PATENT CLAIM ANALYSIS

Application Number: 16234405
Application Type: Utility
Filing Date: 2018-12
Publication Date: 2019-10
Patent Classification: ["705", "003000"]

Abstract:
Computer implemented methods and systems for bundled payment adjudication are disclosed. The method includes receiving patient information of patient. The patient information comprises at least patient identifier and clinical episode of patient. The method includes generating episode card for patient to avail healthcare services from one or more healthcare service providers for predefined time. The episode card includes claims submission information for healthcare services availed by patient from one or more healthcare service providers. The method includes receiving one or more claims associated with patient from at least one healthcare service provider. Each claim is associated with one or more healthcare services availed by patient for clinical episode using episode card. The method includes processing one or more claims for determining validity of each claim based on set of episode definition parameters. The method includes upon processing the claims, facilitating payment amount for one or more claims based on validity.

Claim (Index 4):
The method as claimed in  claim 3 , wherein upon determining if the bundled payment of claims is based on the health plan payor scheme comprises:\n sending, by the processor, a financial information request to the insurance service provider for accessing financial information associated with the patient, the financial information comprising a deductible amount, a copay amount, a coinsurance amount and an out of pocket (OOP) max amount; and upon receiving the financial information, determining, by the processor, the patient responsibility for the clinical episode based on the financial information.

Metadata:
- Claim Count in Document: 50.0
- Percentile: 98.0
- Lexical Diversity: 2.5
- Patent Class: 705.0
- Transitional Phrase Type: open
- Component Type: 1
- Foreign Priority: False
- Related Applications: ['11755713', '10253223', '13425667', '13713687', '13564047']

Analysis Scores:
- 35 USC 101 Eligibility (BERT): 0.1175555156323742
- 35 USC 102 Novelty (BERT): 0.5367052127298007
- Combined Prediction Score: 0.1594704853421169
- Mean Citation Score: 332.81883000000005
- Max Citation Score: 373.21594
- Similarity Product: 306.15365629044294

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

Dataset: test