Patent ID: 7774216
Filing Date: 2010-08-10
Classification: G06Q,G16H

Abstract:
1. A computer-implemented method for processing medical claim data records, the medical claim data records each including at least one of a diagnosis, procedure or drug code, comprising one or more computers performing the following: storing a plurality of diagnostic groups in at least one data storage device, wherein each diagnostic group is associated with one or more diagnosis, procedure or drug codes; upon receiving a first medical claim data record associated with a patient, processing the first medical claim data record using at least one data processor to: identify one or more diagnosis, procedure or drug codes in the first medical claim data record; compare the identified codes in the first medical claim data record with the codes associated with one or more of the plurality of the stored diagnostic groups; and assign the first medical claim data record to a first diagnostic group based upon the one or more diagnosis, procedure or drug codes identified in the first medical claim data record; and upon receiving a second medical claim data record associated with the patient, processing the second medical claim data record using the data processor to: identify one or more diagnosis, procedure or drug codes in the second medical claim data record; determine whether the identified codes in the second medical claim data record indicate a change in the patient's clinical condition; and, shift the first medical claim data record from the first diagnostic group to a second diagnostic group that includes the change in the patient's clinical condition.