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    • 4. 发明申请
    • System and Method For Implementing Program Compliance For Health-Based Rewards
    • 实施基于健康​​奖励计划合规的制度和方法
    • US20140039919A1
    • 2014-02-06
    • US14050333
    • 2013-10-09
    • TriZetto Corporation
    • Kathleen NebenJulie SkeenScott Johnson
    • G06Q50/22G06Q30/02
    • G06Q30/018G06Q30/02G06Q30/0207G06Q30/0217G06Q40/08G06Q50/22
    • A compliance process provides the ability to identify members that have completed a required activity for a Health Incentive Program (HIP) by comparing standard data such as claims, pharmacy, laboratory, biometric, health risk assessment and other pertinent internal and external data (hereafter “source data”) against established compliance criteria for that type of data for the specific HIP. If the member meets all compliance criteria within the designated timeframe, the member's achievement is recorded, resulting in the appropriate reward being granted as defined by the HIP. The compliance process solution provides an automated way for a payer to evaluate internal and/or external data including claims, pharmacy and/or biometric data to identify instances of a member completing required activities.
    • 通过比较索赔,药房,实验室,生物识别,健康风险评估和其他相关内部和外部数据(以下简称“健康风险评估”)的标准数据,合规流程提供了识别已完成健康奖励计划(HIP)所需活动的成员的能力, 源数据“),针对特定HIP的那种类型的数据建立合规性标准。 如果会员在指定的时间内符合所有合规标准,记录会员的成绩,得到HIP定义的适当的奖励。 合规流程解决方案为付款人评估内部和/或外部数据(包括索赔,药房和/或生物特征数据)以识别完成所需活动的成员的实例提供了一种自动化方式。