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Modelling Data Flow in Smart Claim Processing Using Time Invariant Petri Net with Fixed Input Data


Anokye Acheampong Amponsah, Adebayo Felix Adekoya, and Benjamin Asubam Weyori


Vol. 22  No. 2  pp. 413-423


The NHIS provides free or highly subsidized healthcare to all people by providing financial fortification. However, the financial sustainability of the scheme is threatened by numerous factors. Therefore, this work sought to provide a solution to process claims intelligently. The provided Petri net model demonstrated successful data flow among the various participant. For efficiency, scalability, and performance two main subsystems were modelled and integrated ? data input and claims processing subsystems. We provided smart claims processing algorithm that has a simple and efficient error detection method. The complexity of the main algorithm is good but that of the error detection is excellent when compared to literature. Performance indicates that the model output is reachable from input and the token delivery rate is promising.


NHIS, Petri net, claim processing, reachability, data flow