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    • 3. 发明授权
    • Healthcare financial data and clinical information processing system
    • 医疗财务数据和临床信息处理系统
    • US07797172B2
    • 2010-09-14
    • US10253223
    • 2002-09-24
    • David FitzgeraldBrian LucasGreg LongDavid Hiebert Klassen, Sr.John Hunter
    • David FitzgeraldBrian LucasGreg LongDavid Hiebert Klassen, Sr.John Hunter
    • G06Q40/00
    • G06F19/328G06F19/00G06Q20/102G06Q40/02G06Q40/08G06Q50/22
    • A patient claim data processing system responds to and initiates clinical events and attains early accurate claim data during a patient healthcare encounter cycle to support prompt claim data validation and editing both for individual claim elements and for a completed claim to improve claim accuracy prior to claim submission to a payer. The system submits accurate claims to payers and receives remittance advice from payers and applies rules to the advice. A system processes financial data related to provision of healthcare to a patient in response to clinical events. The system includes an interface processor for receiving a message identifying an event and a related change in healthcare data concerning a patient and also includes a source of rules for determining characteristics associated with reimbursement for provision of an individual service to a patient. A rules processor initiates application of a rule derived from the rules source to process financial data concerning provision of the individual service to the patient in response to receiving the message identifying the event. A result processor initiates an action in response to a result derived by the application of the rule to process the financial data. The rules processor also validates the financial data complies with the rule.
    • 患者索赔数据处理系统响应并启动临床事件,并在患者医疗保健相关周期期间获得早期准确的索赔数据,以支持针对个人索赔要素的即时索赔数据验证和编辑,以及完成的索赔,以在索赔提交之前提高索赔准确性 付款人 系统向付款人提交准确的索赔,并从付款人那里收到汇款通知,并对建议采用规则。 系统响应于临床事件处理与向患者提供医疗保健有关的财务数据。 该系统包括接口处理器,用于接收标识事件的消息和关于患者的医疗保健数据的相关变化,并且还包括用于确定与向患者提供个体服务的报销相关联的特征的规则来源。 响应于接收到标识事件的消息,规则处理器启动从规则源导出的规则的应用以处理关于向患者提供单独服务的财务数据。 结果处理器响应于应用规则导出的结果来处理财务数据而发起操作。 规则处理器还验证财务数据符合规则。