Healthcare financial data and clinical information processing system

A system for processing claim data related to patient healthcare in response to clinical events, comprising:

• an interface processor for receiving messages identifying clinical events related to corresponding claim data elements concerning a patient;
• a source of rules for validating claim data elements concerning provision of individual services to a patient;
• a rules processor for initiating application of rules derived from said rules source to individually validate different claim data elements concerning provision of corresponding different individual services to a patient in response to receiving said messages identifying said events;
• and
• a result processor for initiating an action in response to a result derived by said application of said rules to individually validate different claim data elements.

A system for processing claim data related to patient healthcare in response to clinical events, comprising:

• an interface processor for receiving messages identifying clinical events related to corresponding claim data elements concerning a patient;
• a source of rules for validating claim data elements concerning provision of individual services to a patient;
• a rules processor for initiating application of rules derived from said rules source to identify claim data element deficiencies in response to receiving said messages identifying said events;
• and
• a result processor for initiating an action in response to a result derived by said application of said rules to individually validate different claim data elements.

A method for processing financial data related to patient healthcare in response to clinical events, comprising the steps of:

• receiving a message identifying an event and a related change in healthcare data concerning a patient;
• initiating application of a rule derived from a rules source to process financial data concerning provision of an individual service to said patient in response to receiving said message identifying said event, said rules being usable for determining characteristics associated with reimbursement for provision of an individual service to a patient;
• and
• initiating an action in response to a result derived by said application of said rule to process said financial data.

A method for processing claim data related to patient healthcare in response to clinical events, comprising the steps of:

• receiving messages identifying clinical events related to corresponding claim data elements concerning a patient;
• initiating application of rules derived from a rules source to individually validate different claim data elements concerning provision of corresponding different individual services to a patient in response to receiving said messages identifying said events, said rules being usable for validating claim data elements concerning provision of individual services to said patient;
• and
• initiating an action in response to a result derived by said application of said rules to individually validate different claim data elements.

A method for processing claim data related to patient healthcare in response to clinical events, comprising the steps of:

• receiving messages identifying clinical events related to corresponding claim data elements concerning a patient;
• initiating application of rules derived from a rules source to identify claim data element deficiencies in response to receiving said messages identifying said events, said rules being usable for validating claim data elements concerning provision of individual services to said patient;
• and
• initiating an action in response to a result derived by said application of said rules to individually validate different claim data elements.