Medical procedure charge restructuring tools and techniques

A computer system for restructuring classification of multiple medical procedures for a healthcare entity, the system comprising:

• an electronic computer system having an electronic computer processor and at least one data storage medium, the system structured for data communication with multiple different data sources;
• the system programmed for aggregating, in the data storage medium of the electronic computer system, data derived from the multiple different data sources comprising:
• medical procedure data including data associated with multiple patient encounters associated with medical procedures performed on patients involving medical treatment or clinical procedures performed on the patients;
• electronic medical record data including at least one medical procedure related code;
• financial data including data elements associated with charges related to the multiple patient encounters;
• and
• reimbursement data including data associated with payor contract terms for reimbursement;
• and
• data comprising historical surgical log data, claim charge detail data, payor name data, plan name data, account class data, Healthcare Common Procedure Coding System (HCPCS) code data, diagnosis related groups (DRG) code data, and surgical procedure listing data;
• wherein the computer system processor comprises a grouping of multiple networked servers employing load-balancing software and configured for:
• distributing processing workload between or among individual servers of the grouping of multiple networked servers in association with processing the aggregated data and creating the data model, and
• expediting computing processes for the computer system by harnessing collective and cooperative power of the multiple networked servers;
• the system further programmed for:
• creating, by the processor, a data model with the received medical procedure data;
• generating, by the processor and in response to the data model, a predetermined number of procedure charge levels each in association with an acuity resource value range;
• creating, by the processor, relative weight value ranges for each acuity resource value range associated with each procedure charge level;
• reclassifying, by the processor, each of the medical procedures into one of the generated procedure charge levels in accordance with at least one level assignment rule;
• determining, by the processor, whether a reclassified result falls within a predetermined desired data distribution, including determining whether a generated desired data distribution results in a statistical distribution of procedure charge levels that is substantially a bell curve distribution wherein the reclassified result is reclassified, iteratively, until the result falls within the predetermined data distribution;
• providing, by the processor, remote access to multiple access devices of multiple users to view or modify at least one of the predetermined number of procedure charge levels, at least one of the relative weight value ranges, or at least one of the level assignment rules;
• displaying a graphical representation on a computer screen display of each access device of each user, the graphical representation structured for:
• presenting a data distribution indicative of originally classified medical procedures, and
• presenting a data distribution indicative of the reclassified medical procedures;
• storing at least a portion of the reclassified medical procedure data in the data storage medium of the processor;
• determining, by the processor, whether the reclassification of the medical procedures results in a predetermined desired data distribution;
• and
• communicating, by the processor, at least a portion of the reclassified medical procedure data in connection with performing a medical procedure on a patient in accordance with the reclassified medical procedure data.