The Problem

Prior authorization in US healthcare is broken. When a doctor wants to perform a procedure, they have to get approval from the patient's insurance company first. Today that process involves phone calls, faxes, and manual

reviews — it takes 30-90 days on average, costs the industry ~$35B/year in admin overhead, and results in opaque denials that patients and providers can't easily audit or challenge.                      

What EASE eHealth Does

It replaces that manual process with an automated, transparent, on-chain pipeline:

1. Provider submits a prior auth request (procedure, patient consent, policy info)

2. Chainlink CRE workflows running on a decentralized oracle network (DON) handle the entire decision pipeline — verifying consent, checking policy coverage, evaluating medical necessity, and writing the result on-chain

3. Smart contracts enforce a deterministic state machine (SUBMITTED → APPROVED → PAID or SUBMITTED → DENIED) — every transition is auditable, immutable, and trustless

4. Settlement happens automatically via an ERC-20 escrow contract — approved claims get paid in seconds, not months

How It Works (the stack)

- 5 Solidity contracts handle consent, policy, claim decisions, and escrow payouts

- 6 backend services serve as adapters between the traditional healthcare world (EHR data in Synthea format) and the on-chain system

- 8 Chainlink CRE workflows orchestrate everything — from routine approvals, to consent revocation cascades, to automated compliance challenges, to medication benefit checks

- All sensitive medical data stays off-chain (only hashes and state go on-chain) — CRE's confidential compute ensures PHI is encrypted end-to-end through the DON

Why It Matters

- Speed: Claims settle in <120 seconds vs. 30-90 days

- Transparency: Every decision is on-chain and auditable — no hidden denials

- Patient control: Consent is explicit and revocable in real-time (triggers cascading claim challenges and payout cancellations)

- Cost: Eliminates manual phone/fax prior auth workflows

- Privacy: Zero PHI on-chain — the system proves compliance without exposing patient data