Benefit Plan Management System with Automated Code Parsing
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Solution Overview
Problem
Current benefit management systems face challenges such as high costs, error-prone manual processes, lack of end-to-end traceability, and difficulty in identifying cross-dependencies among benefit plan components, leading to inefficient management and compliance issues.
Innovation Solution
The system employs automated code parsing techniques to identify benefit plan components and their cross-dependencies, generating a benefit plan file with metadata that enables canonical and customized searches, impact reports, and end-to-end traceability, reducing manual errors and enhancing audit readiness.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If manual techniques (spreadsheets, emails, handwritten notes) are used to capture and manage benefits, then flexibility and ease of operation are maintained, but error rate increases and reliability decreases
Solution Approach 1:
The patent replaces manual mechanical processes (spreadsheets, emails, handwritten notes) with an automated computer-based system that parses source data and generates benefit plan files automatically. This substitution eliminates manual errors while maintaining operational flexibility through programmable processes.
Solution Approach 2:
The system performs self-service by automatically parsing source data, identifying benefit plan components, generating benefit plan files, and performing impact analysis without requiring manual intervention. The automated code parsing and metadata generation occur autonomously, reducing human error while maintaining ease of use.
2Device complexity
If traditional benefit management systems are used, then implementation simplicity is maintained, but traceability and documentation quality deteriorate
Solution Approach 1:
The system performs preliminary actions by automatically generating comprehensive metadata and documentation during the benefit plan file generation process. Impact analysis is performed in advance to identify potential issues before claims adjudication, ensuring complete traceability without adding complexity to the final system.
Solution Approach 2:
The patent introduces metadata as an intermediary layer between the source data and the benefit plan implementation. This metadata layer captures cross-dependencies, relationships, and traceability information without complicating the core benefit management system, enabling comprehensive documentation while maintaining implementation simplicity.
3Reliability
If automated code parsing and metadata generation are implemented, then traceability and reliability improve, but system complexity increases
Solution Approach 1:
The patent segments the benefit management system into distinct functional modules: source data parsing, benefit plan component identification, metadata generation, benefit plan file creation, and impact analysis. This segmentation improves reliability through specialized processing while managing complexity through modular design, where each segment handles a specific task independently.
4Loss of energy
If manual processes are used for benefit management, then implementation cost is reduced, but productivity and efficiency deteriorate
Solution Approach 1:
The automated system enables continuous processing of benefit plan data without the interruptions inherent in manual processes. The system continuously parses source data, generates metadata, creates benefit plan files, and performs impact analysis in an uninterrupted workflow, significantly improving productivity while the automation efficiency reduces operational costs over time.
Data Source
AI summary
A system for providing end-to-end traceable benefit plans. An intake engine is configured to generate, from input source data, a plurality of benefit plan components having one or more cross-dependencies with respect to each other, wherein the benefit plan components include: data structures reflecting benefit plan aspects and associated rules for implementation with respect to the benefit plan. An assembly module is configured to assemble a benefit plan file from the benefit plan components, the benefit plan file associating benefit components with and across workflows and systems. A claims processing IT environment is configured to load the benefit plan file, and to process claims in accordance with the benefit plan file.