Systems and methods for recovery audit scope determination

Details Systems and methods for recovery audit scope determination Systems and methods for recovery audit scope determination

2006-10-10

2006-10-10

Wassum, Luke S. (Department: 2167)

Data processing: database and file management or data structures

Database design

Data structure types

C705S035000

Reexamination Certificate

active

07120649

ABSTRACT:
The present invention enables the determination of what claim types can be written based on a client data set(s). The reverse is also true where the present invention provides the capability to determine what data sets are required to write different claim categories and types. In an illustrative embodiment, the determination of the scope of an audit in accordance with the present invention includes the determination of the claim types that can be written given a certain client data elements and/or the determination of the data elements needed to write certain claim types, both of which are based on the predefined relationships between claim types and data elements. Possible claim types can also be determined based on the client data set(s) and a permissible number of missing client data fields.

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