METHODS AND SYSTEMS FOR COMPARING AND MATCHING MEDICAL TREATMENT VERSUS DIAGNOSIS AND/OR OTHER INDICATORS RELATED TO MEDICAL TREATMENT AND/OR DIAGNOSIS

摘要

An audit system may audit a medical treatment. The audit system may receive data describing a transaction comprising one or more diagnoses and one or more treatments. The audit system may audit the transaction to identify a treatment within the one or more treatments that does not correspond to any of the one or more diagnoses. The audit system may generate an anomaly report for the identified treatment. The audit system may provide the anomaly report to a treatment fulfillment system prior to fulfillment of the treatment, thereby preventing fulfillment of the treatment and/or changing an entity billed for the treatment.

主权项

1. A method of auditing a medical treatment comprising:
receiving, at an audit system, data describing a transaction comprising one or more diagnoses and one or more treatments; auditing, with the audit system, the transaction to identify a treatment within the one or more treatments that does not correspond to any of the one or more diagnoses; generating, with the audit system, an anomaly report for the identified treatment; and providing, with the audit system, the anomaly report to a treatment fulfillment system prior to fulfillment of the treatment, thereby preventing fulfillment of the treatment and/or changing an entity billed for the treatment.