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Auditing the coding and abstracting of documents

  • US 10,216,901 B2
  • Filed: 05/07/2014
  • Issued: 02/26/2019
  • Est. Priority Date: 03/27/2006
  • Status: Active Grant
First Claim
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1. A method of evaluating coded medical documents performed by a computer, the method comprising:

  • providing, by a computer, a graphical user interface (GUI) wizard;

    receiving, by the computer via the GUI wizard, audit parameters for selecting a document universe and for calculating a sample size;

    calculating, by the computer, a sample size using the received audit parameters;

    selecting, by the computer, a document universe based on the received audit parameters;

    providing, by the computer via the GUI wizard, a plurality of medical documents coded by a coder and selected using the selected document universe and the calculated sample size;

    receiving, by the computer via the GUI wizard, a plurality of corrections by an auditor to the plurality of medical documents;

    recording, by the computer, the plurality of corrections to the coded medical documents to form a plurality of audited medical documents;

    determining, by the computer, a document score for each of the plurality of audited medical documents, each document score based on one or more document corrections provided by the auditor and weighted factors, wherein the weighted factors comprise predefined weights assigned to diagnosis codes and finding codes of each of the plurality of audited medical documents;

    determining, by the computer, a sample score for the plurality of audited medical documents based on the determined document scores;

    determining, by the computer, the acceptability of the sample score by periodically performing an empirical test to compare the sample score to system control limits; and

    displaying, by the computer via the GUI, an X-bar chart analysis comprising the sample score, an upper control limit, a lower control limit, and a previously determined sample score of audited medical documents coded by the coder.

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