Processing patient data using a computer interface

A method for processing patient data, the method comprising:

• a) Receiving patient data associated with a member of a health care plan via an adjudication system computer prior to a reimbursement request submitted by said adjudication system computer based on said patient data;
• b) Determining whether said patient data indicates a potential standardized code update, wherein said potential standardized code update represents a potential health condition associated with said member;
• c) Determining whether a supporting patient record substantiates said potential standardized code update in response to a determination that said patient data indicates said potential standardized code update;
• and
• d) Outputting a response indicating whether said potential standardized code update is substantiated.

A computer program product for processing patient data, the computer program product comprising:

• a computer readable storage medium storing computer executable program code that, when executed by a processor, causes said computer readable storage medium to perform a method comprising:
• a) Receiving patient data associated with a member of a health care plan;
• b) Associating a pending status with said patient data, wherein said pending status delays processing of said patient data by an adjudication system computer;
• c) Determining whether said patient data indicates a potential standardized code update, wherein said potential standardized code update represents a potential health condition associated with said member;
• and
• d) Disassociating said pending status with said patient data in response to determining whether said patient data indicates said potential standardized code update.