Healthcare claim editing system, method, and apparatus
AssigneeADP, Inc.
InventorsJames Troy Young, Travis Don De Angelis, Erin LouAnn Azar, Wendy Aiken
Life of this patent
Estimating the term…
Abstract
A medical claim processing system and method comprising generating default rules and custom rules for inspecting healthcare claims, the default rules having general application to every healthcare claim and the custom rules being created to inspect specific requirements imposed by an insurance company or imposed to a medical code; receiving claim information related to a medical service from a healthcare provider; generating healthcare claims based on the received claim information; and inspecting the medical claims according to the default rules and the custom rules.
Claims17
A healthcare claim processing method comprising:
- generating default rules and custom rules for inspecting healthcare claims, the default rules having general application to every healthcare claim and the custom rules being created to inspect specific requirements imposed by an insurance company or imposed to a medical code;
- receiving claim information related to a medical service from a healthcare provider;
- generating healthcare claims based on the received claim information;
- and
- inspecting the medical claims according to the default rules and the custom rules.
A healthcare claim processing system comprising:
- an electronic device that transmits claim information from a healthcare provider to a computerized billing service device,
- wherein the computerized billing service device includes both default and custom rules for inspecting healthcare claims, the default rules having general application to every healthcare claim and the custom rules being created to inspect specific requirements imposed by an insurance company or imposed to a medical code.
A recording medium storing a program, when executed, causing a processor to execute instructions according to a healthcare claim processing method, the healthcare processing method comprising:
- generating default rules and custom rules for inspecting healthcare claims, the default rules having general application to every healthcare claim and the custom rules being created to inspect specific requirements imposed by an insurance company or imposed to a medical code;
- receiving claim information related to a medical service from a healthcare provider;
- generating healthcare claims based on the received claim information;
- and
- inspecting the medical claims according to the default rules and the custom rules.
Dependencies are inferred from the claim text.