Systems and Methods for Assessment of Billing Practices of Medical Provides

摘要

Embodiments of the current disclosure provide computerized systems and methods for assessing the billing practices of medical providers, which include steps of: (a) receiving data indicative of a user selection of a medical provider for assessment; (b) accessing from a database statistical data representing, for each of a plurality of potential excess fee categories, a percentage of the selected medical provider's bills that have been determined to be excessive or not excessive in the category; (c) for each category, comparing the percentage against a distribution of percentages from other medical providers to determine a grade value for the selected medical provider in that category; (d) for each category, multiplying the grade factor against a weight factor to produce a category value for that category; (e) summing all of the category values to produce an overall value; and (f) calculating an overall grade for the selected medical provider based upon a ratio of the overall value produced for the selected medical provider versus a maximum overall value available.

主权项

1. One or more non-transitory computer readable memory devices comprising computer instructions for directing one or more computer processors to perform a method for assessing the billing practices of medical providers, the method including steps of:
receiving data indicative of a user's selection of a medical provider for assessment; accessing from a database statistical data representing, for each of a plurality of potential excess fee categories, a percentage of the selected medical provider's bills that have been determined to be excessive or not excessive in the category; for each category, comparing the percentage against a distribution of percentages from other medical providers to determine a grade value for the selected medical provider in that category; for each category, multiplying the grade value against a weight factor to produce a category value for that category; summing all of the category values to produce an overall value; calculating an overall grade for the selected medical provider based upon a ratio of the overall value produced for the selected medical provider versus a maximum overall value available.