Method for high-risk member identification
US7640175B1 · kind B1 · utility
Assignee
Inventors
Key dates
| Filing date | Dec 8, 2000 |
| Grant date | Dec 29, 2009 |
| Priority date | — |
| Expiry date | Nov 1, 2022 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG16H50/30
- WIPO fieldMedical technology
- WIPO sectorInstruments
Abstract
A method for using claims data to identify high-risk members of a healthcare plan is disclosed. In one embodiment, the present invention includes searching the plurality of claims of members selected by a filtering criteria to identify the presence of an intervention flag, to identify factors influencing care intervention, and identifying a medical episode driving the member's cost. In one embodiment, the intervention flag the medical episode are displayed in association with an identification of the member. In another embodiment, the member selection criteria includes selection based on the member's predicted future health care utilization.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.