METHOD AND APPARATUS FOR IDENTIFYING PATIENTS OVERDUE FOR AN APPOINTMENT USING STANDARD HEALTHCARE BILLING DATA

• US 20090094054A1
• Filed: 11/09/2007
• Published: 04/09/2009
• Est. Priority Date: 07/10/2006
• Status: Active Grant

• Current Assignee: Brevium Incorporated
• Original Assignee: Brevium Incorporated
• Inventors: PERRIN, BRIAN WILLIAM, GERLACH, BRETT CORNELL
• Granted Patent: US 8,655,699 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/0631 Resource planning, allocation, distributing or scheduling for enterprises or organisations
• CPC Class Codes: G06Q 10/06311 Scheduling, planning or task assignment for a person or group
• CPC Class Codes: G06Q 10/06375 Prediction of business process outcome or impact based on a proposed change
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 10/109 Time management, e.g. calendars, reminders, meetings or time accounting
• CPC Class Codes: G06Q 10/1093 Calendar-based scheduling for persons or groups
• CPC Class Codes: G06Q 10/1095 Meeting or appointment
• CPC Class Codes: G06Q 10/1097 Task assignment
• CPC Class Codes: G06Q 30/0201 Market modelling; Market analysis; Collecting market data
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

A method and apparatus for identifying overdue patients using standard billing or other office management data, so that patients can be contacted and invited to make an appointment. The invention begins by querying the diagnosis codes for each visit from the billing or other encounter tables, and matching these with a set of target medical conditions requiring regular care. Procedure codes and encounter dates for past visits are queried for these patients, to determine when each patient was last seen, and what was done. These procedure codes are matched against a set of exam codes to determine last medical examination dates, and against a set of procedures known to resolve each medical condition. Each condition requiring regular care is matched against any resolving procedures, leaving a set of untreated conditions requiring regular care. Based on the date of the last exam or treatment and accepted standards of care or office policies, a due date is calculated for each patient. The management system is queried for each overdue patient to determine whether they already have an appointment scheduled in the future, or a recall notice recently sent or yet to be sent. Additional filtering based on administrative settings may also be done. Overdue patients requiring contact are then placed on the contact list.

Claims

1. A computerized method for identifying patients who are due for care so that those patients can be personally contacted by staff at a health care facility, comprising:

automatically identifying, using billing or other encounter data from a computerized medical or dental office management system, patients with conditions requiring regular care;

automatically determining the most recent date of treatment using billing or other encounter data from the database;

automatically identifying patients who are due for care by comparing expected visit intervals for each condition with the time since last treatment, and storing these in a contact list;

automatically identifying patients who already have appointments or who will receive reminders to call for an appointment and removing these from the contact list;

displaying patient information to an operator, the patient information including at least the patient'"'"'s name, telephone number, and reason why the patient is due for care;

contacting the patients by the operator; and

scheduling an appointment for healthcare while the patient is on the telephone.

2. The method of claim 1 in which scheduling an appointment includes transferring the call to a scheduler.

3. The method of claim 1 further comprising displaying a screen that the operator can use to record the results of the contact.

4. The method of claim 1 further comprising removing the patient from the contact list.

5. A computerized method for identifying patients who are due for care so that those patients can be personally contact by staff at a health care facility, comprising:

automatically identifying, using billing or other encounter data from a computerized medical office management system, patients with conditions requiring regular care;

automatically determining the most recent date of treatment using billing or other encounter data from the database;

automatically identifying patients who are due for care by comparing expected visit intervals for each condition with the time since last treatment, and storing these in a contact list;

automatically identifying patients who already have appointments or who will receive reminders to call for an appointment and removing these from the contact list;

displaying patient information to an operator, the patient information including at least the patient'"'"'s name, telephone number, and reason why the patient is due for care;

attempting to contact the patient by the operator;

displaying to the operator a computer screen having fields in which to enter contact results; and

automatically determining from the contact results whether to schedule a follow-up telephone call.

