Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management
Reexamination Certificate
2000-12-08
2009-12-29
O'Connor, Gerald J. (Department: 3686)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Health care management
C705S004000
Reexamination Certificate
active
07640175
ABSTRACT:
A method for using claims data to identify high-risk members of a healthcare plan is disclosed. In one embodiment, the present invention includes searching the plurality of claims of members selected by a filtering criteria to identify the presence of an intervention flag, to identify factors influencing care intervention, and identifying a medical episode driving the member's cost. In one embodiment, the intervention flag the medical episode are displayed in association with an identification of the member. In another embodiment, the member selection criteria includes selection based on the member's predicted future health care utilization.
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Georgiou Archelle
Lutgen Gerald L.
Prasad Badri N.
Dorsey & Whitney LLP
Ingenix Inc.
Luedke Adriana S.
O'Connor Gerald J.
Pass Natalie A.
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