Device for approving medical tests across a plurality of medical laboratories, medical providers, and lab payers and methods for using the same
AssigneeOptum, Inc.
InventorsJohn L. WILSON, François CHARETTE
Life of this patent
Estimating the term…
Abstract
Provided is a lab clearinghouse device configured to efficiently and effectively approve medical tests across a plurality of medical laboratories, medical providers, and lab payers. The lab clearinghouse device is configured to communicate with a plurality of medical laboratories, medical providers, and lab payers to efficiently and effectively approve, direct, and manage medical tests.
Claims20
A device for approving medical tests across a plurality of medical providers, a plurality of lab payers, and a plurality of laboratories, the device comprising a processor and a memory storing computer instructions that, when executed by the processor, cause the device to:
- receive a lab request from a lab request initiator, the lab request initiator being associated with at least one medical provider of the plurality of medical providers, wherein the lab request comprises an order for one or more medical tests to be performed;
- evaluate the lab request, wherein evaluating the lab request comprises determining the appropriateness of the lab request by comparing patient data, physician data, provider data, lab data, payer data, or a combination thereof to the lab request;
- and
- approve or deny the lab request based on the appropriateness of the lab request,
- wherein approving the lab request comprises:
- generating lab instructions associated with the lab request for performance of the lab instructions after determining that the lab request is appropriate, and
- transmitting the lab instructions associated with the lab request to one laboratory of the plurality of medical laboratories for performance of one or more corresponding medical tests, and
- wherein denying the lab request comprises transmitting a lab request denial if the lab request is determined not to be appropriate.
A method approving medical tests across a plurality of medical laboratories, medical providers, and lab payers, the method comprising:
- receiving, by a lab management circuitry, a lab request from a lab request initiator, the lab request initiator being associated with at least one medical provider of the plurality of medical providers, wherein the lab request comprises an order for one or more medical tests to be performed;
- evaluating, by an analytical engine, the lab request, wherein evaluating the lab request comprises determining the appropriateness of the lab request by comparing patient data, physician data, provider data, lab data, payer data, or a combination thereof to the lab request;
- and
- approving or denying the lab request based on the appropriateness of the lab request,
- wherein approving the lab request comprises:
- generating, by the analytical engine, lab instructions associated with the lab request for performance of the lab instructions after determining that the lab request is appropriate, and
- transmitting, by a communications interface, the lab instructions associated with the lab request to one laboratory of the plurality of medical laboratories for performance of one or more corresponding medical tests, and
- wherein denying the lab request comprises transmitting, by the communications interface, a lab request denial if the lab request is determined not to be appropriate.
A computer program product is provided comprising a non-transitory computer readable medium having computer program instructions stored therein, said computer program instructions when executed by a processor approve medical tests across a plurality of medical providers, a plurality of lab payers, and a plurality of laboratories, by causing the computer program product to:
- receive a lab request from a lab request initiator, the lab request initiator being associated with at least one medical provider of the plurality of medical providers, wherein the lab request comprises an order for one or more medical tests to be performed;
- evaluate the lab request, wherein evaluating the lab request comprises determining the appropriateness of the lab request by comparing patient data, physician data, provider data, lab data, payer data, or a combination thereof to the lab request;
- and
- approve or deny the lab request based on the appropriateness of the lab request,
- wherein approving the lab request comprises:
- generating lab instructions associated with the lab request for performance of the lab instructions after determining that the lab request is appropriate, and
- transmitting the lab instructions associated with the lab request to one laboratory of the plurality of medical laboratories for performance of one or more corresponding medical tests, and
- wherein denying the lab request comprises transmitting a lab request denial if the lab request is determined not to be appropriate.
Dependencies are inferred from the claim text.