Patent ID: 9378527
Filing Date: 2016-06-28
CPC Classification: G06N,G06Q

Claim Text:
1. A computer system comprising: a data storage module configured to receive, store, and provide access to indeterminate data and determinate data corresponding to historical claim transactions and to current claim transactions, and data indicative of categories of claims that are highly unlikely to be questionable; a computer processor configured to: an output device, coupled to the computer processor, configured to output an indication of whether said one of said current claim transactions should be referred to the investigation unit, said output generated in response to application of data for said one of said current claim transactions to the trained predictive model component and said screening module; and a routing module configured to direct workflow corresponding to said one of said current claim transactions based on the output from the output device, to one of an investigative analyst computer and a field investigator computer.