Automation of auditing claims

• US 8,543,431 B2
• Filed: 11/15/2011
• Issued: 09/24/2013
• 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): Tran, Hai
• Application Number:
  US13/296,427
• Publication Number:
  US 20120059678A1
• Time in Patent Office: 679 Days
• Field of Search: 705/4, 705 15- 45
• US Class Current: 705/4
• CPC Class Codes: G06F 16/258 Data format conversion from or to a database
• CPC Class Codes: G06Q 20/10 specially adapted for electronic funds transfer [EFT] systems; specially adapted for home banking systems
• CPC Class Codes: G06Q 40/00 Finance; Insurance; Tax strategies; Processing of corporate or income taxes
• CPC Class Codes: G06Q 40/03 Credit; Loans; Processing thereof
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Described are computer-based methods and apparatuses, including computer program products, for automation of auditing claims. Data indicative of a vehicle make and model is received, the data comprising one or more make fields and one or more model fields. The one or more model fields are prepared for translation. The one or more make fields are prepared for translation by applying one or more rules from the plurality of rules. Each field of the one or more make fields is associated with one or more make model entries from a plurality of predetermined make model entries. Each field of the one or more model fields is associated with one or more make model entries from the plurality of predetermined make model entries. The data is automatically translated into one or more vehicle identifiers based on the associated make model entries.

Claims

1. A computerized method comprising:

receiving, at a processor, data containing text fields indicative of a vehicle make and model, the text fields comprising one or more make fields and one or more model fields, wherein the one or more make fields and the one or more model fields are provided together in the data received by the processor and wherein the one or more model fields are provided as independent fields and are not limited to a list of models received by the processor based on the one or more make fields, wherein the data includes a line item from an insurance demand file;

preparing, using the processor, the one or more model fields for translation by;

applying one or more rules from a plurality of rules; and

associating each field of the one or more model fields with a class from a list of classes;

preparing, using the processor, the one or more make fields for translation by;

applying one or more rules from the plurality of rules;

associating, using the processor, each field of the one or more make fields with one or more make model entries from a plurality of predetermined make model entries;

associating, using the processor, each field of the one or more model fields with one or more make model entries from the plurality of predetermined make model entries; and

automatically translating, using the processor, the text fields into one or more vehicle identifiers based on the associated make model entries.

2. The method of claim 1, wherein:

the one or more make fields comprise a claim make field and an estimate block make field; and

the one or more model fields comprise a claim model field and an estimate block model field.

3. The method of claim 1, wherein preparing the one or more model fields for translation by applying one or more rules from a plurality of rules comprises:

identifying a model in the one or more model fields that does not need processing;

identifying two words that must be combined into one word, and combining the two words into one word;

identifying a first word that must be separated into two words, and separating the first word into two words; and

identifying a second word as a descriptive classification word, and standardizing a spelling of the second word.

4. The method of claim 1, wherein preparing the one or more model fields for translation by associating each field of the one or more model fields with the class from the list of classes comprises:

identifying a vehicle make of a make field of the one or more make fields is improper for translation, and terminating the translation;

or

determining a model field of the one or more model fields comprises a truck, and applying one or more rules to identify the truck, or any combination thereof.

5. The method of claim 4, further comprising:

correcting an improperly classified model number, wherein the correcting includes;

determining a make field of the one or more make fields comprises a numeric value that has been improperly included in the make field, and a model field of the one or more model fields does not comprise the numeric value;

removing the numeric value from the make field; and

inserting the numeric value in the model field.

7. The method of claim 1, wherein preparing the one or more make fields for translation by applying one or more rules from the plurality of rules comprises:

converting a make abbreviation in a make field of the one or more make fields to an expanded spelling;

or

inserting a space between joined words of a two word pair of all words of the one or more make fields, the one or more model fields, or both.

8. The method of claim 1, wherein each of the one or more predetermined make model entries comprises manufacturer information, make information, and model information.

9. The method of claim 1, wherein the one or more vehicle identifiers each include a numeric value corresponding to a vehicle make and model.

6. The method of 4, wherein applying one or more rules to identify the truck comprises inserting one or more words, removing one or more words, or both.

10. An apparatus comprising:

an auditing system configured to receive data containing text fields indicative of a vehicle make and model, the text fields comprising one or more make fields and one or more model fields, wherein the one or more make fields and the one or more model fields are provided together in the data received by the processor, are provided as independent fields and are not limited to a list of models received by the processor based on the one or more make fields; and

a make model translator in communication with the auditing system configured to;

prepare the one or more model fields for translation by;

applying one or more rules from a plurality of rules; and

associating each field of the one or more model fields with a class from a list of classes;

prepare the one or more make fields for translation by applying one or more rules from the plurality of rules;

associate each field of the one or more make fields with one or more make model entries from a plurality of predetermined make model entries;

associate each field of the one or more model fields with one or more make model entries from the plurality of predetermined make model entries; and

automatically translate the text fields into one or more vehicle identifiers based on the associated make model entries.

