Invention Grant
US07774216B2 Computer-implemented method for grouping medical claims based upon changes in patient condition 有权
基于患者状况变化对医疗索赔进行分组的计算机实现方法

  • Patent Title: Computer-implemented method for grouping medical claims based upon changes in patient condition
  • Patent Title (中): 基于患者状况变化对医疗索赔进行分组的计算机实现方法
  • Application No.: US11841439
    Application Date: 2007-08-20
  • Publication No.: US07774216B2
    Publication Date: 2010-08-10
  • Inventor: Dennis K. Dang
  • Applicant: Dennis K. Dang
  • Applicant Address: US MN Eden Prairie
  • Assignee: Ingenix, Inc.
  • Current Assignee: Ingenix, Inc.
  • Current Assignee Address: US MN Eden Prairie
  • Agency: Dorsey & Whitney LLP
  • Main IPC: A61B5/00
  • IPC: A61B5/00
Computer-implemented method for grouping medical claims based upon changes in patient condition
Abstract:
A computer-implemented method for profiling medical claims to assist health care managers in determining the cost-efficiency and service quality of health care providers. The method allows an objective means for measuring and quantifying health care services. An episode treatment group (ETG) is a patient classification unit, which defines groups that are clinically homogenous (similar cause of illness and treatment) and statistically stable. The ETG grouper methodology uses service or segment-level claim data as input data and assigns each service to the appropriate episode. The program identifies concurrent and recurrent episodes, flags records, creates new groupings, shifts groupings for changed conditions, selects the most recent claims, resets windows, makes a determination if the provider is an independent lab and continues to collect information until an absence of treatment is detected.
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