SYSTEM FOR ANALYZING PATIENT OUT-OF-NETWORK UTILIZATION AND IMPROVING RETENTION

摘要

A patient out-of-network utilization analysis and reporting system includes: an out-of-network utilization analysis server, configured to access one or more databases to obtain healthcare claims information, to generate out-of-network utilization analysis information corresponding to identification of potential sources of patient out-of-network utilization based on the obtained healthcare claims information, and to the send out-of-network utilization analysis information to a client computing device, wherein the healthcare claims information includes procedure-related information and/or physician attribution information; and the client computing device, configured to receive out-of-network utilization analysis information via a network from a server and to display the out-of-network utilization analysis information to a user of the client computing device.

主权项

1. A device for reporting patient out-of-network utilization, comprising:
a non-transitory computer-readable medium having processor-executable instructions stored thereon; a processor, configured, based on execution of the processor-executable instructions, to receive patient healthcare utilization information from an out-of-network utilization analysis system and to facilitate presentation of a graphical user interface (GUI) for reporting the patient out-of-network utilization information to a user; a display, configured to present the GUI for reporting the patient out-of-network utilization to the user, wherein presenting the GUI to the user includes:
displaying, in a first portion of the GUI, a geographic map; anddisplaying, in the first portion of the GUI, an overlay of utilization information on the geographic map, wherein the overlay includes individual display elements joined by connections between the joined individual display elements indicating that respective medical care providers corresponding to the joined individual display elements are part of a same provider network, and wherein the overlay further includes standalone individual display elements without connections to other individual display elements indicating that the standalone individual display elements correspond to out-of-network medical care providers; wherein a size associated with each individual display element corresponds to a magnitude of services associated with a respective medical care provider.