Invention Grant
- Patent Title: Ontology and rule based adjudication
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Application No.: US16037807Application Date: 2018-07-17
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Publication No.: US11586955B2Publication Date: 2023-02-21
- Inventor: Chung-Sheng Li , Guanglei Xiong , Mohammad Ghorbani , Emmanuel Munguia Tapia , Sukryool Kang , Benjamin Nathan Grosof , Ashish Jain , Colin Connors
- Applicant: ACCENTURE GLOBAL SOLUTIONS LIMITED
- Applicant Address: IE Dublin
- Assignee: ACCENTURE GLOBAL SOLUTIONS LIMITED
- Current Assignee: ACCENTURE GLOBAL SOLUTIONS LIMITED
- Current Assignee Address: IE Dublin
- Agency: Mannava & Kang, P.C.
- Main IPC: G06Q40/08
- IPC: G06Q40/08 ; G06N5/04 ; G06N5/046

Abstract:
In an example, an ontology analyzer may generate an ontology, based on a claim adjudication request. The claim adjudication request may be processed, based on the ontology to provide an ontology based inference. A rule based analyzer may identify a predefined rule corresponding to the claim adjudication request and process the request, based on the predefined rule. A conflict resolver may resolve a conflict which may occur between the ontology based inference and the rule based inference. When a conflict is detected, a predefined criteria may be selected for resolving the conflict, the predefined criteria comprising rules to select one of the ontology based inference and the rule based inference to maximize a probability of accurately processing the claim adjudication request in case of a conflict.
Public/Granted literature
- US20190244121A1 ONTOLOGY AND RULE BASED ADJUDICATION Public/Granted day:2019-08-08
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