Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management
Reexamination Certificate
2011-07-12
2011-07-12
Le, Linh Michelle (Department: 3686)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Health care management
C705S002000, C705S004000, C600S300000
Reexamination Certificate
active
07979290
ABSTRACT:
A computer-implemented method for profiling medical claims to assist health care managers in determining the cost-efficiency and service quality of health care providers. The method allows an objective means for measuring and quantifying health care services. An episode treatment group (ETG) is a patient classification unit, which defines groups that are clinically homogenous (similar cause of illness and treatment) and statistically stable. The ETG grouper methodology uses service or segment-level claim data as input data and assigns each service to the appropriate episode. The program identifies concurrent and recurrent episodes, flags records, creates new groupings, shifts groupings for changed conditions, selects the most recent claims, resets windows, makes a determination if the provider is an independent lab and continues to collect information until an absence of treatment is detected.
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Dorsey & Whitney LLP
Ingenix Inc.
Le Linh Michelle
Padmanabhan Devan
LandOfFree
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