Claims analytics engine

US8762180B2 · kind B2 · utility

Assignee

• ACCENTURE GLOBAL SERVICES LIMITED · IE

Inventors

• Rayid Ghani · Chicago, US
• Leana Rachelle Wallace · San Francisco, US
• Michael S Irish · San Francisco, US
• Ajay Kurian Easo · Chicago, US
• Mohit Kumar · Supaul, IN
• Zhu-Song Mei · Chicago, US
• Dmitriy Feferman · Chicago, US
• Nicholas Francisco Howell · San Marino, US
• Lindsey J. Lizardi · State College, US
• Laura J Jantzen · Greenwood Village, US

Key dates

• Filing date: Aug 25, 2009
• Grant date: Jun 24, 2014
• Expiry date: Feb 18, 2030

Classification

• Technology area (CPC G): Physics
• CPC primary: G06Q10/10
• WIPO field: IT methods for management
• WIPO sector: Electrical engineering

Abstract

Methods and systems for processing claims (e.g., healthcare insurance claims) are described. For example, prior to payment of an unpaid claim, a prediction is made as to whether or not an attribute specified in the claim is correct. Depending on the prediction results, the claim can be flagged for an audit. Feedback from the audit can be used to update the prediction models in order to refine the accuracy of those models.