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Method and system for processing medical provider claim data

  • US 8,799,313 B2
  • Filed: 04/04/2011
  • Issued: 08/05/2014
  • Est. Priority Date: 02/20/2001
  • Status: Expired due to Term
First Claim
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1. A computer-implemented method for processing data related to medical insurance, comprising:

  • receiving by a processor from a first source data indicative of medical provider claims submitted to insurance providers, including claim number data, injury type data and provider identification data, from a second source data indicative of insurance payments made by insurance providers to medical providers, including bill control number, procedure code and provider identification data, and from a third source data indicative of medical provider data, including provider identification data;

    identifying by the processor common information items, comprising at least provider identification data, in said data from said first, second and third sources;

    storing by the processor the received data in a data storage device in an intermediate database, wherein said data from said first, second and third sources is cross-referenced with regard to at least said provider identification data of said common information items;

    determining by the processor, based on data from at least two of said first, second and third sources, at least one data item not contained in any of said data from said first, second and third sources; and

    storing by the processor the determined at least one data item in the intermediate database.

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