System, method and computer program product for estimating...

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

08005687

ABSTRACT:
Various embodiments for estimating a cost of a medical procedure. In one example, a method may include the operations of averaging data from various geographies of the amount billed to form a national average amount billed for the medical procedure; associating the average amount billed with one or more claim data items from a health plan; grouping the claim data items from the health plan using episode classes; calculating an average amount billed for each episode class; and adjusting the average amount billed for each episode class by a geographic adjustment factor to form an estimated cost of the medical procedure.

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patent: 5915241 (1999-06-01), Giannini
patent: 6061657 (2000-05-01), Whiting-O'Keefe
patent: 7505916 (2009-03-01), Adrian et al.
patent: 2002/0147617 (2002-10-01), Schoenbaum et al.
AHRQ (Agency for Healthcare Research and Quality), Ambulatory Surgery in U.S. Hospitals, 2003, www.ahrq.gov, www.ahrq.gov/data/hcup/factbk9/factbk9e.htm.

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