Systems and methods for restructuring price records while preserving statistical distributions

A server system, comprising:

• a processor, and
• a memory unit comprising machine-readable instructions, the machine-readable instructions when executed by the processor, cause the server system to at least:
• receive claims data from one or more data sources;
• and
• generate a plurality of statistical price records from the claims data to generate a set of first recommended price records, wherein the set of first recommended price records are generated by:
• grouping the plurality of statistical price records into a plurality of first record groups according to a composite group matching key, wherein the composite group matching key for a first record group is generated by combining one or more identifiers associated with each statistical price record within the corresponding first record group;
• selecting, for each first record group, a calculation method based on the composite group matching key;
• and
• applying the selected calculation method to records within the corresponding first record group to generate the set of first recommended price records from the plurality of statistical price records;
• receive Machine-Readable Files (MRFs) and other pricing arrangements from the one or more data sources, and
• generate a plurality of direct price records from the MRFs and the other pricing arrangements to generate a set of second recommended price records, wherein the set of second recommended price records are generated by:
• grouping the plurality of direct price records into a plurality of second record groups according to a composite group matching key, wherein the composite group matching key for a second record group is generated by combining one or more identifiers associated with each direct price record within the corresponding second record group;
• selecting, for each second record group, a calculation method based on the composite group matching key;
• and
• applying the selected calculation method independently to the records within the corresponding second record group to generate the set of second recommended price records from the plurality of direct price records;
• receive one or more of payor rate overrides and provider rate overrides from one or more respective devices associated with one or more of a payor and a provider, respectively;
• and
• generate universally acceptable price records based on the set of first recommended price records, the set of second recommended price records, the payor rate overrides, and the provider rate overrides.