CLAIMS CATEGORIZATION IN A WORKFLOW
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United States of America Patent
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Issued Date -
Oct 1, 2015
app pub date -
Mar 31, 2015
filing date -
Mar 31, 2014
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Abstract
A claim is processed and categorized prior to the assignment of a claims adjuster. The probability that the total amount of medical charges submitted for a claimant within a certain period of time following the date of loss will be below a certain threshold based on a small set of input variables. The input variables and prediction may be communicated to a claims management systems via web service. The claims management system that receives the prediction may be independent of the claims categorization system itself. That is, the user interface to gain access to the claims processing described herein may be independent of the claims processing itself. The prediction is achieved with analysis models that are configured to easily accommodate changes in the input parameters for the model.
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