| 摘要 |
A system for processing claim data related to provision of healthcare to a patient includes an interface processor for receiving data related to a claim for provision of healthcare to a particular patient and including a claim type identifier. At least one repository includes predetermined claim generation rules for use in generating a claim for submission to a payer institution. The claim generation rules are hierarchically organized to enable more frequently applied rules to be identified and applied first. The repository also includes information associating particular rules to be applied with a particular claim type. A claim processor generates a claim of a particular type for submission to a particular payer institution by applying claim generation rules derived from the repository in a predetermined priority in response to the received claim type identifier.
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