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Method and apparatus for analyzing patient medical records

a patient medical record and analysis method technology, applied in the field of methods and apparatus for analyzing patient medical records, can solve the problems of unproductive approach, high complexity of services, and complicated rules or regulations governing the billing of health insurers and other organizations, such as medicare and medicaid

Inactive Publication Date: 2013-02-14
NUANCE COMM INC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0013]In view of the above disadvantages of the prior art, it is an objective of the present invention to provide an easy, simple, and user-friendly method and apparatus of generating billing codes.
[0015]Yet another objective is to provide a method and apparatus that is flexible so that it can be modified quickly and easily to records having new and unusual formats.

Problems solved by technology

In most instances the rules or regulations governing billing of health insurers and other organizations, such as Medicare and Medicaid, are very complicated, and they are related to the level of complexity of the services provided for each component of the report.
This approach is not very productive because, if the wrong code is used, the amount paid by the insurance organization is either too high, and the clinician may be liable for a penalty, or too low, and therefore unprofitable.
This approach is expensive, and since the personnel has no medical training, mistakes can be made anyway.
However, these programs are always menu or template driven and require a long time to fill out, time that the clinician does not have.
Finally, the programs are very complicated and require long and intensive training periods.

Method used

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  • Method and apparatus for analyzing patient medical records
  • Method and apparatus for analyzing patient medical records
  • Method and apparatus for analyzing patient medical records

Examples

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Embodiment Construction

[0023]FIG. 1 shows a form used by a clinician to document an encounter with a patient. For the sake of simplicity, the form has been abbreviated, it being understood that in actuality, more comprehensive forms are used. As promulgated by the AMA, a typical encounter between a clinician and a patient consists of three phases: establishing the history, performing an examination and making a medical decision. The purpose of the form shown in FIG. 1 is to enable the clinician to capture information associated with each of these phases, thereby generating the record for the encounter. Once this record has been completed, it can be stored for future review, disseminated to other clinician as necessary, used to generate a billing code, etc. The regulations promulgated by the CMS and other organizations, require that the billing codes be related to each phase of the record generating process, as described in detail below.

[0024]Therefore, the form of FIG. 1 is considered to have four areas; ...

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PUM

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Abstract

A medical form is marked by a clinician during a patient / clinician encounter to generate a record with information related to a current complaint. The form is partitioned into several regions related to patient history, examination and medical decision, respectively. The form is automatically analyzed and using the locations of the marks on the form and a predetermined set of rules, a billing code is generated. The billing code determines the fee to be paid to the clinician or health provider.

Description

RELATED APPLICATIONS[0001]NoneBACKGROUND OF THE INVENTION[0002]a. Field of Invention[0003]This invention pertains to a method and apparatus for reviewing, preferably automatically, patient medical records, and to generate a characteristic code for each record that is related to the health of the patient and to medical services provided by a clinician for the patient during a particular encounter. The method and apparatus is particularly useful for generating codes for generating bills to the patient or for a third party, such as a governmental or private health insurance organization.[0004]b. Description of the Prior Art[0005]In this application, the term ‘encounter’ is used to refer to any event between a patient and a clinician associated with the health of a patient. Thus, an encounter may occur at a clinician's office, in the emergency room of a hospital, at a normal bed in the hospital, in an ICU unit, etc. It is well established that any encounter must be memorialized in a cor...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): G06Q50/24G06F19/00G06Q40/02G06Q50/22G16H10/60
CPCG06F19/322G06F19/328G06Q50/22G06Q40/02G06F19/363G06Q10/10G16H10/20G16H10/60G16H15/00
Inventor GOTTLIEB, MEIRGOTTLIEB, SHELDON H.WEISE, GABRIEL
Owner NUANCE COMM INC
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