发明名称 |
Method and apparatus for repricing a reimbursement claim against a contract |
摘要 |
A method for repricing a reimbursement claim under at least one contract is provided herein. The method may include a combination of steps such as: converting each contract into a series of contractual terms; converting a claim into a series of claim lines, containing claim codes, unit numbers and corresponding charges for the claim codes; comparing claim codes and contractual terms and identifying matches therebetween; determining any priority conditions associated to the matching contractual terms, and eliminate any matching contractual terms that are excluded by the priority conditions; calculating the reimbursement amount for the claim by determining the reimbursement charges for the non-excluded matching contractual terms; and determining and making any adjustments depending upon any discount terms for the entire reimbursement amount.
|
申请公布号 |
US8407071(B2) |
申请公布日期 |
2013.03.26 |
申请号 |
US201213352960 |
申请日期 |
2012.01.18 |
申请人 |
LESSWING MARK;HOERLE DALE;THE TRIZETTO GROUP, INC. |
发明人 |
LESSWING MARK;HOERLE DALE |
分类号 |
G06Q40/08;G06Q10/00 |
主分类号 |
G06Q40/08 |
代理机构 |
|
代理人 |
|
主权项 |
|
地址 |
|