METHOD AND SYSTEM FOR HEALTH CARE CODING TRANSITION AND IMPLEMENTATION

• US 20120303383A1
• Filed: 08/10/2012
• Published: 11/29/2012
• Est. Priority Date: 02/23/2009
• Status: Abandoned Application

• Current Assignee: Arkansas Blue Cross And Blue Shield
• Original Assignee: Arkansas Blue Cross And Blue Shield
• Inventors: SMITH, Joseph S.
• Application Number:
  US13/572,079
• Publication Number:
  US 20120303383A1
• Time in Patent Office: Days
• US Class Current: 705/2
• 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

Methods and systems for implementing coding changes for a transaction are provided. At least one transaction in an original format is received and normalized into a different format. The normalized transaction may be processed and the processing results may be associated with the original format to transmit the processing results in the original format to a recipient.

Claims

1. A method for performing transaction coding changes implemented on a suitably programmed computer comprising a processor and a display, the method comprising:

receiving at least one transaction in an original format associated with an original code;

normalizing, via the processor, the received transaction into a normalized format associated with a normalized code;

processing the normalized transaction;

providing processing results in the original format by associating the processed normalized transaction with the original format; and

transmitting the processing results to a recipient of the processed transaction.

2. The method of claim 1, wherein normalizing the received transaction further comprises:

mapping the original code to a group of normalized codes;

determining whether codes in the group of normalized codes are in a priority order; and

selecting the highest priority code from the codes in the group of normalized codes for the normalized code.

3. The method of claim 2, wherein the priority order includes one of a primary and secondary codes, a ranking descending from a highest code to a lowest code, and active and inactive codes.

4. The method of claim 1, further comprising:

generating a report based upon the processing results, the original code and the normalized code.

5. The method of claim 4, wherein generating the report includes performing statistical analysis on the processing results, the original code and the normalized code.

6. The method of claim 1, further comprising:

determining whether an error occurred during receipt of the transaction; and

displaying an error message if the error occurred during receipt of the transaction.

7. The method of claim 6, wherein the error comprises an invalid code and an improperly entered code.

8. The method of claim 1, wherein normalizing the received transaction further comprises:

prompting a user to select a normalized code for normalizing the transaction.

9. A system for performing transaction coding changes, the system comprising:

means for receiving at least one transaction in an original format associated with an original code;

means for normalizing the received transaction into a normalized format associated with a normalized code;

means for processing the normalized transaction;

means for providing processing results in the original format by associating the processed normalized transaction with the original format; and

means for transmitting the processing results to a recipient of the processed transaction.

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

means for mapping the original code to a group of normalized codes;

means for determining whether codes in the group of normalized codes are in a priority order; and

means for selecting the highest priority code from codes in the group of normalized codes for the normalized code.

11. The system of claim 10, wherein the priority order includes one of a primary and secondary codes, a ranking descending from a highest code to a lowest code, and active and inactive codes.

12. The system of claim 9, further comprising:

means for generating a report based upon the processing results, the original code and the normalized code.

13. The system of claim 12, wherein generating the report includes means for performing statistical analysis on the processing results, the original code and the normalized code.

14. The system of claim 9, further comprising:

means for determining whether an error occurred during receipt of the transaction; and

means for displaying an error message if the error occurred during receipt of the transaction.

15. The system of claim 14, wherein the error comprises an invalid code and an improperly entered code.

16. The system of claim 9, wherein normalizing the received transaction further comprises:

means for prompting a user to select a normalized code for normalizing the transaction.

17. A computer program product comprising a computer usable medium having control logic stored therein for causing a computer to perform transaction coding changes, the control logic comprising:

first computer readable program code means for receiving at least one transaction in an original format associated with an original code;

second computer readable program code means for normalizing the received transaction into a normalized format associated with a normalized code;

third computer readable program code means for processing the normalized transaction;

fourth computer readable program code means for providing processing results in the original format by associating the processed normalized transaction with the original format; and

fifth computer readable program code means for transmitting the processing results to a recipient of the processed transaction.