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:
Aug. 28, 2007

Filed:

Feb. 15, 2002
Applicants:

Nallan C Suresh, Irvine, CA (US);

Jean DE Traversay, Solana Beach, CA (US);

Hyma Gollamudi, San Diego, CA (US);

Krassimir G Ianakiev, San Diego, CA (US);

Anu K Pathria, La Jolla, CA (US);

Michael K Tyler, San Diego, CA (US);

Inventors:

Nallan C Suresh, Irvine, CA (US);

Jean de Traversay, Solana Beach, CA (US);

Hyma Gollamudi, San Diego, CA (US);

Krassimir G Ianakiev, San Diego, CA (US);

Anu K Pathria, La Jolla, CA (US);

Michael K Tyler, San Diego, CA (US);

Assignee:

Fair Isaac Corporation, San Diego, CA (US);

Attorneys:
Primary Examiner:
Int. Cl.
CPC ...
G06Q 50/00 (2006.01);
U.S. Cl.
CPC ...
Abstract

Transition probability sequencing models and metrics are derived from healthcare claims data to identify potentially fraudulent or abusive practices, providers, doctors, clients, or other entities. Healthcare reimbursement claims from hospitals, skilled nursing facilities, doctors, etc., are processed to identify sequences of states, and transition probability metrics are determined from frequency information pertaining to the states. The metrics can these be further analyzed in predictive or rule based models, or other tools.


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