Patent ID: 11861503
Assignee: AKASA, INC.
Field: Computer technology (Electrical engineering)
Classification: CPC G | IPC G

Claim 0:
1. A computer-implemented method of analyzing claims, the method comprising:
receiving one or more claims in an electronic format;
identifying a set of claim features of at least one claim of the one or more claims;
generating an embedding of tokens to provide a first input vector based, least in part, on:
application of a tokenization process to the identified set of claim features to provide first numeric values in a first sub-vector to express one or more diagnosis tokens and second numeric values in a second sub-vector to express one or more procedure tokens, the tokenization process comprising one or more machine-learning models having been trained based, at least in part, on a history of claims; and
element-wise multiplication of at least some elements of the first sub-vector with at least some elements of the second sub-vector to provide the first input vector;

executing one or more first neural networks to compute one or more suspiciousness scores and a likelihood of denial of at least at portion the at least one claim based, at least in part, on the first input vector;
communicating at least one of the suspiciousness scores to an operator/user; and
receiving inputs from the operator/user to modify at least a portion of the at least one claim to thereby affect the likelihood of denial of the at least a portion of the at least one claim.