METHOD FOR HIGH-RISK MEMBER IDENTIFICATION

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United States of America Patent

SERIAL NO

12581490

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Abstract

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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.

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Patent Owner(s)

Patent OwnerAddress
OPTUMINSIGHT INC12125 TECHNOLOGY DRIVE EDEN PRAIRIE MN 55344

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Inventor(s)

Inventor Name Address # of filed Patents Total Citations
Georgiou, Archelle Eden Prairie, US 5 22
Lutgen, Gerald L St. Paul, US 3 50
Prasad, Badri N Richfield, US 4 69

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