Adjudicating and reimbursing care providers
AssigneeCerner Innovation, Inc.
InventorNeal L. Patterson
Life of this patent
Estimating the term…
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AssigneeCerner Innovation, Inc.
InventorNeal L. Patterson
Estimating the term…
A method for adjudicating and reimbursing a care provider for services provided for a clinical event is provided. The method includes referencing a transaction including a number of clinical event details electronically documented by a care provider at a point of care for a clinical event for which reimbursement is sought. A first knowledge base comprising a number of quality criterion for assessing quality of health care provided to patients is accessed. Quality criterion are selected based on the clinical event details, and an analysis of the clinical event details against the selected quality criterion is performed to determine the quality of health care provided to a patient. A level of reimbursement is determined based on the quality of health care provided to the patient using electronic health record data elements associated with the patient and using corresponding clinical event details electronically documented by the care provider at the point of care for the clinical event for which reimbursement is sought. The provider is reimbursed in real-time.
A method in a computing environment for adjudicating and reimbursing care providers for services provided for clinical events, comprising:
One or more computer-readable storage media having computer-useable instructions embodied thereon for adjudicating and reimbursing care providers for services provided for clinical events, comprising:
Dependencies are inferred from the claim text.