Patent Document ID: 20090254379
Application ID: 12099388
Patent Flag: 0

Claim One:
1. A computer system comprising: an indeterminate data capture module for capturing indeterminate data; a data storage module in communication with the indeterminate data capture module, said data storage module for receiving, storing, and providing access to indeterminate data captured by the indeterminate data capture module, said data storage module also storing and providing access to determinate data, said indeterminate and determinate data stored by said data storage module related to historical claim transactions and to current claim transactions; a predictive model component, coupled to the data storage module, for determining whether to identify a one of said current claim transactions for referral to an investigation unit; a computer processor for executing programmed instructions and for storing and retrieving said data related to current claim transactions; program memory, coupled to the computer processor, for storing program instruction steps for execution by the computer processor; a model training component, coupled to the computer processor, for training the predictive model component based on the data related to the historical claim transactions in accordance with program instructions stored in the program memory and executed by the computer processor, thereby providing a trained predictive model component; an output device, coupled to the computer processor, for outputting an output indicative of whether said one of said current claim transactions should be referred to the investigation unit, wherein the computer processor generates the output in accordance with program instructions in the program memory and executed by the computer processor, said output generated in response to application of data for said one of said current claim transactions to the trained predictive model component; and a routing module for directing workflow based on the output from the output device.