Patent ID: 11961598
Assignee: EXPRESS SCRIPTS STRATEGIC DEVELOPMENT, INC.
Field: Medical technology (Instruments)
Classification: CPC G | IPC G

Claim 0:
1. A machine learning system for use in dispensing one or more prescription drugs, the machine learning system comprising:
a data warehouse system comprising a data warehouse processor and a data warehouse memory, the data warehouse memory including historical claims, wherein the historical claims include a set of historical claim features and a historical claim status;
a claim processing system comprising a system processor and a system memory, the system memory including pending claims, wherein the pending claims include a set of pending claim features;
a pharmacy fulfillment device configured to dispense a prescription drug; and
a claim analysis device in communication with the data warehouse system, the claim processing system, and the pharmacy fulfillment device, the claim analysis device comprising a processor and a memory, wherein the processor is configured to:
extract subsets of historical claim features from a subset of historical claims received from the data warehouse system, wherein each of the subset of historical claims has a corresponding historical claim status indicating that the claim has been successfully processed;
extract a subset of pending claim features from a pending claim received from the claim processing system;
apply a binarization process on the extracted subsets of historical claim features to obtain a binarized training feature set for the subset of historical claims;
apply the binarization process on the extracted subset of pending claim features to obtain a binarized pending feature set for the pending claim;
calculate an aggregate distance between the binarized pending feature set and the binarized training feature set for the subset of historical claims;
identify, from the subset of historical claims, a historical claim associated with the least aggregate distance as a predictive historical claim;
determine that a billing attribute of the predictive historical claim matches a corresponding billing attribute of the pending claim,
validate the pending claim and transmit, to the pharmacy fulfillment device, an instruction for dispensing the prescription drug in accordance with the pending claim,

wherein the pharmacy fulfillment device is further configured to dispense the prescription drug based on the instruction from the claim analysis device.