Method and apparatus for electronic processing of claims

A computer implemented method for processing a compensation request, the method comprising:

• (a) receiving the compensation request;
• (b) processing the compensation request on a computer using a categorization decision tree to determine the value of the compensation request, the categorization decision tree comprising:
• (1) providing questions related to the highest award category;
• (2) receiving a response to the questions related to the highest award category;
• (3) determining if the requirements for the highest award category are met;
• and
• (4) when the requirements for the highest award category are met, exiting the categorization decision tree and returning the value of the award to step (c)
• (5) when the requirements for a higher award category are not met, providing questions related to a next lower award category;
• (6) receiving a response to the questions related to the next lower award category;
• (7) determining if the requirements for the next lower award category are met;
• (8) when the requirements for the next lower award category are met, exiting the categorization decision tree and returning the value of the award to step (c);
• (9) repeating steps (5)-(8) until all award categories have been evaluated;
• and
• (10) exiting the categorization decision tree and returning a denial of the compensation request to step (c);
• and
• (c) transmitting an offer to settle the compensation request, the value of the offer based on the result of the compensation request processing using the categorization decision tree.

A computer implemented method for processing a compensation request, the method comprising:

• (a) receiving a compensation request;
• (b) processing the compensation request, on a computer programmed to operate as an expert system, to determine the value of the compensation request;
• and
• (c) transmitting an offer to settle the compensation request, the value of the offer based on the result of the compensation request processing using the expert system.

A computer implemented method for processing a compensation request, the method comprising:

• (a) receiving the compensation request;
• (b) processing the compensation request on a computer using an expert system to determine the value of the compensation request, the compensation request processing comprising,
• (1) providing questions related to the highest award category,
• (2) receiving a response to the questions related to the highest award category,
• (3) determining if the requirements for the highest award category are met,
• (4) when the requirements for the highest award category are met, exiting the expert system and returning the value of the claimants award to step (c),
• (5) when the requirements for a higher award category are not met, providing questions related to a next lower award category,
• (6) receiving a response to the questions related to the next lower award category,
• (7) determining if the requirements for the next lower award category are met,
• (8) when the requirements for the next lower award category are met, exiting the expert system and returning the value of the award to step (c),
• (9) repeating steps (5)-(8) until all award categories have been evaluated, and
• (10) exiting the expert system and returning a denial of the compensation request to step (c);
• and
• (c) transmitting an offer to settle the compensation request, the value of the offer based on the result of the compensation request processing using the expert system.

A computer readable device containing a program for processing a compensation request, the device comprising:

• a computer readable medium;
• a processing data structure for processing the compensation request using a categorization decision tree to determine the value of the compensation request, the processing data structure stored on the medium;
• and
• a transmitting data structure for transmitting an offer to settle the compensation request, the value of the offer based on the result of the compensation request processing using the categorization decision tree, the transmitting data structure stored on the medium, wherein
• the categorization decision tree comprises,
• (1) question means for providing questions related to the highest award category,
• (2) response receiving means for receiving a response to the questions related to the highest award category,
• (3) requirements determining means for determining if the requirements for the highest award category are met,
• (4) exiting means for exiting the categorization decision tree and returning the value of the award to the transmitting data structure when the requirements determining means determines that the requirements for the highest award category are met,
• (5) next question providing means for providing questions related to a next lower award category when the requirements for a higher award category are not met,
• (6) next response receiving means for receiving a response to the questions related to the next lower award category,
• (7) next determining means for determining if the requirements for the next lower award category are met,
• (8) next exiting means for exiting the categorization decision tree and returning the value of the award to the transmitting data structure when the next determining means determines that the requirements for the next lower award category are met,
• (9) repeating means for repeating (5)-(8) until all award categories have been evaluated, and
• (10) denial exiting means for exiting the categorization decision tree and returning a denial of the compensation request to the transmitting data structure.

A computer system for processing a compensation request, the system comprising:

• a computer comprising:
• a processor;
• an input device for inputting data into the computer;
• an output device for outputting data from the computer;
• and at least one storage medium for storing instructions for the processor;
• a processing data structure for processing the compensation request using a categorization decision tree to determine the value of the compensation request, the processing data structure stored on the medium.

A computer system for processing a compensation request, the system comprising:

• a computer comprising:
• a processor;
• an input device for inputting data into the computer;
• an output device for outputting data from the computer;
• and at least one storage medium for storing instructions for the processor;
• a processing data structure for processing the compensation request using a categorization decision tree to determine the value of the compensation request, the processing data structure stored on the medium;
• and
• a transmitting data structure for transmitting an offer to settle the compensation request, the value of the offer based on the result of the compensation request processing using the categorization decision tree, the transmitting data structure stored on the medium, wherein
• the categorization decision tree comprises,
• (1) question means for providing questions related to the highest award category,
• (2) response receiving means for receiving a response to the questions related to the highest award category,
• (3) requirements determining means for determining if the requirements for the highest award category are met,
• (4) exiting means for exiting the categorization decision tree and returning the value of the award to the transmitting data structure when the requirements determining means determines that the requirements for the highest award category are met,
• (5) next question providing means for providing questions related to a next lower award category when the requirements for a higher award category are not met,
• (6) next response receiving means for receiving a response to the questions related to the next lower award category,
• (7) next determining means for determining if the requirements for the next lower award category are met,
• (8) exiting means for exiting the categorization decision tree and returning the value of the award to the transmitting data structure when the next determining means determines that the requirements for the next lower award category are met,
• (9) repeating means for repeating (5)-(8) until all award categories have been evaluated, and
• (10) denial exiting means for exiting the categorization decision tree and returning a denial of the compensation request to the transmitting data structure.