| 摘要 |
A computer system for processing data related to medical insurance has a communications device in communication with a network; a data storage device in communication with the communications device; and a processor in communication with the communications device and the data storage device. The processor is configured to receive, via the communications device, from a first source data indicative of medical provider claims, from a second source data indicative of insurance payments, and from a third source data indicative of medical provider data; identify common information items in said data from said first, second and third sources; and store the received data, in a data storage device, in a database, wherein said data from said first, second and third sources is cross-referenced with regard to said common information items. |
| 主权项 |
1. A computer-implemented method for processing data related to medical insurance, comprising:
receiving by a processor from a first source data indicative of medical provider claims submitted to insurance providers, including claim number data, injury type data and provider identification data, from a second source data indicative of insurance payments made by insurance providers to medical providers, including bill control number, procedure code and provider identification data, and from a third source data indicative of medical provider data, including provider identification data; identifying by the processor common information items, comprising at least provider identification data, in said data from said first, second and third sources; storing by the processor the received data in a data storage device in an intermediate database, wherein said data from said first, second and third sources is cross-referenced with regard to at least said provider identification data of said common information items; determining by the processor, based on data from at least two of said first, second and third sources, at least one data item not contained in any of said data from said first, second and third sources; and storing by the processor the determined at least one data item in the intermediate database. |
