The patent badge is an abbreviated version of the USPTO patent document. The patent badge does contain a link to the full patent document.

The patent badge is an abbreviated version of the USPTO patent document. The patent badge covers the following: Patent number, Date patent was issued, Date patent was filed, Title of the patent, Applicant, Inventor, Assignee, Attorney firm, Primary examiner, Assistant examiner, CPCs, and Abstract. The patent badge does contain a link to the full patent document (in Adobe Acrobat format, aka pdf). To download or print any patent click here.

Date of Patent:
Apr. 16, 2019

Filed:

May. 13, 2014
Applicant:

Trizetto Corporation, Denver, CO (US);

Inventors:

Jay Sultan, Athens, GA (US);

Howard Downs, Northfield, IL (US);

Dale Hoerle, Naperville, IL (US);

Assignee:
Attorneys:
Primary Examiner:
Int. Cl.
CPC ...
G06Q 50/22 (2018.01); G06F 19/00 (2018.01); G06Q 20/00 (2012.01); G06Q 40/08 (2012.01);
U.S. Cl.
CPC ...
G06Q 40/08 (2013.01); G06F 19/328 (2013.01); G06Q 20/00 (2013.01); G06Q 50/22 (2013.01);
Abstract

A system and process for prospectively creating patient episodes of care and triggering associated payment bundles during the claim adjudication process facilitates real-time claim pricing in accordance with payment bundle rules to facilitate episodic payment in place of pay-for-service payment. Additionally, various processes are described for modeling patient episodes and payment bundles and unbundling episodic payments.


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