Patent ID: 6223164
Filing Date: 2001-04-24
Classification: G06Q,G16H

Abstract:
A method for generating a medical provider profile using a general purpose computer system wherein said system comprising:a central processing unit,memory,a display device,an input device,an output device,a mass storage device which containsa number of historical medical provider patient billing records identifiable as patient records,a grouping of diagnosis codes,a grouping of qualifying circumstance codes,a grouping of clear window time periods,a grouping of preventive codes,a grouping of complication codes, said method comprising the steps of:(a) selecting a diagnosis code,(b) reading a plurality of patient records from the mass storage device into the memory, each of said patient records having at least one relevant diagnosis code and a respective date of procedure and corresponding to a single patient,(c) comparing each of said read patient records with each qualifying circumstance code in the grouping of qualifying circumstance codes,(d) identifying each of said patient records having the proper qualifying circumstances for said selected diagnosis code,(e) reading an indicator corresponding to an identified diagnosis into the memory, and thereby obtaining a clear window time period based on said indicator,(f) creating a patient specific grouping of patient records, wherein each diagnosis code in said patient specific grouping of patient records corresponds to a diagnosis code in said grouping of diagnosis codes thereby creating a grouping of related patient records,(g) from said patient records having the proper qualifying circumstances, determining a difference between dates of procedure for consecutive patient records, and if the difference is greater than or equal to said clear window time period, defining an earlier one of said two consecutive records as an ending record of an episode of care and a latter one of said two consecutive records as a beginning of an episode of care, wherein each complete episode of care has both a beginning record and an ending record,(h) for each identified episode of care, writing said episode of care into a table to create a profile for said selected diagnosis.