Automation of auditing claims

A computerized auditing method comprising:

• receiving, via a processor, a data file comprising one or more auditable items;
• extracting, using the processor, a word string from each auditable item;
• translating, using the processor, each word string using one or more translation steps into a translated item description;
• for each translated item description:
• comparing, using the processor, the translated item description to a plurality of terms;
• generating, using the processor, a matching table comprising one or more entries, wherein each entry of the matching table comprises a matching term from the plurality of terms and matching information, the matching information comprising a match characteristic between the translated item description and the term and an item identifier;
• determining, using the processor, whether the match characteristic for each entry is below a predetermined threshold;
• if the match characteristic is below the predetermined threshold, removing, using the processor, the entry from the matching table;
• determining, using the processor, if one entry of the matching table comprises a best match;
• if one entry comprises the best match, associating, using the processor, the item identifier of the one entry with the translated item description;
• if no entry comprises the best match:
• determining, using the processor, whether a plurality of entries comprise a similar match indicator value;
• and
• if the plurality of entries comprise the similar match indicator value, associating, using the processor, the item identifier for each of the plurality of entries with the translated item description, otherwise associating the translated item description with a no match indicator;
• accepting, using the processor, or rejecting each auditable item associated with an item identifier based on the item identifier and one or more rules associated with the data file;
• and
• generating, using the processor, an audit report.

A computerized auditing method comprising:

• receiving, via a processor, a data file comprising one or more auditable items, each auditable item comprising a word string having one or more words;
• translating, using the processor, each word string into a translated item description, wherein translating comprises:
• determining, using the processor, whether the word string comprises a primary name;
• if the word string comprises a primary item name, calculating, using the processor, the translated item description based on the primary name;
• and
• if the word string does not comprise a primary item name, calculating, using the processor, the translated item description based on the last word of the word string;
• comparing, using the processor, each translated item description to a plurality of predetermined terms to generate matching information;
• associating, using the processor, each translated item description with an item identifier based on the matching information;
• and
• accepting, using the processor, or rejecting each auditable item based on the item identifier and one or more rules associated with the data file.

A computerized auditing method comprising:

• receiving, using the processor, a data file comprising one or more auditable items, each auditable item comprising a word string having one or more words;
• translating, using the processor, each word string for each auditable item into a translated item description, wherein translating each word string comprises:
• generating, using the processor, relationship information between two or more words of the word string based on a classification of each word of the word string;
• determining, using the processor, whether each word of the word string is associated with the relationship information;
• if each word of the word string is associated with the relationship information, calculate, using the processor, the translated item description based on the relationship information;
• and
• if each word of the word string is not associated with the relationship information, calculate, using the processor, the translated item description based on ordering information;
• comparing, using the processor, each translated item description to a plurality of predetermined terms to generate matching information;
• associating, using the processor, each translated item description with an item identifier based on the matching information;
• and
• accepting, using the processor, or rejecting each auditable item based on the item identifier and one or more rules associated with the data file.

A apparatus comprising:

• an auditing system configured to receive a data file comprising one or more auditable items, each auditable item comprising a word string having one or more words;
• and
• a translator in communication with the auditing apparatus configured to:
• translate each word string for each auditable item using one or more translation steps into a translated item description;
• compare each translated item description to a plurality of terms to generate matching information;
• associate each translated item description with an item identifier based on the matching information;
• and
• accept or reject each auditable item based on the item identifier and one or more rules associated with the data file.

A computer program product, tangibly embodied in a computer readable storage medium, the computer program product including instructions being operable to cause a data processing apparatus to:

• receive a data file comprising one or more auditable items, each auditable item comprising a word string having one or more words;
• translate each word string for each auditable item using one or more translation steps into a translated item description;
• compare each translated item description to a plurality of terms to generate matching information;
• associate each translated item description with an item identifier based on the matching information;
• and
• accept or rejecting each auditable item based on the item identifier and one or more rules associated with the data file.

An apparatus comprising:

• means for receiving a data file comprising one or more auditable items, each auditable item comprising a word string having one or more words;
• means for:
• translating each word string for each auditable item using one or more translation steps into a translated item description;
• comparing each translated item description to a plurality of terms to generate matching information;
• associating each translated item description with an item identifier based on the matching information;
• and
• accepting or rejecting each auditable item based on the item identifier and one or more rules associated with the data file.