Patent ID: 8688480
Filing Date: 2014-04-01
Classification: G06Q

Abstract:
1. An automated system for managing healthcare patient accounts comprising: a computer system including a computer which is programmed with a self learning engine, said computer system further programmed to perform the following steps: (a) receive patient account input data including type of service; denial history for similar claims; and payer for each patient account; (b) based upon the patient account input data, the computer system is further programmed to automatically generate probabilities of claim denials defining risk levels for patient accounts based upon the history of denials for similar claims, the balance of the patient account and the age of the patient account; and (c) based upon the risk levels, the computer system is programmed to automatically analyze patient accounts as a function of their respective risk levels and prioritize those analyzed accounts as a function of said risk levels so that patient accounts with the lowest risk level of denial are assigned the highest priority and patient accounts with the highest risk level of denial are assigned the lowest priority, said priorities also assigned as a function of a combination of the balance of the patient account and the age of the patient account; and (d) said computer system further programmed to prioritize said patient accounts in a work list for follow-up according to their respective risk of denial in order to improve the revenue cycle.