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:
May. 27, 2014

Filed:

Feb. 06, 2013
Applicant:

Trizetto Corporation, Denver, CO (US);

Inventors:

Sherwood Chapman, Gilbert, AZ (US);

J. Mikel Echeverria, Phoenix, AZ (US);

Assignee:

TriZetto Corporation, Denver, CO (US);

Attorney:
Primary Examiner:
Int. Cl.
CPC ...
G06Q 10/00 (2012.01);
U.S. Cl.
CPC ...
Abstract

A method of adjudicating a medical claim includes providing a requirements for a first claim and a second claim, receiving a medical claim for a medical procedure, setting a first score for the first claim and a second score for the second claim to an initial value, comparing components of the medical claim to the requirements of the first and second claims, changing the first and second scores for each one of the components that match one of the requirements and for each one of the requirements that is missing from the components, and selecting the first or second claim based upon predetermined criteria applied to their respective scores to determine either a monetary value of the medical procedure for a medical service provider associated with the medical procedure or a monetary value of medical coverage for a patient associated with the medical procedure.


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