Systems and Methods for Storing and Locating Claim Reimbursement Attachments

• US 20090265187A1
• Filed: 04/21/2008
• Published: 10/22/2009
• Est. Priority Date: 04/21/2008
• Status: Abandoned Application

• Current Assignee: General Electric Company
• Original Assignee: General Electric Company
• Inventors: Parida, Pradip Kumar, Boone, Keith W., Bodlapati, Trivedi
• Application Number:
  US12/106,922
• Publication Number:
  US 20090265187A1
• Time in Patent Office: Days
• US Class Current: 705/3
• CPC Class Codes: G06F 16/3332 Query translation
• CPC Class Codes: G06F 16/93 Document management systems
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records

Abstract

Certain embodiments of the present invention provide a clinical document storage and locator system including a clinical database component, a document retriever component, and a query mapper component. The clinical database component is adapted to store a plurality of clinical documents. The document retriever component is adapted to receive a request. The document retriever component is further adapted to determine an LOINC code using the received request. The query mapper component is adapted to generate a document query using the determined LOINC code. The document retriever component is adapted to retrieve a relevant clinical document from the clinical database component using the generated document query.

Claims

1. A clinical document storage and locator system, the system comprising:

a clinical database component adapted to store a plurality of clinical documents;

a document retriever component adapted to receive a request, wherein the document retriever component is further adapted to determine an LOINC code using the received request; and

a query mapper component adapted to generate a document query using the determined LOINC code, wherein the document retriever component is adapted to retrieve a relevant clinical document from the clinical database component using the generated document query.

2. The system of claim 1, wherein the request comprises the LOINC code.

3. The system of claim 2, wherein the request further comprises a modifier code, and wherein the query mapper component is further adapted to generate the document query using the modifier code.

4. The system of claim 1, wherein the system further comprises:

an LOINC database component adapted to store a plurality of LOINC codes, and wherein the document retriever component is further adapted to determine the LOINC code using the LOINC database component.

5. The system of claim 1, wherein the document query comprises at least one of a patient identifier, a clinical document type, a type of service, a clinical subject matter, a provider role, a provider training level, a provider professional level, a practice setting, an encounter identifier, at least one date of service, and an electronic document location.

6. The system of claim 1, wherein the clinical database component comprises a registry and a repository, wherein the document retriever component is further adapted to retrieve a relevant clinical document identifier from the registry using the document query, and wherein the document retriever component is further adapted to retrieve the relevant clinical document from the clinical database component using the relevant clinical document identifier.

7. The system of claim 1, wherein the request comprises an X12N 277 request.

8. The system of claim 1, wherein the system further comprises:

an agreement database component adapted to store a plurality of partner agreements, wherein each partner agreement is adapted to include a clinical document list, wherein the request is associated with a partner agreement, and wherein the document retriever component is further adapted to use the clinical document list associated with the request to attach the relevant clinical document to a response.

9. The system of claim 1, wherein the clinical database component is further adapted to store a plurality of clinical document identifiers, wherein each of the plurality of clinical document identifiers is associated with at least one of the plurality of clinical documents, wherein the document retriever component is further adapted to retrieve a relevant clinical document identifier from the clinical database component using the document query, and wherein the document retriever component is further adapted to retrieve the relevant clinical document from the clinical database component using the relevant clinical document identifier.

10. The system of claim 9, wherein the system further comprises:

a user interface component adapted to display the relevant clinical document identifier for selection by a user, and wherein the document retriever component is further adapted to attach the relevant clinical document to a response.

11. The system of claim 10, wherein the user interface component is further adapted to display the relevant clinical document.

12. The system of claim 1, wherein the document retriever component is further adapted to attach the relevant clinical document to a response.

13. The system of claim 12, wherein the response comprises at least one of an X12N 275 response and an X12N 837 claim.

14. A clinical document storage and locator system, the system comprising:

a clinical database component adapted to store a plurality of clinical documents and a plurality of clinical document identifiers;

a user interface component adapted to receive a user query;

a document retriever component adapted to retrieve a relevant clinical document identifier from the clinical database component using the received user query, wherein the user interface component is adapted to display the retrieved relevant clinical document identifier for selection by a user, and wherein the document retriever component is further adapted to retrieve a relevant clinical document associated with the displayed relevant clinical document identifier from the clinical database component; and

a temporary storage component adapted to store the retrieved relevant clinical document, wherein the document retriever component is further adapted to attach the stored relevant clinical document to a response.

15. A method for locating claim reimbursement attachments, the method comprising:

receiving a request;

determining an LOINC code using the request;

generating a document query using the LOINC code; and

retrieving a relevant clinical document from a clinical database component using the document query.

16. The method of claim 15, wherein the method further comprises the step of attaching the relevant clinical document to a response.

17. The method of claim 16, wherein the attaching step further comprises formatting the relevant clinical document.

18. The method of claim 16, wherein the attaching step is performed using a clinical document list retrieved from an agreement database component.

19. The method of claim 16, wherein the attaching step further comprises displaying the relevant clinical document using a user interface component.

20. The method of claim 15, wherein the retrieving step further comprises:

retrieving a relevant clinical document identifier from a registry using the document query, wherein the clinical database component comprises the registry and a repository; and

retrieving the relevant clinical document from the repository using the relevant clinical document identifier.

21. The method of claim 15, wherein the determining step further comprises determining a modifier code using the request, and wherein the generating step is performed using the modifier code.

22. The method of claim 15, wherein the request comprises the LOINC code.

23. A method for locating claim reimbursement attachments, the method comprising:

receiving a user query;

retrieving a relevant clinical document identifier using the user query;

displaying the relevant clinical document identifier for selection by a user, wherein the relevant clinical document identifier is associated with a relevant clinical document;

retrieving the relevant clinical document;

caching the retrieved relevant clinical document; and

attaching the cached relevant clinical document to a response.

24. A computer-readable medium comprising a set of instructions for execution on a computer, the set of instructions comprising:

a receiver routine configured to receive a request;

an LOINC routine configured to determine an LOINC code using the request;

a generation routine configured to generate a document query using the determined LOINC code; and

a retrieval routine configured to retrieve a relevant clinical document from a clinical database component using the generated document query.