Patent Document ID: 20130346097
Application ID: 14010980
Patent Flag: 0

Claim One:
1. A computer system for data processing relating to a nurse intervention program for insurance claims, comprising: a nurse intervention program referral determination computer system, comprising: a data storage device storing data indicative of a trained predictive model configured to determine, based on insurance claim transaction data, a nurse intervention program score, the score indicative of a likelihood of suitability for nurse intervention of insurance claim transactions; one or more computer processors in communication with the data storage device; and a program memory, coupled to the one or more computer processors, storing program instruction steps for execution by the one or more computer processors, the program instructions, when executed by the one or more computer processors, causing the one or more computer processors to: receive data indicative of an insurance claim transaction, the data comprising at least injury data, employee occupation data, and co-morbidity data; apply the predictive model to the received data indicative of an insurance claim transaction to determine a nurse intervention program score, the predictive model being responsive to values of each of injury, occupation, and co-morbidity data; and based on the nurse intervention program score, determine a positive or negative nurse intervention program recommendation; responsive to a positive nurse intervention program recommendation, output data relating to the received insurance claim transaction; and a nurse intervention program computer in communication with the nurse intervention program referral determination computer system and configured to receive the data relating to the received insurance claim transaction output responsive to the positive nurse intervention program recommendation.