Sequencing models of healthcare related states

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

Reexamination Certificate

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C705S003000

Reexamination Certificate

active

10076961

ABSTRACT:
Transition probability sequencing models and metrics are derived from healthcare claims data to identify potentially fraudulent or abusive practices, providers, doctors, clients, or other entities. Healthcare reimbursement claims from hospitals, skilled nursing facilities, doctors, etc., are processed to identify sequences of states, and transition probability metrics are determined from frequency information pertaining to the states. The metrics can these be further analyzed in predictive or rule based models, or other tools.

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