{"id":"https://openalex.org/W7154959774","doi":"https://doi.org/10.1145/3809482","title":"Addressing Improper Payments in Government Healthcare through Blockchain and Generative AI","display_name":"Addressing Improper Payments in Government Healthcare through Blockchain and Generative AI","publication_year":2026,"publication_date":"2026-04-20","ids":{"openalex":"https://openalex.org/W7154959774","doi":"https://doi.org/10.1145/3809482"},"language":"en","primary_location":{"id":"doi:10.1145/3809482","is_oa":true,"landing_page_url":"https://doi.org/10.1145/3809482","pdf_url":null,"source":{"id":"https://openalex.org/S4210232200","display_name":"Digital Government Research and Practice","issn_l":"2639-0175","issn":["2639-0175","2691-199X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319798","host_organization_name":"Association for Computing Machinery","host_organization_lineage":["https://openalex.org/P4310319798"],"host_organization_lineage_names":["Association for Computing Machinery"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Digital Government: Research and Practice","raw_type":"journal-article"},"type":"article","indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://doi.org/10.1145/3809482","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5056952444","display_name":"James R. Clavin","orcid":"https://orcid.org/0000-0001-5745-0158"},"institutions":[{"id":"https://openalex.org/I79272384","display_name":"University of Maryland, Baltimore County","ror":"https://ror.org/02qskvh78","country_code":"US","type":"education","lineage":["https://openalex.org/I79272384"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"James Clavin","raw_affiliation_strings":["University of Maryland, Baltimore County"],"raw_orcid":"https://orcid.org/0000-0001-5745-0158","affiliations":[{"raw_affiliation_string":"University of Maryland, Baltimore County","institution_ids":["https://openalex.org/I79272384"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5130770756","display_name":"Satyasai Mandlem","orcid":null},"institutions":[{"id":"https://openalex.org/I79272384","display_name":"University of Maryland, Baltimore County","ror":"https://ror.org/02qskvh78","country_code":"US","type":"education","lineage":["https://openalex.org/I79272384"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Satyasai Mandlem","raw_affiliation_strings":["University of Maryland, Baltimore County"],"raw_orcid":"https://orcid.org/0009-0003-0683-6159","affiliations":[{"raw_affiliation_string":"University of Maryland, Baltimore County","institution_ids":["https://openalex.org/I79272384"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5122241913","display_name":"Karuna Joshi","orcid":null},"institutions":[{"id":"https://openalex.org/I79272384","display_name":"University of Maryland, Baltimore County","ror":"https://ror.org/02qskvh78","country_code":"US","type":"education","lineage":["https://openalex.org/I79272384"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Karuna Joshi","raw_affiliation_strings":["Information Systems, University of Maryland, Baltimore County"],"raw_orcid":"https://orcid.org/0000-0002-6354-1686","affiliations":[{"raw_affiliation_string":"Information Systems, University of Maryland, Baltimore County","institution_ids":["https://openalex.org/I79272384"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I79272384"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.47741729,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"7","issue":"2","first_page":"1","last_page":"15"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.23639999330043793,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.23639999330043793,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.17970000207424164,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T12026","display_name":"Explainable Artificial Intelligence (XAI)","score":0.056699998676776886,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/medicaid","display_name":"Medicaid","score":0.8849999904632568},{"id":"https://openalex.org/keywords/payment","display_name":"Payment","score":0.707099974155426},{"id":"https://openalex.org/keywords/government","display_name":"Government (linguistics)","score":0.631600022315979},{"id":"https://openalex.org/keywords/health-care","display_name":"Health care","score":0.491100013256073},{"id":"https://openalex.org/keywords/state","display_name":"State (computer science)","score":0.45509999990463257},{"id":"https://openalex.org/keywords/process","display_name":"Process (computing)","score":0.45329999923706055}],"concepts":[{"id":"https://openalex.org/C2776534028","wikidata":"https://www.wikidata.org/wiki/Q1141363","display_name":"Medicaid","level":3,"score":0.8849999904632568},{"id":"https://openalex.org/C145097563","wikidata":"https://www.wikidata.org/wiki/Q1148747","display_name":"Payment","level":2,"score":0.707099974155426},{"id":"https://openalex.org/C2778137410","wikidata":"https://www.wikidata.org/wiki/Q2732820","display_name":"Government (linguistics)","level":2,"score":0.631600022315979},{"id":"https://openalex.org/C144133560","wikidata":"https://www.wikidata.org/wiki/Q4830453","display_name":"Business","level":0,"score":0.6171000003814697},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.491100013256073},{"id":"https://openalex.org/C48103436","wikidata":"https://www.wikidata.org/wiki/Q599031","display_name":"State (computer science)","level":2,"score":0.45509999990463257},{"id":"https://openalex.org/C98045186","wikidata":"https://www.wikidata.org/wiki/Q205663","display_name":"Process (computing)","level":2,"score":0.45329999923706055},{"id":"https://openalex.org/C162118730","wikidata":"https://www.wikidata.org/wiki/Q1128453","display_name":"Actuarial science","level":1,"score":0.3939000070095062},{"id":"https://openalex.org/C2779687700","wikidata":"https://www.wikidata.org/wiki/Q20514253","display_name":"Blockchain","level":2,"score":0.3741999864578247},{"id":"https://openalex.org/C10138342","wikidata":"https://www.wikidata.org/wiki/Q43015","display_name":"Finance","level":1,"score":0.3427000045776367},{"id":"https://openalex.org/C38652104","wikidata":"https://www.wikidata.org/wiki/Q3510521","display_name":"Computer security","level":1,"score":0.320499986410141},{"id":"https://openalex.org/C185822510","wikidata":"https://www.wikidata.org/wiki/Q1956140","display_name":"Payment service provider","level":3,"score":0.2921000123023987},{"id":"https://openalex.org/C139043278","wikidata":"https://www.wikidata.org/wiki/Q837171","display_name":"Financial services","level":2,"score":0.27730000019073486},{"id":"https://openalex.org/C181907467","wikidata":"https://www.wikidata.org/wiki/Q17027869","display_name":"Human services","level":2,"score":0.271699994802475},{"id":"https://openalex.org/C121955636","wikidata":"https://www.wikidata.org/wiki/Q4116214","display_name":"Accounting","level":1,"score":0.26820001006126404}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1145/3809482","is_oa":true,"landing_page_url":"https://doi.org/10.1145/3809482","pdf_url":null,"source":{"id":"https://openalex.org/S4210232200","display_name":"Digital Government Research and Practice","issn_l":"2639-0175","issn":["2639-0175","2691-199X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319798","host_organization_name":"Association for Computing Machinery","host_organization_lineage":["https://openalex.org/P4310319798"],"host_organization_lineage_names":["Association for Computing Machinery"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Digital Government: Research and Practice","raw_type":"journal-article"},{"id":"pmh:doi:10.13016/m2rxk7-pe5u","is_oa":true,"landing_page_url":"http://hdl.handle.net/11603/42937","pdf_url":null,"source":{"id":"https://openalex.org/S4406922384","display_name":"Open MIND","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":null,"host_organization_name":null,"host_organization_lineage":[],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":null,"raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1145/3809482","is_oa":true,"landing_page_url":"https://doi.org/10.1145/3809482","pdf_url":null,"source":{"id":"https://openalex.org/S4210232200","display_name":"Digital Government Research and Practice","issn_l":"2639-0175","issn":["2639-0175","2691-199X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319798","host_organization_name":"Association for Computing Machinery","host_organization_lineage":["https://openalex.org/P4310319798"],"host_organization_lineage_names":["Association for Computing Machinery"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Digital Government: Research and Practice","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":15,"referenced_works":["https://openalex.org/W2620904645","https://openalex.org/W2763398287","https://openalex.org/W2885402769","https://openalex.org/W2963507231","https://openalex.org/W2975871742","https://openalex.org/W2979990733","https://openalex.org/W3014028770","https://openalex.org/W3045493768","https://openalex.org/W3095656130","https://openalex.org/W3194729503","https://openalex.org/W4283034560","https://openalex.org/W4310029361","https://openalex.org/W4312009748","https://openalex.org/W4391485407","https://openalex.org/W4395675278"],"related_works":[],"abstract_inverted_index":{"Clinical":[0],"patient":[1],"data":[2,34,46,64],"must":[3],"be":[4],"transformed":[5],"into":[6],"financial":[7,69],"claim":[8],"formats":[9],"for":[10,20,45,87],"submission":[11],"to":[12],"state":[13,123],"Medicaid":[14,23,95,114],"agencies":[15],"and":[16,22,42,62,71,94,101,113,129,138],"the":[17,52,63,68,78,84,89,103,121,125],"federal":[18],"Centers":[19],"Medicare":[21,112],"Services":[24],"(CMS).":[25],"This":[26,60],"is":[27,38,67],"achieved":[28],"through":[29],"a":[30,131],"process":[31,66],"called":[32],"electronic":[33],"interchange":[35],"(EDI),":[36],"which":[37],"specified":[39],"in":[40,111,127],"regulation":[41],"has":[43],"standards":[44],"definition":[47],"that":[48,73],"are":[49],"maintained":[50],"by":[51,77,83,106],"American":[53],"National":[54],"Standards":[55,57],"Institute/Accredited":[56],"Committee":[58],"X12.":[59],"standard":[61],"exchange":[65],"gas":[70],"protocols":[72],"enable":[74],"healthcare":[75],"payment":[76],"government.":[79],"Claims":[80],"payments":[81,110],"made":[82],"U.S.":[85],"Government":[86],"Medicare,":[88],"Children\u2019s":[90],"Health":[91],"Insurance":[92],"Program,":[93],"exceed":[96],"$1T":[97],"annually.":[98],"Of":[99],"this,":[100],"despite":[102],"validations":[104],"enforced":[105],"EDI":[107],"transmission,":[108],"improper":[109,144],"exceeds":[115],"$100B":[116],"each":[117],"year.":[118],"We":[119],"analyze":[120],"current":[122],"of":[124,135],"art":[126],"EDI,":[128],"provide":[130],"design-oriented":[132],"technical":[133],"brief":[134],"how":[136],"blockchain":[137],"large":[139],"language":[140],"models":[141],"could":[142],"address":[143],"payments.":[145]},"counts_by_year":[],"updated_date":"2026-06-26T08:34:08.712188","created_date":"2026-04-21T00:00:00"}