System and method for hierarchically pricing items

• US 7,565,300 B2
• Filed: 08/10/2007
• Issued: 07/21/2009
• Est. Priority Date: 08/10/2006
• Status: Active Grant

• Current Assignee: MedCom Solutions, Inc.
• Original Assignee: MedCom Solutions, Inc.
• Inventors: O'Connell, Susan M, Hunt, William A, Menicucci, Jennifer
• Primary Examiner(s): Gilligan; C. Luke
• Assistant Examiner(s): Rapillo; Kristine K
• Application Number:
  US11/836,856
• Publication Number:
  US 20080040154A1
• Time in Patent Office: 711 Days
• Field of Search: 705 2- 3
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 20/201 Price look-up processing, e.g. updating
• CPC Class Codes: G06Q 30/00 Commerce

Abstract

A computer-assisted method for hierarchically pricing chargeable items in a healthcare provider'"'"'s chargeable item database is disclosed. The method applies hierarchical pricing to related chargeable items. A system for hierarchically pricing related chargeable items is also disclosed.

Claims

1. A computer-assisted method of hierarchical pricing, said method comprising the steps of:

a. creating a hierarchy comprising a plurality of groups, each said group having at least one procedural code that corresponds to a chargeable item;

b. for each group, sequentially ordering said procedural codes in said group in a first sequential order that provides a comparative value for each of said chargeable items relative to said other chargeable items in said group;

c. for each group, assigning a ranked character to each said procedural code that symbolizes said first sequential order, wherein each said ranked character is derived from a scale having a total population equal to the total number of procedural codes comprising said group;

d. searching said hierarchy for a selected procedural code;

e. identifying all related procedural codes in said group to which said selected procedural code is assigned;

f. performing a computer-assisted search of a healthcare providers chargeable item database to identify all of said procedural codes in said group to which said selected procedural code is assigned;

g. sequentially, by a computer, ordering said procedural codes identified in said chargeable item database in a second sequential order according to price;

h. comparing, by a computer, said first and second sequential orders; and

i. updating, by a computer, a price of said chargeable items in said chargeable item database having said identified procedural codes to price said chargeable items according to said first sequential order.

2. A method as set forth in claim 1 wherein said hierarchy is stored in a second database.

3. A method as set forth in claim 1 wherein at least one of said procedural codes identified in said chargeable item database is excluded from said step of comparing.

4. A method as set forth in claim 1 further comprising a duplicate database that stores a duplicate copy of each of said hierarchy and said chargeable item database.

5. A method as set forth in claim 4 wherein said steps of searching said hierarchy and searching said chargeable item database are performed in said duplicate database.

6. A method as set forth in claim 1 further comprising the step of generating a report that summarizes a comparison of said first and second sequential orders.

7. A method as set forth in claim 1 wherein said chargeable item database is selected from the group consisting of a Chargemaster, a product list, and a Service Master.

8. A method as set forth in claim 1 wherein said chargeable item database is a Chargemaster.

9. A method as set forth in claim 1 wherein said chargeable item database is a product list.

10. A method as set forth in claim 1 wherein said chargeable item database is a Service Master.

11. A method as set forth in claim 1 wherein said at least one procedural code is selected from the group consisting of a Current Procedural Terminology code, a HCFA Common Procedure Coding System code, an International Classification of Disease code, an internal code, and a private insurer'"'"'s code.

12. A method as set forth in claim 1 wherein said at least one procedural code is a Current Procedural Terminology code.

13. A method as set forth in claim 1 wherein said at least one procedural code is a HCFA Common Procedure Coding System code.

14. A method as set forth in claim 1 wherein said at least one procedural code is an International Classification of Disease code.

15. A hierarchical pricing system for use by a healthcare provider, said system comprising:

a. a hierarchy, stored on a computer readable media, comprising a plurality of groups, each said group having at least one procedural code that corresponds to a chargeable item, wherein said procedural codes in each said group are sequentially ordered in a first sequential order that provides a comparative value for each of said chargeable items relative to said other chargeable items in said group, and wherein a ranked character is assigned to each of said chargeable items in each said group that symbolizes said first sequential order, each said ranked character being derived from a scale having a total population equal to the total number of procedural codes comprising said group; and

b. a processor configured to;

i. search said hierarchy for a selected procedural code;

ii. identify all of said procedural codes in said group to which said selected procedural code is assigned;

iii. search a healthcare provider'"'"'s chargeable item database to identify all of said procedural codes in said group to which said selected procedural code is assigned;

iv. sequentially order said procedural codes identified in said chargeable item database in a second sequential order according to price;

v. compare said first and second sequential orders to derive a comparison; and

vi. update a price of said chargeable items in said chargeable item database having said identified procedural codes to price said chargeable items according to said first sequential order.

