Invention Grant
US08099302B2 Method of increasing efficiency in a medical claim transaction, and computer program capable of executing same
有权
提高医疗索赔交易效率的方法，以及能够执行医疗索赔交易的计算机程序
- Patent Title: Method of increasing efficiency in a medical claim transaction, and computer program capable of executing same
- Patent Title (中): 提高医疗索赔交易效率的方法，以及能够执行医疗索赔交易的计算机程序
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Application No.: US13049389Application Date: 2011-03-16
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Publication No.: US08099302B2Publication Date: 2012-01-17
- Inventor: Sherwood Chapman , J. Mikel Echeverria
- Applicant: Sherwood Chapman , J. Mikel Echeverria
- Applicant Address: US CA Newport Beach
- Assignee: The TriZetto Group, Inc.
- Current Assignee: The TriZetto Group, Inc.
- Current Assignee Address: US CA Newport Beach
- Agency: Fish & Associates, PC
- Main IPC: G06Q10/00
- IPC: G06Q10/00
Abstract:
A method of adjudicating a medical claim includes providing a requirements for a first claim and a second claim, receiving a medical claim for a medical procedure, setting a first score for the first claim and a second score for the second claim to an initial value, comparing components of the medical claim to the requirements of the first and second claims, changing the first and second scores for each one of the components that match one of the requirements and for each one of the requirements that is missing from the components, and selecting the first or second claim based upon predetermined criteria applied to their respective scores to determine either a monetary value of the medical procedure for a medical service provider associated with the medical procedure or a monetary value of medical coverage for a patient associated with the medical procedure.
Public/Granted literature
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