44 results about "Risk adjustment" patented technology

The Automated Healthcare Risk Management System is a real-time Software as a Service application which interfaces and assists investigators, law enforcement and risk management analysts by focusing their efforts on the highest risk and highest value healthcare payments. The system's Risk Management design utilizes real-time Predictive Models, a Provider Cost Index, Edit Analytics, Strategy Management, a Managed Learning Environment, Contact Management, Forensic GUI, Case Management and Reporting System for individually targeting, identifying and preventing fraud, abuse, waste and errors prior to payment. The Automated Healthcare Risk Management System analyzes hundreds of millions of transactions and automatically takes actions such as declining or queuing a suspect payment. Claim payment risk is optimally prioritized through a Managed Learning environment, from high risk to low risk for efficient resolution by investigators.

A user may be identified and authenticated to an institution system and may adjust the annual miles driven estimate for their vehicle. The annual miles driven estimate is used in the determination of the premium for the vehicle insurance for the vehicle. The premium for the vehicle insurance may be revised based on the adjustment by the user to the annual miles driven estimate. In an implementation, the user may reduce the annual miles driven estimate to zero to indicate that they are not driving the vehicle. The user may keep some elements of the vehicle insurance coverage and the vehicle insurance policy may remain active although the annual miles driven estimate is zero.

A method and system for providing a standardization and commoditizing the process of technology contracts and creating method for assessing, scoring, ranking and rating technology vendors for the purpose of comparing vendor bids on a project and for structuring and pricing insurance/surety contracts. Intrinsic and two-way vendor ratings are established for each of the vendors in a particular project. This two-way rating is used to provide a risk adjustment to the nominal bid of each of the vendors. The two-way rating is also utilized to structure and calculate an insurance premium based upon the probability that the vendor would fail/default on the delivery of a technology project.

A system and method for providing optimization of a financial portfolio using a parametric leptokurtic distribution is presented. One or more risk factors associated with a plurality of financial assets maintained in a portfolio and applicable over at least one time horizon are provided. A subordinated parametric distribution model having leptokurtic behaviors is specified for the risk factors with a measurement of risk expressed as a function of expected tail loss for a significance level or quantile. The subordinated distribution model is applied at each such time horizon to determine a distribution of the risk factors for the financial assets. Portfolio weights providing a substantially maximum risk adjusted return for the portfolio are determined.

The present invention provides systems and methods for risk-adjusted performance analysis for a specific healthcare test, market or opportunity by evaluating patient outcomes against a real-time benchmark portfolio of patient outcomes. The risk-adjusted performance measures are based on financial methods such as CAPM, single-index model and arbitrage pricing theory methods. In place of examining the financial returns for a portfolio of companies against a financial benchmark, the outcomes for a patient or a portfolio of patients is compared to a benchmark portfolio of patient outcomes. The risk-adjusted performance measures including the Sharpe's measure, Treynor's measure, Jensen's measure and similar analysis tools are then used to compare different healthcare groups. The method has utility in many areas of healthcare including management of healthcare facilities, providing insurance reimbursement to a healthcare facility (e.g., “pay-for-performance”), making investment decisions in the healthcare marketplace and developing dynamic prognostic dynamic medical tests.

A vehicle control device basically includes a first risk computation unit, a second risk computing unit and a first risk adjustment unit. The first risk computation unit calculates a first risk with respect to a nearby obstacle located in a nearby detection region near a host vehicle. The second risk computing unit calculates a second risk with respect to a remote obstacle located further from the nearby detection region. The first risk adjustment unit adjusts at least one of the first and the second risks to preferentially execute a warning or vehicle control based on one of the first risk or the second risk versus a warning or vehicle control based on the other of the first risk or the second risk based on an entry state of the host vehicle of entering a planned parking place, or an exit state of the host vehicle of exiting from a parking place.

An automated, real-time mortality classification and signaling system for real-time risk assessment, and adjustment based on an automated selective multi-level triage process, where risks associated with a plurality of risk-exposed individuals are at least partially transferable from a risk-exposed individual to a first insurance system and from the first insurance system to an associated second insurance system, the real-time mortality classification and signaling system accesses a database stored in a memory to retrieve risk classes, identifies and selects a specific risk class associated with the risk of the exposed individual, processes specific parameters of the exposed individual using a machine learning-based pattern recognition to automatically assign risk-exposed individuals with detected non-smoking patterns to a second triage channel, and automatically assigning risk-exposed individuals with detected smoking patterns to a third triage channel as predicted smokers. Based on the classified risk, the system provides an alert notification to a third-party system.

The invention, which relates to the technical field of financial data analysis, provides a fund evaluation method and device. The method comprises: a value assessment table of a target fund is obtained; information of first parameters of the target fund is read from the value assessment table and second parameters are calculated based on the first parameters, wherein the second parameters includean annual yield, a scanning statistic value, a winning percentage, a Sharpe ratio, a Calmar ratio, a Sortino ratio, a volatility value, a maximum withdrawing rate, and CVaR; according to the second parameters, ranks of all third parameters are determined, wherein the third parameters include an earning power value, a performance persistence value, a risk adjustment performance value, and a risk control ability value, all rank values are corresponding parameter values; and on the basis of the third parameters, a capability radar chart and/or comprehensive capability value of the target fund are/is obtained. According to the fund evaluation method, attributions of risk sources and earning sources of the equity bulls and stock index future hedging ends in the relative value strategy are analyzed in details; and a complete, comprehensive and reliable fund performance attribution report is provided.

