Payment Assurance and Claim Pre-Validation

Patent №

US 10,318,923

Granted

2019-06-11

Filed 2012

Owner

THE TRIZETTO GROUP, INC.

+1 more

Lab

AI components

2

nlp · planning

Assignment

Recorded

Dataset

AIPD

2023_r1 edition

Application

13564047

Methods and systems for payment assurance and claim pre-validation are described. In one embodiment, a pre-visit claim for health care related services is received for payment assurance. In response to the pre-visit claim, a payer is queried for pre-visit claim detail information indicating any payment or authorization issues for services to be rendered. The pre-visit claim may be updated in certain embodiments based on the pre-visit claim detail information, and an appointment may be scheduled for services. In other aspects, a claim for health care related services is received for pre-validation. In response, a payer is queried for claim detail information indicating any payment or authorization issues for the claim. The claim may be updated in certain embodiments based on the claim detail information, and payment for services rendered may be provided by a payer in response to a submitted claim.

AI classification

Planning1.00
Natural language0.90
Vision0.01
Machine learning0.00
Knowledge representation0.00
AI hardware0.00
Evolutionary computation0.00
Speech0.00

Ownership

THE TRIZETTO GROUP, INC.

assignment · 286970333

TRIZETTO CORPORATION

namechg · 305010128

Assignors

MACLEOD, DAVID

On an employer assignment, the assignors are typically the inventors.

From the same owner

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