Ontology based method for automatically generating healthcare billing codes from a patient encounter

• US 20060020493A1
• Filed: 07/22/2005
• Published: 01/26/2006
• Est. Priority Date: 07/26/2004
• Status: Abandoned Application

• Current Assignee: Wisper Technologies LLC
• Original Assignee: Wisper Technologies LLC
• Inventors: Cousineau, Leo E., Young, Harry, Cherpes, Peter L., Brewster, Ravindra R.
• Application Number:
  US11/186,762
• Publication Number:
  US 20060020493A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G10L 15/1822 Parsing for meaning understanding
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof

Abstract

A healthcare related method corrects on non-standard input data in a syntax processing block with reference to one or more healthcare lexicons, and a resulting corrected data file is thereafter used by an ontology processing block to reference an ontology and generate a standardized output including one or more healthcare billing codes.

Claims

1. A method of generating healthcare billing codes, comprising:

receiving non-standard data produced during a patient encounter with a healthcare provider;

processing the non-standard data in a syntax processing block and generating a corrected data file with reference to a healthcare lexicon; and

,

receiving the corrected data file in an ontology processing block and, in response to the corrected data file, generating standardized output data including one or more healthcare billing codes associated with the patient encounter.

2. The method of claim 1, wherein generating one or more healthcare billing codes includes generating at least one of a medical diagnosis code and a healthcare procedure code.

3. The method of claim 2, wherein generating one or more healthcare billing codes includes generating at least one healthcare procedure code belonging to a set of healthcare procedure codes of Current Procedure Terminology, Yth edition, where Y≧

4.

4. The method of claim 3, where the healthcare procedure code is an Evaluation &

Management (E&

M) code.

5. The method of claim 2, wherein generating one or more healthcare billing codes includes generating a medical diagnosis code belonging to a set of diagnosis codes of the International Classification of Diseases, Xth edition, Clinical Modification, where X≧

9.

6. The method of claim 1, wherein generating standardized output data includes generating a healthcare services claim form that is at least partially completed.

7. The method of claim 6, where the healthcare service claim form is one of a CMS-1450 and a HCFA-1500 claim form.

8. The method of claim 6, where generating a healthcare services claim form that is at least partially completed includes entering in the claim form an Evaluation &

Management (E&

M) code belonging to a set of E&

M codes of Current Procedure Terminology, Yth edition, where Y≧

4.

9. The method of claim 1, wherein the non-standard data comprises voice data, and the syntax processing block comprises a speech recognition application associated with the healthcare lexicon.

10. The method of claim 1, wherein the non-standard data comprises handwriting, and the syntax processing block comprises a handwriting recognition application associated with the healthcare lexicon.

11. The method of claim 1, wherein the non-standard data comprises text data, and the syntax processing block comprises a forms recognition application.

12. The method of claim 1, wherein the non-standard data comprises an electronic file, and the syntax processing block comprises a file parsing application.

13. The method of claim 1, wherein the non-standard data comprises at least one of voice, handwriting, text, image data, and an electronic file, and wherein the syntax processing block comprises at least one of a voice recognition application, a forms recognition application, an image recognition application, and a file parsing application associated with the healthcare lexicon.

14. The method of claim 1, wherein the syntax processing block comprises a capture block and a staging block, the method comprising:

receiving the non-standard data in the capture block; and

wirelessly communicating the non-standard data to the staging block.

15. The method of claim 14, wherein the capture block comprises a wireless microphone, and wherein the staging block comprises a digital logic platform, and wherein wirelessly communicating the non-standard data from the capture block to the staging block comprises generating a voice transcript signal in the wireless microphone, the method further comprising:

generating the corrected data file in the digital logic platform in response to the voice transcript signal and with reference to the healthcare lexicon.

16. The method of claim 15, wherein the digital logic platform comprises a Personal Computer (PC), a tablet PC, a laptop PC, or Personal Digital Assistant (PDA), or other transportable computing hardware.

17. The method of claim 15, wherein generating the corrected data file in the digital logic platform comprises:

running a capture application enabling receipt of the voice transcript signal and generation of a voice data file from the voice transcript signal;

running a syntax application generating the corrected data file from the voice data file; and

running an interface application allowing reference to the healthcare lexicon by the capture application or the syntax application.

18. The method of claim 17, wherein the syntax application comprises a subroutine correcting components in the voice data file with reference to the healthcare lexicon.

19. The method of claim 17, wherein the syntax application comprises a subroutine correcting the voice data file in accordance with a criteria.

20. The method of claim 17, wherein the syntax application comprises one subroutine correcting components in the voice data file with reference to the healthcare lexicon and another subroutine correcting the voice data file in accordance with a criteria.

21. The method of claim 1, wherein the ontology processing block comprises a database or other persistent data storage mechanism, and a server, the method further comprising:

saving the corrected data file in the database or other persistent data storage mechanism.

22. The method of claim 1, wherein generating the standardized output comprises:

running an ontology application on the server adapted to reference an ontology in relation to the corrected data file.

