Systems and methods for recovery audit scope determination
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United States of America Patent
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Oct 10, 2006
Issued Date -
N/A
app pub date -
Apr 23, 2004
filing date -
Apr 23, 2003
priority date (Note) -
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Abstract
The present invention enables the determination of what claim types can be written based on a client data set(s). The reverse is also true where the present invention provides the capability to determine what data sets are required to write different claim categories and types. In an illustrative embodiment, the determination of the scope of an audit in accordance with the present invention includes the determination of the claim types that can be written given a certain client data elements and/or the determination of the data elements needed to write certain claim types, both of which are based on the predefined relationships between claim types and data elements. Possible claim types can also be determined based on the client data set(s) and a permissible number of missing client data fields.
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