PATENT CLAIM ANALYSIS

Application Number: 16405408
Application Type: Utility
Filing Date: 2019-05
Publication Date: 2019-08
Patent Classification: ["705", "002000"]

Abstract:
A method of optimizing healthcare services consumption according to the invention includes the steps of assessing the healthcare situation of an employer providing healthcare benefits to a population, identifying a first group of patients from the population likely to generate expensive healthcare claims based on data representing past claims, periodically determining whether patients in the first group have satisfied certain predetermined healthcare requirements, identifying a first group of providers who provide high quality, cost efficient healthcare services based on the practice patterns of the providers, prompting patients who have not satisfied the predetermined healthcare requirements to obtain services from providers in the first group, and responding to healthcare requests from patients by determining whether the requesting patient is seeking services from a provider in the first group, and, if not, urging the patient to obtain such services from a provider in the first group.

Claim (Index 13):
The method of  claim 12 , wherein using the at least one computing device to transform past practice patterns data includes rating providers who service patients in the healthcare plan; wherein rating providers includes determining a cost efficiency index for each provider based on claim information stored in the at least one database by determining an average cost (AC1) for completed episodes of healthcare associated with the provider, determining an average cost (AC2) for similar episodes of health care treated by other providers who provide the same specialty service as the provider, dividing AC1 by AC2, and determining whether the cost efficiency index is less than a first predetermined threshold.

Metadata:
- Claim Count in Document: 6.0
- Percentile: 100.0
- Lexical Diversity: 2.2
- Patent Class: 705.0
- Transitional Phrase Type: none
- Component Type: 0
- Foreign Priority: False
- Related Applications: ['10313370', '12773334', '13178174', '15584664', '11447627']

Analysis Scores:
- 35 USC 101 Eligibility (BERT): 0.1558924497858342
- 35 USC 102 Novelty (BERT): 0.5898885489318177
- Combined Prediction Score: 0.1992920597004326
- Mean Citation Score: 462.20940999999993
- Max Citation Score: 527.3645
- Similarity Product: 420.5508157319427

Labels:
- Claim Label 101: 0
- Claim Label 102: 1
- Claim Label 103: 1
- Claim Label 112: 0
- Combined Label: 0
- Label 101 Adjusted: 0

Dataset: test