公开(公告)号：US11961598B1

公开(公告)日：2024-04-16

申请号：US16913797

申请日：2020-06-26

申请人： Express Scripts Strategic Development, Inc.

发明人： Morgan J. Finley ,  Garret L. Anderson ,  Camille Patel ,  Michael Nassar ,  Siju Vattakunnumpurath Eugin ,  Daniel Owens

IPC分类号： G16H20/10 ,  G06F16/28 ,  G06N20/00 ,  G16H40/20

CPC分类号： G16H20/10 ,  G06F16/283 ,  G06N20/00 ,  G16H40/20

摘要： A method for predicting errors in prescription claim data is performed by a claim analysis device. The method includes extracting historical claim features from successfully processed historical claims received from the data warehouse system. The method includes extracting pending claim features from a pending claim. The method includes applying a binarization process on the extracted historical claim features to obtain a binarized training feature set. The method includes applying the binarization process on the extracted pending claim features to obtain a binarized pending feature set. The method includes calculating an aggregate distance between the binarized pending feature set and the binarized training feature set. The method includes identifying the historical claim associated with the least aggregate distance as a predictive historical claim. The method includes transmitting an alert upon determining that a billing attribute of the predictive historical claim fails to match a corresponding billing attribute of the pending claim.