AUTOMATED CLAIMS PROCESS MANAGEMENT SYSTEM

摘要

Health care claims are managed and processed automatically. Data related to a plurality of health care claims is stored on a computer readable medium. The health care claims are retrieved from the computer readable medium, and each of the plurality of health care claims is assigned a type indicator with the processor from a set of type indicators that characterizes a health care service associated with each health care claim. The plurality of health care claims is then grouped based on the type indicator assigned to each of the health care claims. A programmed set of pricing rules is applied to the grouped plurality of health care claims to price each of the health care claims. The programmed set of pricing rules is derived from pricing standards for one or more health insurance systems.