System and method for identifying and analyzing patterns or aberrations in healthcare claims
作者： David Anderson , Jean Rawlings , Jonathan Arthur
DOI:
关键词:
摘要: In a system and method for identifying aberrations in treatment pattern medical condition, group of healthcare claim data to be analyzed is identified, wherein the includes representing condition. Actual generated that represents analyzed. Defined condition retrieved compared actual identify one or more discrepancies therebetween, corresponding comparison results generated. The may represent patient's defined other patients Alternatively, multiple by provider, an established procedure also generate compiling relating from database historical data.
lens.org 参考文章(13)
James Moore, Management of health care data ,(2006)
Aaron Michael Seib, Michael Yvan Wallace, David Stanton Whipple, Paul A. Dubose, Samir Ibrahim Abed, Unsupervised method of identifying aberrant behavior by an entity with respect to healthcare claim transactions and associated computer software program product, computer device, and system ,(2001)
Bert Forman, Health care billing monitor system for detecting health care provider fraud ,(2000)
Edward J. Lockwood, Michael Volpe, Jeffrey Tarrant, Method and apparatus for objectively monitoring and assessing the performance of health-care providers based on the severity of sickness episodes treated by the providers ,(1996)
Christopher S. Walsh, Healthcare verification methods, apparatus and systems ,(2002)
Richard C. Davis, Rheological treatment methods and related apheresis systems ,(1999)
Sean M. McCune, R. Michael McGrady, System for dispensing medical items by brand or generic name ,(1996)
Jacquelyn Ann Kalscheuer, Gary Thomas McIlroy, Julie Ellen Kees, Health care management system for comparing user-proposed and recommended resources required for treatment ,(1997)
Sheila Leatherman, Method for evaluation of health care quality ,(1991)
David R. Montgomery, David A. Martin, Method of medical malpractice and insurance collaboration ,(2002)