization platforms. The research identifies five essential elements which include smart contracts, identity tokens, claim tokens, off-chain medical data orchestration, and interoperability systems as the core subjects of the study. The paper presents its research findings about digital transformation advantages which include fraud reduction and automated adjudication and real-time tracking and increased participant trust. The paper establishes an essential discussion about multiple obstacles which include universal token standardization issues and privacy concerns and legal compliance requirements that create scalability and interoperability challenges. The survey not only covers the technology, operations and regulation, but it also points out the future of health insurance as being secure, fast and easily scalable through tokenization.

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Publication Details

Journal
Frontiers in Blockchain
Published
2026-04-01
DOI
https://doi.org/10.3389/fbloc.2026.1768301
Primary Topic
Blockchain Technology Applications and Security
Type
article
Field-Weighted Citation Impact
0.00
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article

Blockchain-enabled tokenization for health insurance claims: trends, challenges, and future directions

Vimal Dwivedi, B. K. Tyagi, Naga Priyadarsini R, Priyadharsini M
Frontiers in Blockchain
Blockchain Technology Applications and Security
article

Blockchain-enabled tokenization for health insurance claims: trends, challenges, and future directions

Vimal Dwivedi, B. K. Tyagi, Naga Priyadarsini R, Priyadharsini M
article en

Abstract

The vaccine of blockchain technology has quickly altered the processing, validation, and settlement of health insurance claims by bringing transparency, automation, and tamper-proof data exchange. The traditional insurance claims systems continue to suffer from fragmented workflows, inconsistent data standards and high risk of fraud. This paper provides a detailed survey of the issues currently affecting claim management and the increasing importance of blockchain as a trust-enhancing technology. The present advancements in healthcare insurance blockchain research are established through a review of current literature that identifies required research areas. To enhance understanding of frauds, we organize healthcare insurance fraud into a framework that shows different attack methods that tokenization can protect. The fundamental principles of blockchain and data tokenization as healthcare assets are explained which led to the development of a complex survey system that operates on blockchain-based tokenization platforms. The research identifies five essential elements which include smart contracts, identity tokens, claim tokens, off-chain medical data orchestration, and interoperability systems as the core subjects of the study. The paper presents its research findings about digital transformation advantages which include fraud reduction and automated adjudication and real-time tracking and increased participant trust. The paper establishes an essential discussion about multiple obstacles which include universal token standardization issues and privacy concerns and legal compliance requirements that create scalability and interoperability challenges. The survey not only covers the technology, operations and regulation, but it also points out the future of health insurance as being secure, fast and easily scalable through tokenization.

Frontiers in BlockchainVol. 9
University of Ulster (GB), Intelligent Systems Research (United States) (US), Vellore Institute of Technology University (IN)
Peace, Justice and strong institutions
Openalex Percentile: Top 30%
Blockchain Technology Applications and Security
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