Automation of auditing claims

• US 8,255,205 B2
• Filed: 05/29/2009
• Issued: 08/28/2012
• Est. Priority Date: 05/29/2009
• Status: Active Grant

• Current Assignee: HyperQuest, Inc. (Solera Holdings Incorporated)
• Original Assignee: HyperQuest, Inc. (Solera Holdings Incorporated)
• Inventors: Hogan, Dennis M., Hogan, Jeffrey J.
• Primary Examiner(s): Shah, Paras D
• Application Number:
  US12/474,482
• Publication Number:
  US 20100305941A1
• Time in Patent Office: 1,187 Days
• Field of Search: 704/1, 704/9, 715256-258, 707/705
• US Class Current: 704/9
• CPC Class Codes: G06F 40/237 Lexical tools

Abstract

Described are computer-based methods and apparatuses, including computer program products, for automation of auditing claims. Data indicative of an insurance company name is received, the data comprising one or more words. The data is processed through one or more processing steps to generate processed data comprising one or more processed words. One or more candidate word strings are selected based on the one or more processed words. Matching information is associated with each of the one or more candidate word strings. Analysis information is generated for each of the one or more candidate word strings based on the associated matching information. An insurance company identifier is associated with received data based on the analysis information and one or more matching rules.

Claims

1. A computerized method comprising:

receiving, via a processor, data indicative of an insurance company name, the data comprising one or more words;

processing, using the processor, the data through one or more processing steps to generate processed data comprising one or more processed words;

selecting, using the processor, one or more candidate word strings based on the one or more processed words;

associating, using the processor, matching information with each of the one or more candidate word strings;

generating, using the processor, analysis information for each of the one or more candidate word strings based on the associated matching information; and

associating, using the processor, an insurance company identifier with received data based on the analysis information and one or more matching rules;

wherein selecting one or more candidate word strings based on the one or more processed words comprises;

determining whether the data includes two or more words with a same usage number;

selecting a first word in the data, wherein the first word has an earliest location in the data of the two or more words with the same usage number; and

selecting the one or more candidate word strings based on the first word.

2. A computerized method comprising:

receiving, via a processor, data indicative of an insurance company name, the data comprising one or more words;

processing, using the processor, the data through one or more processing steps to generate processed data comprising one or more processed words;

selecting, using the processor, one or more candidate word strings based on the one or more processed words;

associating, using the processor, matching information with each of the one or more candidate word strings;

generating using the processor, analysis information for each of the one or more candidate word strings based on the associated matching information; and

associating, using the processor, an insurance company identifier with received data based on the analysis information and one or more matching rules, wherein generating analysis information for each of the one or more candidate word strings based on the associated matching information comprises;

determining whether a location word is in the data, the location word being indicative of an insurance company name; and

if there is a location word, for each location word;

determining a position of the location word in the data indicative of an insurance company name; and

associating the word with an identifier indicative of the position;

calculating a weighted word match count based on a word usage number for the data indicative of an insurance company name, the one or more candidate word strings, or both; and

calculating a sequence number count based on a difference in relative sequence of a lowest usage word in the data indicative of an insurance company name and each of the one or more candidate word strings.

3. The method of claim 2, wherein the lowest usage word is a word used least in the data indicative of an insurance company name.

4. A computerized method comprising:

receiving, via a processor, data indicative of an insurance company name, the data comprising one or more words;

processing, using the processor, the data through one or more processing steps to generate processed data comprising one or more processed words;

selecting, using the processor, one or more candidate word strings based on the one or more processed words;

associating, using the processor, matching information with each of the one or more candidate word strings;

generating, using the processor, analysis information for each of the one or more candidate word strings based on the associated matching information; and

associating, using the processor, an insurance company identifier with received data based on the analysis information and one or more matching rules, wherein generating analysis information for each of the one or more candidate word strings based on the associated matching information comprises;

determining whether a location word is in the data, the location word being indicative of an insurance company name; and

if there is a location word, for each location word;

determining a position of the location word in the data indicative of an insurance company name; and

associating the word with an identifier indicative of the position; and

calculating an average absolute sequence number count for each of the one or more candidate word strings based on a difference in relative sequence of a word in the data indicative of an insurance company name and the candidate word string.

5. A computerized method comprising:

receiving, via a processor, data indicative of an insurance company name, the data comprising one or more words;

processing, using the processor, the data through one or more processing steps to generate processed data comprising one or more processed words;

selecting, using the processor, one or more candidate word strings based on the one or more processed words;

associating, using the processor, matching information with each of the one or more candidate word strings;

generating, using the processor, analysis information for each of the one or more candidate word strings based on the associated matching information; and

associating, using the processor, an insurance company identifier with received data based on the analysis information and one or more matching rules wherein associating an insurance company identifier with received data based on the analysis information and one or more matching rules comprises associating the insurance company identifier based on a word usage number and a number of candidate word string matches.