Technologies for identifying coding/care gaps of an insurance claim include a computing device configured to receive an insurance claim from a healthcare provider, create a claim encounter reconciliation data pack (CERDP) based on the received insurance claim, and analyze the CERDP to identify whether any coding/care gaps exist in the received insurance claim. Upon determining any coding/care gaps, the computing device is additionally configured to provide an interface to the healthcare provider usable to view and resolve the identified coding/care gaps. The computing device is further configured to receive updated claim information as a function of the resolution of the identified coding/care gaps and transmit a related insurance claim to a corresponding health plan. Other embodiments are described herein.

The invention provides a bank debt risk detection system based on WEB. The system comprises: a WEB client-side unit used to input the debt data information which at least includes the customer code through a WEB page as well as generate and send a detection request; a risk exposure detection unit used to calculate the debt risk exposure according to the debt data information; an expected recovery amount detection unit used to calculate the total of the expected recovery amount of the debt; a risk coefficient detection unit used to calculate the debt risk coefficient; an expected recovery rate detection unit used to calculate the expected recovery rate of the debt according to the debt risk exposure, the total of the expected recovery amount of the debt and the debt risk coefficient, wherein, the debt expected recovery rate is equal to (the total of the expected recovery amount of the debt/the debt risk exposure) x the debt risk adjustment coefficient; a breach loss rate detection unit used to calculate the debt breach loss rate according to the debt expected recovery rate further to detect the bank debt risk. The bank debt risk detection system and the bank debt risk detection method based on WEB of the invention can quantitatively control the credit risk of the bank to reduce loss and avoid risk.

The present invention is a system and method for providing improved functionality for management of derivative instruments. The improved system includes functionality implementing single interest rate sale sessions initiated either as a result of market conditions or a user request, risk adjustment sales to allow users to balance portfolio risks, consolidated sweeps to more efficiently allow a user to manage an investment swap portfolio, and credit limit clearance functionality to improve the management of credit limits associated with users and clearance facilities.

The invention discloses a performance evaluation method for open-ended funds based on principal component analysis, which mainly includes selection of sample data, selection and processing of relevantvariables in the model and statistical analysis of the sample data, wherein the selection of sample data includes selection of sample funds, selection of a sample period and determination of a samplerate-of-return frequency and a data source, the selection and processing of relevant variables in the model mainly includes the risk-free interest rate and the market portfolio rate of return, the statistical analysis of the sample data includes fund return and risk analysis, relative return analysis after risk adjustment, fund manager management ability analysis and principal component analysis,and the principal component analysis method aims to convert multiple indexes into a few of comprehensive indexes by using the idea of dimension reduction. The performance evaluation method reduces multiple indexes into a few of principal components by adopting the principal component analysis method so as to evaluate the fund performance more reasonably.

Systems and methods have been developed that provide for the examination of data available on members of a Plan and based on the examined data, and on each reported ailment for a member, a determination is made as to the risk level such member presents to the Plan. This risk level is a measure of how likely it is that an assigned ailment identified from a claim will be found to be in error during an official CMS audit of member medical records for a particular year. The examination is made without necessarily reviewing actual physician's charts.

The invention discloses a regional hospital and subject ranking method based on disease risk adjustment. The method comprises the following steps of determining an individual performance indicator inperformance evaluation; dividing the individual performance indicator into an absolute value indicator and a relative value indicator; calculating and quantizing the absolute value indicator and the relative value indicator into scores according to different calculation methods; and acquiring the quantitative score of each individual performance indicator and ranking. By using a medical performance evaluation method, the key indicators of the various processes before, during and after disease treatment are fully considered, a clinical work ability and treatment result comparison and the like are comprehensively and integrally evaluated, and the impartiality and the fairness of an assessment result are effectively increased through an assessment after risk adjusting.

The invention discloses a credit line measuring and calculating method and equipment and a medium. The scheme comprises the following steps: determining a default rate of an enterprise, and constructing a first function; incorporating the first function into a risk adjustment capital return rate model to obtain a first credit line enabling a risk adjustment capital return rate of a commercial bank to be maximum under a preset condition; obtaining modeling indexes related to a preset general scoring model, performing data cleaning, feature screening and model training on sample features corresponding to the modeling indexes, and determining a performance prediction probability of the general scoring model; converting the performance prediction probability of the general scoring model into a scoring rating result of the enterprise, and determining a second credit line of the enterprise according to the scoring rating result of the enterprise and a credit rating amplification coefficient of the enterprise; and comparing and analyzing the first credit line and the second credit line based on credit restrictive conditions to obtain a comparison and analysis result, and determining a credit line of the enterprise according to the comparison and analysis result.

Techniques are provided for receiving a first set of historical agricultural data and a second set of historical agricultural data; generating a plurality of projected target yield ranges using the first set and the second set of historical agricultural data by generating a historic yield distribution; generating one or more yield ranking scores for one or more fields of a grower using the first set of historical agricultural data, and assigning a projected target yield range of the plurality of projected target yield ranges to each of the one or more fields based on the one or more yield ranking scores to generate assigned projected target yield ranges; receiving a third set of historical agricultural data comprising seed optimization data, and generating a recommended change in seed population or a recommended change in seed density; causing displaying the yield improvement recommendation for each of the one or more fields.

The invention provides a calculation method of the risk value compensation coefficient in overseas oil and gas asset evaluation. The calculation method comprises the following steps: calculating the average return rate of the oil and gas industry; calculating the national risk adjustment factors; calculating the project risk adjustment factors; calculating the rate of return on exchange risk; calculating the contribution rate of technological progress; and calculating the risk value compensation coefficient in overseas oil and gas asset evaluation based on the average return of the oil and gasindustry, the national risk adjustment factor, the project risk adjustment factor, the rate of return on exchange risk and the contribution rate of technological progress. According to the method, all kinds of risks are quantified so as to provide a reliable basis for overseas oil and gas asset acquisition.