EP 1525550 A2 20050427 - A SYSTEM AND USER INTERFACE SUPPORTING USE OF RULES FOR PROCESSING HEALTHCARE AND OTHER CLAIM DATA
Title (en)
A SYSTEM AND USER INTERFACE SUPPORTING USE OF RULES FOR PROCESSING HEALTHCARE AND OTHER CLAIM DATA
Title (de)
SYSTEM UND BENUTZERSCHNITTSTELLE MIT UNTERSTÜTZUNG VON REGELN FÜR DIE VERARBEITUNG VON GESUNDHEITSPFLEGE- UND ANDEREN ANSPRUCHSDATEN
Title (fr)
SYSTEME ET INTERFACE UTILISATEUR SOUTENANT L'UTILISATION DE REGLES PERMETTANT LE TRAITEMENT DE DONNEES DE DEMANDES DE SOINS DE SANTE ET AUTRES DONNEES DE DEMANDES
Publication
Application
Priority
- US 0310193 W 20030403
- US 37276402 P 20020412
- US 30864802 A 20021203
Abstract (en)
[origin: WO03088124A2] A centralized rules repository maintains consistently expressed rules used to process patient claim data in supporting medical procedure eligibility verification, patient referrals, treatment authorization, data entry editing, electronic claim submission, claim status determination and electronic remittance processing. A system for managing rules used for processing claim data related to provision of healthcare to a patient includes an interface processor for acquiring data representing rules from a plurality of different sources. The system includes a rules repository for accumulating data representing acquired rules and a rules processor for initiating application of a selected rule derived from the repository to process claim data in response to a received message. A result processor processes a result being derived by the application of the selected rule to the claim data for output. The interface processor also transforms acquired rules to a common syntax suitable for storage in the rules repository.
IPC 1-7
IPC 8 full level
G06Q 10/00 (2006.01); G06Q 40/00 (2006.01); G06Q 50/00 (2006.01)
CPC (source: EP)
G06Q 10/10 (2013.01); G06Q 40/02 (2013.01)
Citation (search report)
See references of WO 03088124A2
Designated contracting state (EPC)
AT BE BG CH CY CZ DE DK EE ES FI FR GB GR HU IE IT LI LU MC NL PT RO SE SI SK TR
DOCDB simple family (publication)
WO 03088124 A2 20031023; WO 03088124 A3 20050210; CA 2482433 A1 20031023; EP 1525550 A2 20050427; JP 2005522789 A 20050728
DOCDB simple family (application)
US 0310193 W 20030403; CA 2482433 A 20030403; EP 03746586 A 20030403; JP 2003584988 A 20030403