16. A system as set forth in claim 15 wherein said processor is further configured to recognize an exclusionary code that excludes at least one of said procedural codes identified in said chargeable item database from said comparison.

17. A system as set forth in claim 15 further comprising a duplicate database that stores a duplicate copy of each of said hierarchy and said chargeable item database, said duplicate database being used by said processor to perform said searches and comparison.

18. A system as set froth in claim 15 wherein said processor is further configured to generate a report that summarizes said comparison.

19. A system as set forth in claim 15 wherein said chargeable item database is selected from the group consisting of a Chargemaster, a product list, and a Service Master.

20. A system as set forth in claim 15 wherein said chargeable item database is a Chargemaster.

21. A system as set forth in claim 15 wherein said chargeable item database is a product list.

22. A system as set forth in claim 15 wherein said chargeable item database is a Service Master.

23. A system as set forth in claim 15 wherein said procedural code is selected from the group consisting of a Current Procedural Terminology code, a HCFA Common Procedure Coding System code, an International Classification of Disease code, an internal code, and a private insurer'"'"'s code.

24. A system as set forth in claim 15 wherein said procedural code is a Current Procedural Terminology code.

25. A system as set forth in claim 15 wherein said procedural code is a HCFA Common Procedure Coding System code.

26. A system as set forth in claim 15 wherein said procedural code is an International Classification of Disease code.

27. A hierarchical pricing apparatus for use by a healthcare provider, said apparatus comprising:

a. means for creating a hierarchy comprising a plurality of groups, each said group having at least one procedural code that corresponds to a chargeable item;

b. means for sequentially ordering said procedural codes in each said group in a first sequential order that provides a comparative value for each of said items relative to said other items in said group;

c. means for assigning a ranked character to each said procedural code in each said group, said ranked character symbolizing said first sequential order, wherein each said ranked character is derived from a scale having a total population equal to the total number of procedural codes comprising said group;

d. means for searching said hierarchy for a selected procedural code;

e. means for identifying all of said procedural codes in said group to which said selected procedural code is assigned;

f. means for searching a healthcare provider'"'"'s chargeable item database to identify all of said procedural codes in said group to which said selected procedural code is assigned;

g. means for sequentially ordering said procedural codes identified in said chargeable item database in a second sequential order according to price;

h. means for comparing said first and second sequential orders; and

i. means for updating a price of said chargeable items in said chargeable item database having said identified procedural codes to price said chargeable items according to said first sequential order.

28. An apparatus as set forth in claim 27 wherein said chargeable item database is at least one of a Chargemaster, a product list, or a Service Master.

29. An apparatus as set forth in claim 27 wherein said procedural code is at least one of a Current Procedural Terminology code, a HCFA Common Procedure Coding System code, or an International Classification of Disease code.

30. A computer readable medium having stored therein instructions which, when executed by a processor, cause the processor to:

a. create a hierarchy comprising a plurality of groups, each said group having at least one procedural code that corresponds to a chargeable item;

b. sequentially order said procedural codes each said group in a first sequential order that provides a comparative value for each of said items relative to said other items in said group;

c. assign a ranked character to each said procedural code in each said group, said ranked character symbolizing said first sequential order, wherein each said ranked character is derived from a scale having a total population equal to the total number of procedural codes comprising said group;

d. search said hierarchy for a selected procedural code;

e. identify all of said procedural codes in said group to which said selected procedural code is assigned;

f. search a healthcare provider'"'"'s chargeable item database to identify all of said procedural codes in said group to which said selected procedural code is assigned;

g. sequentially order said procedural codes identified in said chargeable item database in a second sequential order according to price;

h. compare said first and second sequential orders; and

i. update a price of said chargeable items in said chargeable item database having said identified procedural codes to price said chargeable items according to said first sequential order.

31. A computer readable medium as set forth in claim 30 wherein said chargeable item database is at least one of a Chargemaster, a product list, or a Service Master.

32. An computer readable medium as set forth in claim 30 wherein said procedural code is at least one of a Current Procedural Terminology code, a HCFA Common Procedure Coding System code, or an International Classification of Disease code.