System and method for intelligent management of medical care

Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management

Reexamination Certificate

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Reexamination Certificate

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07979289

ABSTRACT:
A computerized medical care system provides validation of a diagnosis of a medical condition and requested medical services for treating the medical condition. The medial care system invokes multiple filters to determine the appropriateness of the diagnosis and medical service. Real time feedback is provided based on the determination. If the medical care cannot be validated, the feedback includes the reasons for the failure to validate, and any supporting materials for the lack of validation. The feedback may also prompt the requesting entity to provide additional information to help support the medical provider's position as to why the requested medical care is appropriate.

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HCFA 1500 Health Claim Form.

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