23. The method of claim 1, wherein the standardized output is standardized in relation to at least one of:

Health Insurance Portability &

Accountability Act (HIPAA) standard;

a Health Care Procedures Coding System (HCPCS) standard;

Systematized Nomenclature of Medicine—

Clinical Terms (SNOMED CT);

International Classification of Diseases;

X^th revision, Clinical Modification (ICD-X-CM) standard, where X≧

9;

Current Procedural Terminology (CPT-Y) standard, where Y≧

4;

Health Level 7 (HL7);

a Digital Imaging and Communications in Medicine (DICOM) standard;

a Food &

Drug Administration (FDA) standard;

a Veterans Affairs (VA) standard;

a National Library of Medicine (NLM) standard;

a Health and Human Services (HHS) standard;

a Centers of Medicare and Medicaid Services (CMS) standard, or a World Health Organization (WHO) standard.

24. The method of claim 1, wherein the corrected data file is communicated from the syntax processing block to the ontology processing block via a Wireless Local Area Network (WLAN), a Wireless Metropolitan Area Network (WMAN), an ad-hoc wireless network, a hardwired Local Area Network (LAN), or an Ethernet connected network.

25. A method, comprising:

receiving with a wireless microphone system non-standard voice input data relating to a patient encounter, and in response thereto generating a voice transcript signal;

wirelessly communicating the voice transcript signal to a digital logic platform and generating a corrected data file in response to the voice transcript signal and with reference to a healthcare lexicon;

communicating the corrected data file to a server;

referencing an ontology in relation to the corrected data file; and

,

generating a standardized output, including one or more healthcare billing codes, in response to the referencing of the ontology in relation to the corrected data file.

26. The method of claim 25, wherein generating one or more healthcare billing codes includes generating at least one of a medical diagnosis code and a healthcare procedure code.

27. The method of claim 26, wherein generating one or more healthcare billing codes includes generating at least one healthcare procedure code belonging to a set of healthcare procedure codes of Current Procedure Terminology, Yth edition, where Y≧

4.

28. The method of claim 27, where the healthcare procedure code is an Evaluation &

Management (E&

M) code.

29. The method of claim 26, wherein generating one or more healthcare billing codes includes generating a medical diagnosis code belonging to a set of diagnosis codes of the International Classification of Diseases, Xth edition, Clinical Modification, where X≧

9.

30. The method of claim 25, wherein generating standardized output data includes generating a healthcare services claim form that is at least partially completed.

31. The method of claim 30, where the healthcare service claim form is one of a CMS-1450 and a HCFA-1500 claim form.

32. The method of claim 30, where generating a healthcare services claim form that is at least partially completed includes entering in the claim form an Evaluation &

Management (E&

M) code belonging to a set of E&

M codes of Current Procedure Terminology, Yth edition, where Y≧

4.

33. The method of claim 25, where the server is adapted to communicate the healthcare billing code to the digital logic platform for review.

34. The method of claim 25, wherein generating the corrected data file in response to the voice transcript signal comprises:

running a voice enabled application establishing a control grammar controlling receipt of the voice input data, and an audio, visual, or both acknowledgement of the voice input data.

35. The method of claim 25, wherein the standardized output is standardized in relation to at least one of:

Health Insurance Portability &

Accountability Act (HIPAA) standard;

a Health Care Procedures Coding System (HCPCS) standard;

Systematized Nomenclature of Medicine—

Clinical Terms (SNOMED CT);

International Classification of Diseases;

X^th revision, Clinical Modification (ICD-X-CM) standard, where X≧

9;

Current Procedural Terminology (CPT-Y) standard, where Y≧

4;

Health Level 7 (HL7);

a Digital Imaging and Communications in Medicine (DICOM) standard;

a Food &

Drug Administration (FDA) standard;

a Veterans Affairs (VA) standard;

a National Library of Medicine (NLM) standard;

a Health and Human Services (HHS) standard;

a Centers of Medicare and Medicaid Services (CMS) standard, or a World Health Organization (WHO) standard.

36. A method, comprising:

receiving non-standard voice input data produced as a result of a patient encounter with a healthcare provider;

processing the non-standard voice input data through a syntax processing block to generate a corrected data file with reference to a healthcare lexicon; and

processing the corrected data file with reference to a billing code ontology to generate standardized output data including at least one healthcare billing code pertaining to the patient encounter.

37. The method of claim 36, wherein processing the non-standard voice input data includes performing a speech recognition algorithm on the voice input data with reference to the healthcare lexicon.

38. The method of claim 37, further comprising receiving user feedback to an output of the speech recognition algorithm.

39. The method of claim 38, further comprising further correcting the output of the speech recognition algorithm to produce the corrected data file.

40. The method of claim 36, wherein generating one or more healthcare billing codes includes generating at least one of a medical diagnosis code and a healthcare procedure code.

41. The method of claim 40, wherein generating one or more healthcare billing codes includes generating at least one healthcare procedure code belonging to a set of healthcare procedure codes of Current Procedure Terminology, Yth edition, where Y≧

4.

42. The method of claim 41, where the healthcare procedure code is an Evaluation &

Management (E&

M) code.

43. The method of claim 40, wherein generating one or more healthcare billing codes includes generating a medical diagnosis code belonging to a set of diagnosis codes of the International Classification of Diseases, Xth edition, Clinical Modification, where X≧

9.

44. The method of claim 36, wherein generating standardized output data includes generating a healthcare services claim form that is at least partially completed.

45. The method of claim 44, where the healthcare service claim form is one of a CMS-1450 and a HCFA-1500 claim form.

46. The method of claim 44, where generating a healthcare services claim form that is at least partially completed includes entering in the claim form an Evaluation &

Management (E&

M) code belonging to a set of E&

M codes of Current Procedure Terminology, Yth edition, where Y≧

4.