# US 2014/0207485 A1 · Computerized system for tracking, managing and analyzing hospital privileges through the use of specifically researched content in conjunction with icd, cpt or other codes

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- Number: US 2014/0207485 A1
- Document ID: US20140207485A1
- Status: Published application
- Kind: A1
- Application number: 14/224,436
- Filed: 2014-03-25
- Published: 2014-07-24
- Earliest claimed: 2006-08-08
- Inventors: James F. Cox
- Web page: https://patentgrep.com/patent/US20140207485A1

## CPC

- G06Q 10/10: Office automation; Time management
- G06Q 10/00: Administration; Management
- G06Q 40/08: Insurance
- G16H 40/20: for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
- G16H 70/60: relating to pathologies
- G06Q: INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA

## Abstract

A computerized system to manage privileges and billing codes individually and in concert. Including tracking, managing and analyzing hospital privileges through the use of specifically researched content in conjunction with ICD, CPT or other codes.

## Claims

### Claim 1

(canceled)

### Claim 2

A computerized system for tracking, managing and analyzing hospital/facility privileges, comprising:
privilege information stored on a computer readable medium identifying a comprehensive list of privileges for each medical specialty performed at a hospital/facility, each said privilege being individually assignable to individual healthcare workers;
billing code information stored on the computer readable medium, said billing code information including a comprehensive list of medical billing codes, each said medical billing code being assignable to one or more individual ones of said privileges;
relational information stored on the computer readable medium keeping track of medical procedures performed by said individual healthcare workers and appropriate one(s) of said medical billing codes reflective of each said medical procedure; and
a privileging computer for generating a privilege determination for the individual healthcare workers using said privilege information, said billing code information, and said relational information,
wherein each privilege within each medical specialty:
contains a description of the basic education a healthcare worker is required to have for said privilege;
describes a list of procedures that are included in the healthcare worker's basic education;
describes a list of special procedures that require training or other limitations on performing of such special procedures, including:
additional educational requirements to perform each said special procedure;
a description of each said special procedure;
a performance level required to grant or renew each said special privilege to a particular one of said healthcare workers; and
approval from an authorized medical entity within the hospital/facility,
wherein each of the privileges for each medical specialty is matched to one or more of said medical billing codes related to each said privilege to measure the performance level of each said privilege,
wherein the computerized system analyzes and updates individual healthcare worker performance level or privileging requirements by use of said relational information containing medical billing codes reflective of said performed medical procedures to assess whether individual ones of said healthcare workers have reached the performance level required to be granted or have renewed one or more of said special privileges.

### Claim 3 (depends on 2)

The computerized system of claim 2, wherein the at least one medical billing code comprises at least one International Classification of Diseases (ICD) code.

### Claim 4 (depends on 2)

The computerized system of claim 2, wherein the at least one medical billing code comprises at least one Current Procedural Terminology (CPT) code.

### Claim 5 (depends on 2)

The computerized system of claim 2, further comprising:
a local database comprising:
local privilege information corresponding to said privilege information;
local billing code information corresponding to said billing code information; and
an interface for editing the local database and for permitting users of said computerized system to modify at least one of said local privilege information and said local billing code information.

### Claim 6 (depends on 2)

The computerized system of claim 2, wherein the privilege information is pre-loaded in the system.

### Claim 7 (depends on 2)

The computerized system of claim 2, further comprising:
a master privilege and billing code database stored on a computer readable medium, said master privilege and billing code database including a default set of said privileges and a corresponding default set of said medical billing codes;
a local user privilege and billing code database stored on a computer readable medium, said local user privilege and billing code database being formed from information stored in said master privilege and billing code database and including a local set of privileges and a corresponding local set of medical billing codes; and
an interface configured to allow a local user to modify at least one of said local set of privileges and said corresponding local set of medical billing codes.

### Claim 8

A database stored on a computer readable medium and adapted for use with a computerized medical privileging system, said database comprising:
privilege information stored on a computer readable medium identifying a comprehensive list of privileges for each medical specialty performed at a hospital/facility, each said privilege being individually assignable to individual healthcare workers;
billing code information stored on the computer readable medium, said billing code information including a comprehensive list of medical billing codes, each said medical billing code being assignable to one or more individual ones of said privileges; and
relational information stored on the computer readable medium keeping track of medical procedures performed by said individual healthcare workers and appropriate one(s) of said medical billing codes reflective of each said medical procedure,
wherein each privilege within each medical specialty:
contains a description of the basic education a healthcare worker is required to have for said privilege;
describes a list of procedures that are included in the healthcare worker's basic education;
describes a list of special procedures that require training or other limitations on performing of such special procedures, including:
additional educational requirements to perform each said special procedure;
a description of each said special procedure;
a performance level required to grant or renew each said special privilege to a particular one of said healthcare workers; and
approval from an authorized medical entity within the hospital/facility,
wherein each of the privileges for each medical specialty is matched to one or more of said medical billing codes related to each said privilege to measure the performance level of each said privilege to be used in assessing whether individual ones of said healthcare workers have reached the performance level required to be granted or have renewed one or more of said special privileges.

### Claim 9 (depends on 8)

The database of claim 8, wherein the at least one medical billing code comprises at least one International Classification of Diseases (ICD) code.

### Claim 10 (depends on 8)

The database of claim 8, wherein the at least one medical billing code comprises at least one Current Procedural Terminology (CPT) code.