Automated system for capturing and archiving information to verify medical necessity of performing medical procedure
First Claim
1. For use with a medical information collection and processing system of a medical facility, where a medical procedure may be performed upon a patient of said facility, an application software routine that is executable on said system and is operative to verify the medical necessity of performing said procedure upon said patient, said routine comprising the steps of:
- (a) in response to initiating said routine, proceeding to search for and acquire information that has been collected with respect to said patient, including patient history and physiological parameters of said patient required by criteria that must be satisfied to verify the need for performing said procedure;
(b) providing visual indications, on a graphical user interface of said system, of the extent to which information collected on said patient comply with said criteria;
(c) in response to one or more visual indications on said graphical user interface indicating that one or more of said criteria has not been satisfied, communicating with information sources from which information of said patient necessary to satisfy said one or more criteria may be obtained, and acquiring therefrom said necessary information; and
(d) storing, in an auditable archival file, all information that has been collected with respect to said patient and said procedure, required by criteria that must be satisfied to verify the need for performing said procedure.
2 Assignments
0 Petitions
Accused Products
Abstract
An automated routine verifies the medical necessity of a procedure. When a procedure is scheduled, the routine searches for, captures and archives patient and clinical information in an audit file, to evidence medical necessity of the procedure. If the audit file lacks one or more pieces of information, medical personnel will be visually alerted to the shortcoming and what is lacking. The user may then activate one or more objects of a user interface, to search resources that contain the required information, so that the audit file may be updated, as necessary, so as to comply with requirements of the Center for Medicare/Medicaid Services.
70 Citations
19 Claims
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1. For use with a medical information collection and processing system of a medical facility, where a medical procedure may be performed upon a patient of said facility, an application software routine that is executable on said system and is operative to verify the medical necessity of performing said procedure upon said patient, said routine comprising the steps of:
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(a) in response to initiating said routine, proceeding to search for and acquire information that has been collected with respect to said patient, including patient history and physiological parameters of said patient required by criteria that must be satisfied to verify the need for performing said procedure;
(b) providing visual indications, on a graphical user interface of said system, of the extent to which information collected on said patient comply with said criteria;
(c) in response to one or more visual indications on said graphical user interface indicating that one or more of said criteria has not been satisfied, communicating with information sources from which information of said patient necessary to satisfy said one or more criteria may be obtained, and acquiring therefrom said necessary information; and
(d) storing, in an auditable archival file, all information that has been collected with respect to said patient and said procedure, required by criteria that must be satisfied to verify the need for performing said procedure. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. For use with a medical information collection and processing system of a medical facility, where a medical procedure may be performed upon a patient of said facility, an application software routine that is executable on said system and is operative to verify the medical necessity of performing said procedure upon said patient, said routine comprising the steps of:
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(a) in response to scheduling said medical procedure for said patient, proceeding to search for and acquire information collected with respect to said patient that is necessary to satisfy criteria for verifying the medical necessity of performing said procedure, as promulgated by the Center for Medicare/Medicaid Services;
(b) providing visual indications, on a graphical user interface of said system, of the extent to which information collected on said patient satisfy said criteria;
(c) in response to one or more visual indications on said graphical user interface indicating that one or more of said criteria has not been satisfied by said collected information, communicating with information sources from which information of said patient necessary to satisfy said one or more criteria may be obtained, and acquiring therefrom said necessary information; and
(d) storing, in an auditable archival file, all information that has been collected with respect to said patient and said procedure, required by said criteria that must be satisfied to verify the need for performing said procedure. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19)
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Specification