Patent ID: 8756071

Claim:
A method of processing a plurality of medical billing claims stored in a queue, wherein the medical billing claims stored in the queue are associated with a plurality of attributes identifying characteristics of the medical billing claims, the method comprising acts of: grouping, by at least one computer processor, at least some of the plurality of medical billing claims into a first cluster based, at least in part, on a first cluster pattern indicating at least one shared attribute from among the plurality of attributes associated with the medical billing claims, wherein the medical billing claims in the first cluster are claims that have not received remittance from a payer or have been denied by a payer; validating the first cluster using predetermined criteria to determine if the first cluster should be analyzed, discarded, and/or marked for further analysis; collecting in response to determining that the first cluster should be analyzed, information about each of the medical billing claims in the first cluster, wherein the collected information relates to the at least one shared attribute of the first cluster pattern; determining a root cause issue for the medical billing claims in the first cluster based on the collected information; receiving a solution to the root cause issue for the medical billing claims in the first cluster; storing information related to the solution to the root cause issue and the first cluster pattern and attributes to which the solution applies; and applying the solution to at least one new medical billing claim received after the information related to the solution has been stored.