Patent ID: 8103522
Filing Date: 2012-01-24
Classification: G06Q,G16H

Abstract:
1. A server for calculating a reimbursement amount for a health care claim, comprising: a computer processor and associated memory; an input module encoded on a computer-readable medium assessable by said computer processor for enabling said computer processor to receive medical claim data from a hospital; a database stored on said memory containing hospital cost benchmarking data; a benchmarking module encoded on the computer readable medium configured to calculate the hospital cost benchmarking data by grouping inpatient medical claims into one or more benchmark groups based on a refined diagnosis related group assignment and a severity classification assignment, said computer processor capable of calculating the reimbursement amount for the received medical claim, wherein a methodology module is encoded on the computer-readable medium and enables said computer processor to apply a pre-selected calculation methodology in calculating the reimbursement amount based upon the received medical claim data and hospital cost benchmarking data; the pre-selected calculation methodology including: an output module is encoded on the computer-readable medium and enables said processor to provide the reimbursement amount and hospital cost benchmarking data to the hospital.