MEDICAL CLAIMS LEAD SUMMARY REPORT GENERATION

    公开(公告)号:US20190326010A1

    公开(公告)日:2019-10-24

    申请号:US16457348

    申请日:2019-06-28

    Abstract: In an embodiment, a computer-implemented method comprises, in response to receiving lead data identifying an entity associated with a health care claim relating to suspected fraud, determining one or more data sources that were used to identify the entity or the suspected fraud; determining a subset of a plurality of data display elements, based on the determined one or more data sources, wherein each of the plurality of data display elements is configured to cause displaying health care claims data associated with the entity in a designated format; automatically obtaining, from a data repository, specific health care claims data associated with the entity for each of the plurality of data display elements in the subset; generating a lead summary report associated with the entity using a report template, the subset, and the obtained specific health care claims data.

    Medical claims lead summary report generation

    公开(公告)号:US10372879B2

    公开(公告)日:2019-08-06

    申请号:US14975697

    申请日:2015-12-21

    Abstract: In an embodiment, a computer-implemented method comprises, in response to receiving lead data identifying an entity associated with a health care claim relating to suspected fraud, determining one or more data sources that were used to identify the entity or the suspected fraud; determining a subset of a plurality of data display elements, based on the determined one or more data sources, wherein each of the plurality of data display elements is configured to cause displaying health care claims data associated with the entity in a designated format; automatically obtaining, from a data repository, specific health care claims data associated with the entity for each of the plurality of data display elements in the subset; generating a lead summary report associated with the entity using a report template, the subset, and the obtained specific health care claims data.

    MEDICAL CLAIMS LEAD SUMMARY REPORT GENERATION
    7.
    发明申请
    MEDICAL CLAIMS LEAD SUMMARY REPORT GENERATION 审中-公开
    医疗索赔摘要报告生成

    公开(公告)号:US20160188819A1

    公开(公告)日:2016-06-30

    申请号:US14975697

    申请日:2015-12-21

    CPC classification number: G06F19/328 G06Q30/018 G16H15/00

    Abstract: In an embodiment, a computer-implemented method comprises, in response to receiving lead data identifying an entity associated with a health care claim relating to suspected fraud, determining one or more data sources that were used to identify the entity or the suspected fraud; determining a subset of a plurality of data display elements, based on the determined one or more data sources, wherein each of the plurality of data display elements is configured to cause displaying health care claims data associated with the entity in a designated format; automatically obtaining, from a data repository, specific health care claims data associated with the entity for each of the plurality of data display elements in the subset; generating a lead summary report associated with the entity using a report template, the subset, and the obtained specific health care claims data.

    Abstract translation: 在一个实施例中,计算机实现的方法包括响应于接收到标识与涉嫌涉嫌欺诈的医疗保健声明相关联的实体的线索数据,确定用于识别实体或可疑欺诈的一个或多个数据源; 基于所确定的一个或多个数据源来确定多个数据显示元素的子集,其中所述多个数据显示元素中的每一个被配置为导致以指定格式显示与所述实体相关联的医疗保健理赔数据; 从所述数据存储库自动获得与所述子集中的所述多个数据显示元素中的每一个相关联的与所述实体相关联的特定医疗保健声明数据; 使用报告模板,子集和获得的特定医疗保健索赔数据生成与实体相关联的牵头摘要报告。

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