Patent ID: 11967431
Assignee: OPTUM, INC.
Field: Medical technology (Instruments)
Classification: CPC G | IPC G

Claim 12:
13. A computer program product comprising a non-transitory computer-readable storage medium having computer-readable program code portions stored therein, that when executed by one or more processors, cause the one or more processors to:
store, in memory, a plurality of individual claim records, wherein each individual claim record of the plurality of individual claim records is in a non-hierarchical data structure;
generate a plurality of single-level episode data objects, each of the plurality of single-level episode data objects relating to an episode-specific subset of individual claim records of the plurality of individual claim records, wherein each single-level episode data object of the plurality of single-level episode data objects identifies (a) a parent episode date range indicating an episode start date and an episode end date, and (b) a parent episode anchor record of a plurality of parent episode anchor records that corresponds to the episode-specific subset of individual claim records, wherein each parent episode anchor record of the plurality of parent episode anchor records identifies an episode type of the corresponding single-level episode data object;
retrieve, from the memory and based at least in part on data stored within the plurality of single-level episode data objects, reference table from a plurality of data tables stored in the memory, wherein the reference table comprises a plurality of data entries collectively identifying one or more episode types that are eligible for supporting one or more sub-episodes;
identify, from the plurality of single-level episode data objects and based at least in part on the reference table, a subset of the plurality of single-level episode data objects eligible for supporting the one or more sub-episodes;
retrieve, from the memory, one or more sub-episode eligibility criteria comprising sub-episode eligibility criteria reference data tables retrieved from the plurality of data tables stored in the memory;
for a first single-level episode data object of the subset of the plurality of single-level episode data objects, sequentially generate, by the one or more processors, one or more entries of a sub-episode eligibility listing in the memory based at least in part on characteristics identified for the first single-level episode data object, wherein each of the one or more entries has a corresponding individual claim record associated with the first single-level episode data object;
identify, from the one or more entries, one or more sub-episode anchor records satisfying the sub-episode eligibility criteria;
identify, from the plurality of individual claim records, one or more sub-episode ancillary records associated with the sub-episode anchor records;
generate one or more sub-episode data objects that each (a) identifies one of the one or more sub-episode anchor records and the sub-episode ancillary records, and (b) comprises data identifying a first sub-episode date range;
update the one or more sub-episode data objects based at least in part on a first parent episode date range for the first single-level episode data object to truncate the first sub-episode date range to fall within the first parent episode date range;
transform the first single-level episode data object into a multi-level hierarchical data object to include metadata tags providing a hierarchical data structure comprising one or more sub-episode identifiers corresponding with the one or more sub-episode data objects, wherein each sub-episode data object has a sub-episode date range occurring within the first parent episode date range;
store, into the memory, the multi-level hierarchical data object; and
cause, based on the multi-level hierarchical data object, display of a multi-level view of (1) at least one individual claim record associated with the first single-level episode data object and (2) at least one of the one or more sub-episode anchor records or the sub-episode ancillary records identified by the one or more sub-episode data objects.