Methods for generating healthcare provider quality and cost rating data
US8069080B2 · kind B2 · utility
Assignee
Inventor
Key dates
| Filing date | Nov 14, 2007 |
| Grant date | Nov 29, 2011 |
| Priority date | — |
| Expiry date | Dec 22, 2028 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG06Q30/0282
- WIPO fieldIT methods for management
- WIPO sectorElectrical engineering
Abstract
A method for generating healthcare provider quality rating data includes grouping claim records into one or more claim groups, assigning each claim group to a responsible provider, assessing the claim records in each claim group using guidelines for the particular disease or condition, and generating a compliance score for the claim group, wherein the compliance score indicates the extent to which the claim records in the claim group match the guidelines, and generating normalized provider quality rating data. A method for generating healthcare provider cost rating data includes grouping claim records into one or more claim groups, assigning each claim group to a responsible provider, calculating the total cost of each claim group, aggregating the total cost for each claim group, and comparing the total aggregate cost of each claim group assigned to each provider to an expected cost value.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.