Cerner Innovation, Inc.

Raymond Glen Delano, Iii

James L Poteet, Iii

Julie Ann Jensen

Andrew Lee Heeren

Methods, computer systems, and computer storage media are provided for utilizing machine learning to predict health plans. A machine learning model is trained to predict valid combinations of employer-payer-health plan in response to one or more missing identifiers based on transaction data from electronic data interchange (EDI) insurance transactions that include valid combinations of employer identifier, payer identifier, and health plan identifier. In response to a request to identify a valid combination based on at least one missing identifier, at least one known identifier corresponding to an employer name, a payer name, or a health plan name is inputted and work location data associated with a patient. The machine learning model generates and displays on a user interface, a predicted set of one or more valid combinations of employer-payer-health plans that correspond to the one known identifier and the work location information that is inputted.

Machine learning model for predicting health plans based on missing input data

Methods, computer systems, and computer storage media are provided for utilizing machine learning to verify payers and/or health plans. HIPAA transactions can be utilized to train a machine learning model to intelligently link payers and/or health plans to specific employers. Initially, transaction data is received from electronic data interchange (EDI) insurance transactions. The transaction data comprises data corresponding to a plurality of employers, a plurality of payers, and a plurality of health plans provided by the plurality of payers. A machine learning model is trained with the transaction data to build a mapping of the plurality of employers, the plurality of payers contracted with each employer of the plurality of employers, and the plurality of health plans provided by the plurality of payers for each employer of the plurality of employers. The machine learning model is utilized to verify the scan data is mapped in accordance with the mapping.

Intelligently linking payer/health plan combinations to specific employers

Methods, computer systems and computer readable media for online authentication of an organization are provided. Authentication is accomplished by receiving a first set of patient specific attributes from an organization. This first set of attributes is obtained from an eligibility transaction between the organization and a payor for the patient. The first set of attributes is compared to a second set of attributes involving the same patient, where the second set of attributes is obtained from an eligibility transaction between the online service provider and the payor. If the first set of attributes matches the second set of attributes, the secure online service provider will be notified that the organization is authentic.

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Kansas City, MO, United States of America

Raymond Glen Delano, Iii