6. The method of claim 5 further comprising displaying a screen that the operator can use to record the results of the contact.

7. The method of claim 5 in which contacting the patient includes receiving information indicating that the patient is not to be contacted and further comprising removing the patient from the contact list.

8. The method of claim 5 in which contacting the patient includes receiving information indicating that the patient has a different telephone number and further comprising attempting to contact the patient using the new telephone number and recording the telephone number in the office database.

9. A computerized method for identifying and attempting to contact patients who are due for care, comprising:

automatically identifying, using billing or other encounter data from a computerized medical office management system, patients with conditions requiring regular care;

automatically determining the most recent date of treatment using billing or other encounter data from the database;

automatically identifying patients who are due for care by comparing expected visit intervals for each condition with the time since last treatment, and storing these in a contact list;

automatically identifying patients who already have appointments or who will receive reminders to call for an appointment and removing these from the contact list; and

attempting to contact patients on the contact list.

10. The method according to claim 9, further comprising eliminating from the list:

patients having specific insurance, patients over a given age, patients who have not been seen for a very long time, patients seen by specific doctors or at specific location, patients who have been discharged or are in collections, or patients who are deceased.

11. The method according to claim 9 in which attempting to contact patients on the contact list includes attempting to contact patients via a human caller using a telephone.

12. The method according to claim 9 in which attempting to contact patients on the contact list includes attempting to contact patients via an automated calling system.

13. The method according to claim 9, further comprising automatically generating recalls or mailing labels from the list to send patients written reminders to call for an appointment.

14. The method according to claim 9, further comprising automatically generating from the list email to patients requesting the patients to call for an appointment.

15. A computer-readable media having thereon computer-readable instructions for:

automatically identifying, using billing or other encounter data from a computerized medical office management system, patients with conditions requiring regular care;

automatically determining the most recent date of treatment using billing or other encounter data from the database;

automatically identifying patients who are due for care by comparing expected visit intervals for each condition with the time since last treatment, and storing these in a contact list;

automatically identifying patients who already have appointments or who will receive a reminder to call for an appointment and removing these from the contact list.

16. A method for identifying patients who are due for care in an office that schedules appointments for the office using an office management system, comprising the steps of:

identifying patients with conditions requiring regular care using billing data from the management system;

identifying patients with one or more conditions which have been resolved;

determining the most recent date of treatment for unresolved conditions using billing data from the management system;

identifying patients who are due for care by comparing expected visit intervals for each condition with the time since last treatment, and storing these in a contact list; and

identifying patients who already have appointments or who will receive reminders to call for an appointment and removing these from the contact list.

17. The method according to claim 16, further comprising eliminating from the list patients based on one or more of the following criteria;

patients having specific insurance, patients over a given age, patients who have not been seen for a very long time, patients seen by specific doctors or at specific location, patients who have been discharged or are in collections, or patients who are deceased.

18. The method according to claim 16, further comprising using the list to drive personal contact with patients via a human caller using a telephone.

19. The method according to claim 16, further comprising using the list to drive contact with patients via an automated calling system.

20. The method according to claim 16, further comprising using the list to automatically generate recalls or mailing labels to send patients written reminders to call for an appointment.

21. The method according to claim 16, further comprising using the list to automatically generate email to patients reminding them to call for an appointment.

22. An apparatus for identifying patients who are due for care in an office that schedules appointments for the office using an office management system, the apparatus comprising a computer programmed with computer instructions for carrying out the following steps:

automatically identifying, using billing or other encounter data from a computerized medical office management system, patients with conditions requiring regular care;

automatically determining the most recent date of treatment using billing or other encounter data from the database;

automatically identifying patients who are due for care by comparing expected visit intervals for each condition with the time since last treatment, and storing these in a contact list;

automatically identifying patients who already have appointments or who will receive reminders to call for an appointment and removing these from the contact list.