11. The apparatus of claim 10, wherein the one or more vehicle identifiers each include a numeric value corresponding to a vehicle make and model.

12. A computer program product, tangibly embodied in a non-transitory computer readable storage medium, the computer program product including instructions being operable to cause a data processing apparatus to:

receive data indicative of a vehicle make and model, the data containing text fields including one or more make fields and one or more model fields, wherein the one or more make fields and the one or more model fields are provided together in the data received by the processor as independent fields and are not limited to a list of models received by the processor based on the one or more make fields;

prepare the one or more model fields for translation by;

applying one or more rules from a plurality of rules; and

associating each field of the one or more model fields with a class from a list of classes;

prepare the one or more make fields for translation by applying one or more rules from the plurality of rules;

associate each field of the one or more make fields with one or more make model entries from a plurality of predetermined make model entries;

associate each field of the one or more model fields with one or more make model entries from the plurality of predetermined make model entries; and

automatically translate the text fields into one or more vehicle identifiers based on the associated make model entries.

13. The computer program product of claim 12, wherein the one or more vehicle identifiers each include a numeric value corresponding to a vehicle make and model.

14. An apparatus comprising:

a processor adapted to perform a translation of auditable items;

a data receiver coupled to the processor, the data receiver adapted to receive data containing text fields indicative of a vehicle make and model, wherein the text fields include one or more make fields and one or more model fields, wherein the one or more make fields and the one or more model fields are provided together in the data received by the processor, wherein the one or more model fields are provided as independent fields and wherein the one or more model fields are not limited to a list of models received by the processor based on the one or more make fields; and

wherein the processor is programmed to perform operations including;

preparing the one or more model fields for translation by;

applying one or more rules from a plurality of rules; and

associating each field of the one or more model fields with a class from a list of classes;

preparing the one or more make fields for translation by applying one or more rules from the plurality of rules;

associating each field of the one or more make fields with one or more make model entries from a plurality of predetermined make model entries;

associating each field of the one or more model fields with one or more make model entries from the plurality of predetermined make model entries; and

automatically translating the text fields into one or more vehicle identifiers based on the associated make model entries.

15. The apparatus of claim 14, wherein the one or more vehicle identifiers each include a numeric value corresponding to a vehicle make and model.

16. A computerized method comprising:

receiving, at a processor, data having text fields indicative of a vehicle make and model, the text fields comprising one or more make fields and one or more model fields, wherein the one or more make fields and the one or more model fields are provided together in the data received by the processor, wherein the one or more model fields are provided independently, and wherein the one or more model fields are not selected from a list of models received by the processor based on the one or more make fields;

associating, using the processor, each field of the one or more make fields with one or more make model entries from a plurality of predetermined make model entries, the associating including generating a temporary translation table, wherein each row of the temporary translation table comprises a manufacturer field, a make field, a model superset field, and a model subset field;

identifying a match of a make field of the one or more make fields with a predetermined make model entry; and

populating a row of the temporary translation table with match information;

associating, using the processor, each field of the one or more model fields with one or more make model entries from the plurality of predetermined make model entries; and

automatically translating, using the processor, the text fields into one or more vehicle identifiers based on the associated make model entries.

17. A computerized method comprising:

receiving, at a processor, data having text fields indicative of a vehicle make and model, the text fields comprising one or more make fields and one or more model fields, wherein the one or more make fields and the one or more model fields are provided together in the data received by the processor, wherein the one or more model fields are provided independently, and wherein the one or more model fields are not limited to a list of models received by the processor based on the one or more make fields;

preparing, using the processor, the one or more model fields for translation by;

applying one or more rules from a plurality of rules; and

associating each field of the one or more model fields with a class from a list of classes;

preparing, using the processor, the one or more make fields for translation by applying one or more rules from the plurality of rules;

associating, using the processor, each field of the one or more make fields with one or more make model entries from a plurality of predetermined make model entries, the associating including generating a temporary translation table, identifying a match of a make field of the one or more make fields with a predetermined make model entry, and populating a row of the temporary translation table with match information;

associating, using the processor, each field of the one or more model fields with one or more make model entries from the plurality of predetermined make model entries; and

automatically translating, using the processor, the text fields into one or more vehicle identifiers based on the associated make model entries.