Database Record Tagging for Workflow Automation
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Solution Overview
Problem
Current systems for managing transaction records in a database face delays due to data anomalies and issues with handling records, leading to inefficiencies and potential payment problems, particularly in healthcare and financial transactions, where timely processing is critical for cash flow and accuracy.
Innovation Solution
A records management and processing system that applies a set of predefined rules to transaction records, assigning tags based on conditions defined in these rules to prioritize and expedite processing, using a rules engine and workflow engine to automate and manage the handling of records, ensuring timely and accurate processing.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If manual processing methods are used for transaction records, then flexibility in handling individual cases is maintained, but processing speed and efficiency deteriorate
Solution Approach 1:
The patent segments the transaction processing system into distinct modules: a rules engine that evaluates transaction data against predefined criteria, a tagging system that categorizes transactions based on rule violations, and a workflow engine that routes tagged transactions to appropriate handling procedures. This segmentation enables automated high-speed processing of routine transactions while flagging only anomalous cases for manual review, thus improving overall processing speed without requiring complete automation of the entire system.
Solution Approach 2:
The system performs preliminary actions by pre-defining rules and tags that identify potential issues in transaction records before they reach manual processing. The rules engine proactively evaluates transactions against compliance criteria, and the tagging system pre-categorizes problematic transactions with relevant metadata, enabling workflow automation to handle them systematically. This preliminary automation reduces the burden on manual processors and accelerates overall processing throughput.
2Productivity
If automated rule-based processing is implemented, then processing efficiency improves, but the ability to handle nuanced exceptions deteriorates
Solution Approach 1:
The patent introduces tags as intermediary elements that bridge automated rule-based processing and nuanced exception handling. When the rules engine identifies a transaction violating predefined criteria, it applies descriptive tags that capture the nature and severity of the violation. These tags serve as intermediaries that preserve contextual information about the exception, enabling workflow automation to route transactions to appropriate human reviewers with full awareness of the underlying issues, thus maintaining both efficiency and adaptability.
Solution Approach 2:
The system implements dynamic adaptability through configurable rules and tags that can be modified without requiring system reconfiguration. The rules engine allows dynamic addition, modification, and prioritization of processing rules, while the tagging system enables flexible categorization of transactions based on emerging patterns. This dynamic capability allows the system to adapt to new exception types and compliance requirements while maintaining automated processing efficiency for established transaction types.
3Measurement precision
If all records are processed through detailed review, then accuracy improves, but processing time increases
Solution Approach 1:
The patent applies local quality by directing detailed review resources only to transactions that exhibit specific problematic characteristics identified by the rules engine. Rather than uniformly reviewing all transactions, the system applies tags to mark transactions with compliance issues, and the workflow engine routes only these tagged transactions to detailed human review. This selective application of review resources maintains high accuracy for problematic transactions while allowing routine transactions to proceed through faster automated channels, thus reducing overall processing time without sacrificing accuracy where needed.
Solution Approach 2:
The system implements feedback mechanisms where the outcomes of manual reviews are fed back into the rules engine to refine future processing. When human reviewers correct or override automated decisions, this feedback is used to adjust rule parameters, modify tag definitions, or update transaction patterns, thereby continuously improving the accuracy of automated identification. This feedback loop enables the system to maintain high processing accuracy for routine transactions while minimizing the need for manual review over time.
Data Source
AI summary
Embodiments of the present disclosure are directed to methods and systems for the timely processing of records exchanged between service provider systems and responsible entity systems by a records management and processing system. More specifically, the records management and processing system can maintain a set of rules defining conditions for processing records and associated actions to affect that processing upon satisfaction of or failure to satisfy the conditions of that rule. The records management and processing system can also maintain tags identifying data in a record or processing of a record. The records management and processing system can apply the rules to the records and assign tags to the records based on the conditions defined in the applied rules. The records management and processing system can then process the records according to workflows for processing the records based on the assigned tags and applied rules.