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.
Patent No.:
Date of Patent:
Mar. 29, 2011
Filed:
Sep. 20, 2002
David Fitzgerald, West Grove, PA (US);
Brian Lucas, Springfield, PA (US);
Greg Long, Conshohocken, PA (US);
David Hiebert Klassen, Sr., Paoli, PA (US);
John Hunter, North Wales, PA (US);
Jon Zimmerman, Pitman, NJ (US);
David Fitzgerald, West Grove, PA (US);
Brian Lucas, Springfield, PA (US);
Greg Long, Conshohocken, PA (US);
David Hiebert Klassen, Sr., Paoli, PA (US);
John Hunter, North Wales, PA (US);
Jon Zimmerman, Pitman, NJ (US);
Siemens Medical Solutions USA, Inc., Malvern, PA (US);
Abstract
A claim pre-processing system employs trial adjudication to improve claim accuracy prior to claim submission to a healthcare payer institution or other entity. A system processes claim data related to provision of healthcare to a patient The system includes a claim data collator for collating data related to a claim for a particular patient for submission to a payer and a source of rules for use in processing collated claim data. A pre-processor submits the collated claim data for processing using the rules to validate the collated claim data is in condition for processing to initiate generation of payment. A claim processor submits the collated claim data to a payer, in response to successful validation by the pre-processor. A rules processor processes acquired claim data to identify a condition triggering application of a different set of rules for determining validity of an individual claim element. The pre-processor re-submits amended collated claim data for processing using the rules to validate the collated claim data is in condition for processing to initiate generation of payment, the amended collated claim data being received in response to unsuccessful validation using the rules.