Machine learning systems for error detection in data processing systems and related methods

A method for use in dispensing one or more prescription drugs, said method performed by a claim analysis device and a pharmacy fulfillment device in communication with a data warehouse system and a claim processing system, the data warehouse system including historical claims including a set of historical claim features and a historical claim status, the claim processing system including pending claims including a set of pending claim features, the pharmacy fulfillment device configured to dispense a prescription drug, the claim analysis device including a processor and a memory, said method comprising:

• extracting, by the claim analysis device, subsets of historical claim features from a subset of historical claims received from the data warehouse system, wherein each of the subset of historical claims has a corresponding historical claim status indicating that the claim has been successfully processed;
• extracting, by the claim analysis device, a subset of pending claim features from a pending claim received from the claim processing system;
• applying, by the claim analysis device, a binarization process on the extracted subsets of historical claim features to obtain a binarized training feature set for the subset of historical claims;
• applying, by the claim analysis device, the binarization process on the extracted subset of pending claim features to obtain a binarized pending feature set for the pending claim;
• calculating, by the claim analysis device, an aggregate distance between the binarized pending feature set and the binarized training feature set for the subset of historical claims;
• identifying, by the claim analysis device, from the subset of historical claims, a historical claim associated with the least aggregate distance as a predictive historical claim;
• determining, by the claim analysis device, that a billing attribute of the predictive historical claim matches a corresponding billing attribute of the pending claim;
• validating, by the claim analysis device, the pending claim and transmitting, to the pharmacy fulfillment device, an instruction for dispensing the prescription drug in accordance with the pending claim;
• and
• dispensing, by the pharmacy fulfillment device, the prescription drug based on the instruction from the claim analysis device.

A system comprising a first non-transitory computer readable storage medium of a claim analysis device and a second non-transitory computer readable storage medium of a pharmacy fulfillment device,

• the first non-transitory computer readable storage medium having stored thereon a first set of instructions for processing instructions of a software program that when executed by the claim analysis device, causes the claim analysis device to:
• extract subsets of historical claim features from a subset of historical claims received from a data warehouse system, wherein each of the subset of historical claims has a corresponding historical claim status indicating that the claim has been successfully processed;
• extract a subset of pending claim features from a pending claim received from a claim processing system;
• apply a binarization process on the extracted subsets of historical claim features to obtain a binarized training feature set for the subset of historical claims;
• apply the binarization process on the extracted subset of pending claim features to obtain a binarized pending feature set for the pending claim;
• calculate an aggregate distance between the binarized pending feature set and the binarized training feature set for the subset of historical claims;
• identify, from the subset of historical claims, a historical claim associated with the least aggregate distance as a predictive historical claim;
• determine that a billing attribute of the predictive historical claim matches a corresponding billing attribute of the pending claim;
• validate the pending claim and transmit an instruction to the pharmacy fulfillment device for dispensing the prescription drug in accordance with the pending claim;
• and
• the second non-transitory computer readable storage medium of the pharmacy fulfillment device having stored thereon a second set of instructions that, when executed by the pharmacy fulfillment device, cause the pharmacy fulfillment device to:
• dispense the prescription drug based on the instruction from the claim analysis device.