US Patent No: 8,069,080
Number of patents in Portfolio can not be more than 2000
Methods for generating healthcare provider quality and cost rating data
Stats
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Nov 29, 2011
Issued date -
Nov 14, 2007
filing date -
11/939,900
serial no -
In Force
status
Importance
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Abstract
A method for generating healthcare provider quality rating data includes grouping claim records into one or more claim groups, assigning each claim group to a responsible provider, assessing the claim records in each claim group using guidelines for the particular disease or condition, and generating a compliance score for the claim group, wherein the compliance score indicates the extent to which the claim records in the claim group match the guidelines, and generating normalized provider quality rating data. A method for generating healthcare provider cost rating data includes grouping claim records into one or more claim groups, assigning each claim group to a responsible provider, calculating the total cost of each claim group, aggregating the total cost for each claim group, and comparing the total aggregate cost of each claim group assigned to each provider to an expected cost value.
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First Claim
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International Classification(s)
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Cited Art
| Patent Info | (Count) | # Cites | Year |
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| 2003/0158,751 Fraud and abuse detection and entity profiling in hierarchical coded payment systems | 17 | 2002 | |
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| 2007/0156,455 System and Method for Providing a Consumer Healthcare Guide | 2 | 2006 | |
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| 2004/0111,291 Method of optimizing healthcare services consumption | 20 | 2002 | |
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| 5,835,897 Computer-implemented method for profiling medical claims | 130 | 1995 | |
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| 5,544,044 Method for evaluation of health care quality | 87 | 1991 | |
Patent Citation Ranking
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