Insurance file note generation method and system

• US 7,017,111 B1
• Filed: 04/14/2000
• Issued: 03/21/2006
• Est. Priority Date: 04/14/2000
• Status: Expired due to Fees

• Current Assignee: DUCK Creek Technologies Incorporated
• Original Assignee: Accenture LLP (Accenture PLC)
• Inventors: Guyan, G. Victor, Treacy, Peter L., Shaheen, Amy N., Moran, Mark W.
• Primary Examiner(s): VAUGHN, GREGORY J
• Application Number:
  US09/550,499
• Time in Patent Office: 2,167 Days
• Field of Search: 715/505, 715/506, 715/507, 715/508, 715/512, 715/537
• US Class Current: 715/230
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Methods and systems consistent with the principles of the present invention automatically generate file notes for insurance claims using predefined text to complete each file note. A claim folder interface creates detailed claims and provides suffixes and participants to a file note interface. The file note interface displays file notes with prefilled suffix and participant fields as well as selectable items in a category and subcategory field. Moreover, methods and systems consistent with the present invention, enable a claim handler to select a selectable category and subcategory and provide short text associated with the selection in a predefined text area. In addition, a larger text area may also be provided to capture any free form text.

Claims

1. A method for generating a file note for an insurance claim, comprising the steps of, executed in a data processing system, of:

prefilling a first set of fields with information identifying a file note, said information comprising at least one suffix indicating a type of insurance coverage for a participant in a claim and identification of the participant, wherein the at least one suffix is preselected from one or more types of insurance coverage applicable to the claim;

obtaining a selection of fields of a first set of fields from a user, the selection identifying information for a second set of fields;

displaying in the second set of fields, the information identified by selection of field of the first set of fields;

permitting the user to add data to a predefined text area related to each field of the second set of fields based on the selected fields;

generating a file note that contains the first set of fields, the second set of fields, and the data in the predefined text area;

identifying a level of significance of the file note; and

storing the file note with the identified level of significance in a claim database including file notes associated with the claim.

2. The method of claim 1, further comprising the step of storing, in a claim database, the generated file note.

3. The method of claim 1, wherein the data is short text, and where the predefined text area includes a table of variables and a corresponding field that receives short text for each variable.

4. The method of claim 1, wherein permitting the user to add data further comprises the step of permitting the user to add free form notes in a file note area.

5. The method of claim 4, further comprising the steps of:

combining the file note area and the predefined text area; and

storing, in a database, the combined area as a file note.

6. The method of claim 1, further comprising the step of obtaining from the user an indication of whether the file note is significant.

7. The method of claim 1, wherein the second set of fields includes a category and a subcategory.

8. The method of claim 1, wherein the first set of fields include a suffix field and a participant field, wherein the suffix field indicates the type of insurance coverage, and wherein the participant field indicates an entity involved with the claim.

9. A method for generating a file note for an insurance claim folder, comprising:

providing on a display device a claim folder screen depicting attributes associated with a claim, the attributes comprising at least one suffix indicating a type of insurance coverage for a participant in the claim;

permitting the selection of at least one attribute associated with a claim on the claim folder screen;

providing on a display device a file note screen depicting the selected at least one attribute in a criteria section, and a text entry section, wherein the text entry section is based on the selected at least one attribute in the criteria section;

receiving from a user information associated with the text entry section;

generating the file note based on information received from the user;

identifying a level of significance of the file note according to information received from the user; and

storing the file note with the identified level of significance in a searchable claim database, the claim database associating the file note being with a file note index indicating changes to the file note.

10. The method of claim 9, wherein the criteria section contains a selected suffix and a selected participant, wherein the suffix and the participant are selected by a user in the claim folder screen, and wherein the criteria section further contains a category and subcategory field containing categories and subcategories selectable by the handler.

11. The method of claim 10, wherein the categories and subcategories are based on the suffix, participant, or the claim.

12. The method of claim 9, wherein the file note screen further comprises a free form note section containing a text area.

13. A system for generating a file note for an insurance claim, comprising:

prefilling means for prefilling a first set of fields with information identifying a file note, said information comprising at least one suffix indicating a type of insurance coverage for a participant in a claim and identification of the participant, wherein the at least one suffix is preselected from one or more types of insurance coverage applicable to the claim;

obtaining means for obtaining a selection of fields of a first set of fields from a user, the selection identifying information for a second set of fields;

displaying means for displaying in the second set of fields, the information identified by selection of field of the first set of fields;

permitting means for permitting the user to add data to a predefined text area related to each field of the second set of fields based on the selected fields;

generating means for generating a file note that contains the first set of fields, the second set of fields, and the data in the predefined text area; and

identifying means for identifying a level of significance of the file note; and

storing means for storing the file note with the identified level of significance in a claim database including file notes associated with the claim.

14. The method of claim 13, further comprising a claim database, wherein the database stores the generated file note.

15. The system of claim 13, wherein the data is short text, and where the predefined text area includes a table of variables and a corresponding field that receives short text for each variable.

16. The system of claim 13, wherein the permitting means further permits the user to add free form notes in a file note area.

17. The system of claim 16, further comprising:

combining means for combining the file note area and the predefined text area; and

a database for storing the combined area as a file note.

18. The system of claim 13, further comprising obtaining means for obtaining an indication of whether the file note is significant.

19. The system of claim 13, wherein the second set of fields includes a category and a subcategory.

20. The system of claim 13, wherein the first set of fields include a suffix field and a participant field, wherein the suffix field indicates the type of insurance coverage, and wherein the participant field indicates a participant to the claim.

21. The system of claim 13, further comprising the display means for displaying a file note interface screen containing the first set of fields, the second set of fields, and the predefined text area.