Dynamic Reimbursement System for Invoice Processing
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Solution Overview
Problem
Existing systems face challenges in efficiently processing invoices for automatic reimbursement, particularly due to lack of uniformity in invoice formats and codes, leading to delays in claim adjudication and increased manual processing requirements.
Innovation Solution
A computer-implemented method for automatic reimbursement that dynamically evaluates claims and available reimbursement methods by processing invoices, generating digitized versions, and using machine learning algorithms to identify reimbursement amounts and prevent negative balances, thereby streamlining the reimbursement process.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If manual processing methods are used to handle non-uniform invoice formats, then processing accuracy can be maintained, but processing time increases and productivity decreases
Solution Approach 1:
The system transforms invoice data from various formats into a standardized parameter structure through digitalization. By converting diverse invoice formats into uniform digital parameters, the system enables automated processing while maintaining accuracy, resolving the contradiction between processing speed and accuracy
Solution Approach 2:
The system creates digital copies of invoices in standardized formats. These digital replicas can be processed automatically multiple times without degradation, enabling high-speed processing while maintaining the integrity and accuracy of the original data through consistent digital representation
2Productivity
If automated processing is implemented without balance verification, then processing speed increases, but errors occur due to negative balances
Solution Approach 1:
The system performs balance verification as a preliminary action before executing reimbursement processing. By checking account balances in advance and preventing transactions that would create negative balances, the system ensures reliability while maintaining automated high-speed processing through proactive error prevention
Solution Approach 2:
The system implements real-time feedback loops where balance information is continuously monitored and fed back into the processing decision-making. This feedback mechanism allows the automated system to adjust processing actions dynamically, preventing errors while maintaining processing speed through intelligent control
3Measurement precision
If multiple reimbursement methods are evaluated dynamically, then reimbursement accuracy improves, but system complexity increases
Solution Approach 1:
The system dynamically evaluates multiple reimbursement methods by adjusting evaluation criteria and available methods based on real-time claim characteristics. This dynamic adaptation allows accurate reimbursement determination for diverse claims while managing complexity through context-dependent method selection rather than exhaustive static evaluation of all possible methods
Solution Approach 2:
The system segments the reimbursement evaluation process into distinct modules: claim validation, balance verification, method selection, and transaction execution. This segmentation allows each module to handle specific aspects independently, improving overall accuracy while reducing system complexity through modular design and localized processing logic
Data Source
AI summary
Systems and methods provide a framework through which automatic reimbursement for adjudicated claims is performed through dynamic evaluation of claims and of available reimbursement methods. In response to a reimbursement request, a system, through dynamically trained machine learning algorithms, can dynamically generate different reimbursement method recommendations. For a selected reimbursement method, the system can further automatically interact with different payment instrument services to ensure that corresponding payment instruments can be used for the reimbursements. This interaction can be facilitated through the use of tokenized payment instruments provided by these payment instrument services.