Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Discount or incentive
Reexamination Certificate
2007-11-14
2011-11-29
Dixon, Thomas (Department: 3684)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Discount or incentive
Reexamination Certificate
active
08069080
ABSTRACT:
A method for generating healthcare provider quality rating data includes grouping claim records into one or more claim groups, assigning each claim group to a responsible provider, assessing the claim records in each claim group using guidelines for the particular disease or condition, and generating a compliance score for the claim group, wherein the compliance score indicates the extent to which the claim records in the claim group match the guidelines, and generating normalized provider quality rating data. A method for generating healthcare provider cost rating data includes grouping claim records into one or more claim groups, assigning each claim group to a responsible provider, calculating the total cost of each claim group, aggregating the total cost for each claim group, and comparing the total aggregate cost of each claim group assigned to each provider to an expected cost value.
REFERENCES:
patent: 5544044 (1996-08-01), Leatherman
patent: 5835897 (1998-11-01), Dang
patent: 2003/0158751 (2003-08-01), Suresh et al.
patent: 2004/0111291 (2004-06-01), Dust et al.
patent: 2007/0156455 (2007-07-01), Tarino
Press Release, “Med-Vantage Innovative Patent Empowers Health Plan Members to Compare Physician Quality and Cost”, Jul. 26, 2006.
Dixon Thomas
Dorsey & Whitney LLP
Ingenix Inc.
Padmanabhan Devan V.
LandOfFree
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