Invention Grant
- Patent Title: Method and system for scheduling tracking, adjudicating appointments and claims in a health services environment
- Patent Title (中): 在卫生服务环境中调度跟踪,裁定约会和索赔的方法和系统
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Application No.: US11412836Application Date: 2006-04-28
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Publication No.: US08126738B2Publication Date: 2012-02-28
- Inventor: Jason Reinis Green , Raymond Michael Wood , Robert John Snyder , Richard R. Willich
- Applicant: Jason Reinis Green , Raymond Michael Wood , Robert John Snyder , Richard R. Willich
- Applicant Address: US FL Ponte Vedra
- Assignee: MDI Technologies, Inc.
- Current Assignee: MDI Technologies, Inc.
- Current Assignee Address: US FL Ponte Vedra
- Agency: Williams Mullen, PC
- Agent Thomas F. Bergert
- Main IPC: G06Q50/00
- IPC: G06Q50/00 ; G06Q40/00

Abstract:
An exemplary method for determining the appropriateness of service provider claims for payment includes scheduling appointments for patients with service providers based on requests for services, generating appointment information corresponding to each of the scheduled appointments, and capturing service information corresponding to claims received from the service providers for payment of charges associated with services rendered by the service providers to the patients. The method further includes automatically identifying candidate appointments that correspond to a particular received claim based on a degree of similarity between the service information associated with the particular received claim and the appointment information associated with the scheduled appointments. Additionally, the method includes flagging the particular received claim for resolution when none of the candidate appointments corresponds to the particular received claim, and presenting the particular received claim for payment when at least one of the candidate appointments corresponds to the particular received claim.
Public/Granted literature
Information query