Method, apparatus, and computer program product for using machine learning to encode a healthcare claim as a predefined sized vector
US11437137B1 · kind B1 · utility
Assignee
Inventor
Key dates
| Filing date | Jul 18, 2019 |
| Grant date | Sep 6, 2022 |
| Priority date | — |
| Expiry date | Nov 25, 2040 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG16H10/60
- WIPO fieldMedical technology
- WIPO sectorInstruments
Abstract
A method, apparatus and computer program product are provided for generating a predefined sized vector representative of a healthcare claim including a variable number of service lines. A neural network is trained to identify hierarchical relationships between claim lines and services lines and to represent the relationships in the predefined sized vector. The predefined sized vector may be used to make predictions regarding adjudication, such as probability of denial (claim-level or service-level), days to pay, probability of being paid as a diagnosis related group (DRG), allowed amount, and/or denial reason. Predictions may also be made from the predefined sized vector relating to the likelihood and/or identification of missing procedure codes.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.