Boots – shoes – and leggings
Patent
1991-01-29
1993-10-12
Hayes, Gail O.
Boots, shoes, and leggings
364401, G06F 1521
Patent
active
052531643
ABSTRACT:
An expert computer system for processing medical claims. Medical claims and associated representation are inputted into the expert computer system. The inputted claims are interpreted according to specific rules and against a predetermined database to determine whether the medical claims are appropriate.
REFERENCES:
patent: 4658370 (1987-04-01), Erman et al.
patent: 4803641 (1989-02-01), Hardy et al.
patent: 4858121 (1989-08-01), Barber et al.
"Automated Claims Processing", Insurance Software Review, Marva J. Croaff, Autumn 1988, pp. 52, 54.
"Enhancing Accuracy and Timeliness Is Integral to the Claims Adjudication Process", Employee Benefit Plan Review, Anonymous, Dec. 1985 pp. 10-12.
"Healthstar", Health Benefits Management System, Product Description, Version 1.024.
"System validates medical fee schedules", Bests Review: Life/Health, Jun. 1987, 92.
"Expert system identifies miscoded health claims", Bests Review: Life/Health, Nov. 1990, 60.
"Claims editing software runs coding rule checks", Bests Review: Life/Health, Nov. 1990, 62.
Woolsey, C. "Employer spots inflated medical bills", Business Insurance, Jun. 25, 1990, 3.
Weitzel, J. R. et al. "A Company/University joint venture to build a knowledge-based system", MIS Quarterly, vol. 12, No. 1, Mar. 1988, 23-34.
Leary, E. "SSA applies expertise to develop expert systems". (Spotlight on AI-expert systems, Social Security Administration), Government Computer News, vol. 6, No. 17, Aug. 28, 1987, 49(3).
Beard, P. "Blue Cross develops insurance claim ES", AIWeek, vol. 6, No. 7, Apr. 1, 1989, 3.
Sullivan-Trainor, M. "Catching new clients", Computerworld, vol. 21, No. 50, Dec. 14, 1987, 95,99.
Snyeder, C. "From research to reality: the leading edge of expert systems", Insurance Software Review, vol. 12, No. 3, Autumn 1987, 22-4, 26-7, 30.
Christensen, J. "Insuring", High Technology Business, vol. 8, No. 10, Oct. 1988, 47-8.
Expert Systems in the Insurance Industry: 1987 Survey Report Update, Coopers & Lybrand, 1987.
Pallatto, J. "Expert system cures the blues". (Blue Cross develops insurance claims analysis system NERSys), PC Week, vol. 5, No. 50, Dec. 12, 1988, 35,44.
Dugan Kelli A.
Goldberg George A.
Hertenstein Robert D.
Holloway Donald C.
Hayes Gail O.
HPR, Inc.
LandOfFree
System and method for detecting fraudulent medical claims via ex does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with System and method for detecting fraudulent medical claims via ex, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and System and method for detecting fraudulent medical claims via ex will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-1910290