System and method for episode service item cost estimation based on historical data
First Claim
1. A system, comprising:
- one or more processors; and
memory coupled to the one or more processors, and storing program instructions executable by the one or more processors to implement a system configured to;
collect, from a plurality of sources, historical healthcare data about actual healthcare episodes previously experienced by respective ones of a plurality of consumers other than a user of the system, each episode having one or more service items associated with diagnosis, treatment, and followup related to the episode, the one or more service items including one or more of treatments and medication related to the episode, actual historical cost data associated with the one or more service items, and provider information indicating at least one provider who performed the service item;
receive a cost estimate request for a specified episode, the request being received from the user not of the plurality of consumers;
receive input from the user selecting at least two service providers to compare;
in response to receiving the cost estimate request;
access the historical healthcare data;
analyze the historical healthcare data to determine service items previously accomplished by the at least two user-selected service providers, for at least one of the plurality of consumers for the specified episode, and to determine actual historical cost information for each determined service item, for the at least two user-selected service providers according to the historical healthcare data; and
generate a response to the cost estimate request which includes a comparison of the actual historical costs of service items previously accomplished by the at least two user-selected service providers for the specified episode, wherein the response indicates service item information for each determined service item, the service item information including at least an in-network actual cost for each of the at least two user-selected service providers for the service item, an out of network actual cost for each of the at least two user-selected service providers for the service item, the actual historical cost information provided as a cost comparison of the cost of individual ones of each of the plurality of service items at each of the at least two user-selected service providers.
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Accused Products
Abstract
A system is implemented to collect data from a plurality of different sources. The data comprises information about episodes experienced by a plurality of consumers. The system is configured to receive a cost estimate request from a user for a specified episode. The may access the data to determine a plurality of service items for the specified episode and the associated cost of each service item. An episode may be associated with one or many service items. The network-based service may generate a response to the cost estimate request. The response may include the plurality of service items determined for the specified episode and the associated cost information. The system may send the response to the user.
40 Citations
18 Claims
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1. A system, comprising:
- one or more processors; and
memory coupled to the one or more processors, and storing program instructions executable by the one or more processors to implement a system configured to; collect, from a plurality of sources, historical healthcare data about actual healthcare episodes previously experienced by respective ones of a plurality of consumers other than a user of the system, each episode having one or more service items associated with diagnosis, treatment, and followup related to the episode, the one or more service items including one or more of treatments and medication related to the episode, actual historical cost data associated with the one or more service items, and provider information indicating at least one provider who performed the service item; receive a cost estimate request for a specified episode, the request being received from the user not of the plurality of consumers; receive input from the user selecting at least two service providers to compare; in response to receiving the cost estimate request;
access the historical healthcare data;analyze the historical healthcare data to determine service items previously accomplished by the at least two user-selected service providers, for at least one of the plurality of consumers for the specified episode, and to determine actual historical cost information for each determined service item, for the at least two user-selected service providers according to the historical healthcare data; and generate a response to the cost estimate request which includes a comparison of the actual historical costs of service items previously accomplished by the at least two user-selected service providers for the specified episode, wherein the response indicates service item information for each determined service item, the service item information including at least an in-network actual cost for each of the at least two user-selected service providers for the service item, an out of network actual cost for each of the at least two user-selected service providers for the service item, the actual historical cost information provided as a cost comparison of the cost of individual ones of each of the plurality of service items at each of the at least two user-selected service providers. - View Dependent Claims (3, 4, 5, 6, 7, 8, 9, 10)
- one or more processors; and
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2. A non-transitory computer-accessible storage medium, comprising program instructions, wherein the program instructions are computer-executable to implement a system to:
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collect, from a plurality of sources, historical healthcare data about actual healthcare episodes previously experienced by respective ones of a plurality of consumers other than a user of the system, each episode having one or more service items associated with diagnosis, treatment, and followup related to the episode, the one or more service items including one or more of treatments and medication related to the episode, actual historical cost data associated with the one or more service items, and provider information indicating at least one provider who performed the service item; receive a cost estimate request for a specified episode, the request being received from the user not of the plurality of consumers; receive input from the user selecting at least two service providers to compare; in response to receiving the cost estimate request;
access the historical healthcare data;analyze the historical healthcare data to determine service items previously accomplished by the at least two user-selected service providers, for at least one of the plurality of consumers for the specified episode, and to determine actual historical cost information for each determined service item, for the at least two user-selected service providers according to the historical healthcare data; and generate a response to the cost estimate request which includes a comparison of the actual historical costs of service items previously accomplished by the at least two user-selected service providers for the specified episode, wherein the response indicates service item information for each determined service item, the service item information including at least an in-network actual cost for each of the at least two user-selected service providers for the service item, an out of network actual cost for each of the at least two user-selected service providers for the service item, the actual historical cost information provided as a cost comparison of the cost of individual ones of each of the plurality of service items at each of the at least two user-selected service providers. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18)
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Specification