Method and system for generating statistically-based medical provider utilization profiles

US7774252B2 · kind B2 · utility

Assignee

• Ingenix, Inc. · US

Inventors

• Jerry G. Seare · Salt Lake City, US
• Patricia A. Smith-Wilson · North Salt Lake, US
• Kurt Van Wagoner · Centerville, US
• Jean Andrea Mattey · Westlake, US
• Eileen K. Synder · Sandy, US
• Candace C. Wahlstrom · Salt Lake City, US
• Michelle Willis · Sandy, US
• Matthew R. Bentley · West Jordan, US

Key dates

• Filing date: Aug 29, 2006
• Grant date: Aug 10, 2010
• Expiry date: Nov 24, 2027

Classification

• Technology area (CPC G): Physics
• CPC primary: G16H50/20
• WIPO field: IT methods for management
• WIPO sector: Electrical engineering

Abstract

A method and system for analyzing historical medical provider billings to statistically establish a normative utilization profile. Comparison of a medical provider's utilization profile with a normative profile is enabled. Based on historical treatment patterns and a fee schedule, an accurate model of the cost of a specific medical episode can be created. Various treatment patterns for a particular diagnosis can be compared by treatment cost and patient outcome to determine the most cost-effective treatment approach. It is also possible to identify those medical providers who provide treatment that does not fall within the statistically established treatment patterns or profiles.