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System to predict future performance characteristic for an electronic record

  • US 10,394,871 B2
  • Filed: 10/18/2016
  • Issued: 08/27/2019
  • Est. Priority Date: 10/18/2016
  • Status: Active Grant
First Claim
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1. A system for predicting a future performance characteristic associated with an electronic record, comprising:

  • a text mining platform, including;

    a text mining communication device to receive text input data associated with the electronic record from multiple sources;

    a text mining processor coupled to the text mining communication device; and

    a text mining storage device in communication with said text mining processor and storing instructions adapted to be executed by said text mining processor to;

    (i) aggregate and map the received text input data to create composite text input data,(ii) automatically detect a semantic event in the composite text input data triggered by a semantic rule and associated semantic tag,(iii) flag the detected semantic event as meeting a pre-determined condition,(iv) update a text mining result database, responsive to the flag, by adding an entry to the database identifying the detected semantic event and the triggering semantic rule, and(v) transmit an indication for the electronic record based on the associated data in the text mining result database; and

    a back-end application computer server coupled to the text mining platform, including;

    a back-end communication device to receive the indication for the electronic record transmitted by the text mining platform;

    a back-end processor coupled to the back end communication device; and

    a back-end storage device in communication with said back-end processor and storing instructions adapted to be executed by said back-end processor to;

    (i) determine at least one parameter corresponding to a characteristic of the electronic record,(ii) execute a computerized predictive model to predict a future performance characteristic indicator for the electronic record based on the at least one parameter and the indictor received from the text mining platform, wherein the future performance characteristic indicator is indicative of a likelihood of an actual value of the electronic record differing from a predicted value of the electronic record, wherein the computerized predictive model is generated based at least in part on an analysis of medical spending costs for a plurality of insurance claims and the volatility indictor is used to provide a degree of certainty in connection with at least one of;

    (i) a loss ratio prediction, and (ii) a return on equity prediction, and(iii) output an indication of the predicted future performance characteristic indictor for the electronic record,wherein the predicted future performance characteristic is a volatility indictor, the electronic record is associated with an insurance claim, and the volatility indicator is indicative of a likelihood of an actual total resolution cost of the insurance claim differing from a predicted total resolution cost of the insurance claim.

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