Scheduling assessments for determining risk adjustment payment information

• US 8,983,856 B1
• Filed: 12/27/2013
• Issued: 03/17/2015
• Est. Priority Date: 12/27/2013
• Status: Active Grant

• Current Assignee: Community Care Health Network, LLC
• Original Assignee: Community Care Health Network, Inc.
• Inventors: Cantor, Michael A., Chen, George S., Garcia, Alan A., Kyi, Theodore T., Watson, David J.
• Primary Examiner(s): Lubin, Valerie
• Application Number:
  US14/142,496
• Time in Patent Office: 445 Days
• Field of Search: None
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 10/1095 Meeting or appointment
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A computer-implemented method includes, in one aspect, identifying, in a data repository, (i) information indicative of a health care provider who is assigned to a pre-defined calling zone, and (ii) radius information; accessing scheduling information that comprises a plurality of time slots, wherein each time slot corresponds to a time for the health care provider to perform the health risk assessment; selecting, by one or more computer systems, a particular slot from the scheduling information; for the selected slot, applying a geo-dialing algorithm to candidate information that is indicative of one or more members of one or more health plans who are candidates for scheduling in the selected time slot; identifying, based on application of the geo-dialing algorithm, a candidate with a geographic location that is a decreased distance from a geographic location of the health care provider; and causing a call to be placed to the identified candidate.

Claims

1. A computer-implemented method comprising:

identifying, in a data repository, (i) information indicative of a health care provider who is assigned to a pre-defined calling zone, and (ii) radius information indicative of a radial distance from a starting location that the health care provider will travel to perform a health risk assessment;

accessing scheduling information that comprises a plurality of time slots, wherein each time slot corresponds to a time for the health care provider to perform the health risk assessment;

automatically selecting, using one or more computer systems, a particular slot from the scheduling information;

determining that a particular candidate is required to be prioritized in scheduling of health risk assessments;

retrieving, using one or more computer systems from the data repository, a distance offset value that is associated with the particular candidate, with the distance offset value specifying an amount by which a distance between a geographic location of the particular candidate and a geographic location of the health care provider is decreased to promote scheduling of a health risk assessment for the particular candidate before scheduling of health risk assessments for other clients;

for the selected slot,

computing using one or more computer systems distances between geographic locations of candidates and the geographic location of the health care provider;

applying the distance offset value to a computed distance for the particular candidate;

decreasing, using one or more computer systems based on applying the distance offset value, an amount of the computed distance between the geographic location of the health care provider and the geographic location for the particular candidate; and

increasing, using one or more computer systems based on the decreased computed distance, a priority of the particular candidate for scheduling with the health care provider;

applying a geo-dialing algorithm to computed distances with applied one or more distance offset values and candidate information that is indicative of one or more members of one or more health plans who are candidates for scheduling in the selected time slot;

identifying, using one or more computer systems based on application of the geo-dialing algorithm, a candidate with a geographic location that is a decreased distance from a geographic location of the health care provider, relative to other distances of other candidates from the health care provider;

comparing using one or more computer systems (i) an amount of distance between the geographic location of the identified candidate and the starting location of the health care provider, to (ii) the radial distance;

confirming, using one or more computer systems and based on comparing, that the geographic location of the identified candidate is within the radial distance; and

causing a call to be placed to the identified candidate to promote scheduling of the health risk assessment between the identified candidate and the health care provider at a time that is associated with the selected slot.

2. The computer-implemented method of claim 1, further comprising:

retrieving a priority call queue, with the priority call queue specifying an order in which the one or more computer systems place calls to candidates in accordance with distances between geographic locations of the candidates and the geographic location of the health care provider;

wherein identifying the candidate comprises identifying a candidate ranked first in the priority call queue.

3. The computer-implemented method of claim 1, further comprising repeating the actions of selecting a slot, applying the geo-dialing algorithm, identifying a candidate and causing a call to be placed until each of the slots in the scheduling information is populated with scheduling information.

4. The computer-implemented method of claim 1, wherein the identified candidate is a first identified candidate, the amount of distance is a first amount of distance, and wherein the method further comprises:

determining that a second amount of distance between a geographic location of a second identified candidate and the starting location of the health care provider is greater than the radial distance;

determining that the second identified candidate is ineligible to be seen by the health care provider; and

replacing the ineligible candidate with another candidate who is associated with a geographic location that is a decreased distance from the geographic location of the health care provider, relative to other distances of other candidates from the health care provider.

5. The computer-implemented method of claim 1, further comprising

receiving acceptance information specifying that the candidate has scheduled the health risk assessment;

updating the selected slot with identifying information for the candidate to schedule the health care provider to perform the health risk assessment at a time associated with the selected slot;

updating the geographic location of the health care provider to be the geographic location of the candidate who scheduled the appointment;

selecting another slot from the scheduling information, with the selected other slot being a next slot in the scheduling information;

for the selected other slot,

identifying another candidate with a geographic location that is a decreased distance from the updated geographic location of the health care provider, relative to other distances of other candidates from the health care provider; and

causing a call to be placed to the identified other candidate.

6. One or more machine-readable hardware storage devices storing instructions that are executable by one or more processing devices to perform operations comprising:

identifying, in a data repository, (i) information indicative of a health care provider who is assigned to a pre-defined calling, and (ii) radius information indicative of a radial distance from a starting location that the health care provider will travel to perform a health risk assessment;

accessing scheduling information that comprises a plurality of time slots, wherein each time slot corresponds to a time for the health care provider to perform the health risk assessment;

automatically selecting a particular slot from the scheduling information;

determining that a particular candidate is required to be prioritized in scheduling of health risk assessments;

retrieving, from the data repository, a distance offset value that is associated with the particular candidate, with the distance offset value specifying an amount by which a distance between a geographic location of the particular candidate and a geographic location of the health care provider is decreased to promote scheduling of a health risk assessment for the particular candidate before scheduling of health risk assessments for other clients;

for the selected slot,

computing distances between geographic locations of candidates and the geographic location of the health care provider;

applying the distance offset value to a computed distance for the particular candidate;

decreasing, based on applying the distance offset value, an amount of the computed distance between the geographic location of the health care provider and the geographic location for the particular candidate; and

increasing, based on the decreased computed distance, a priority of the particular candidate for scheduling with the health care provider;

applying a geo-dialing algorithm to computed distances with applied one or more distance offset values and candidate information that is indicative of one or more members of one or more health plans who are candidates for scheduling in the selected time slot;

identifying, based on application of the geo-dialing algorithm, a candidate with a geographic location that is a decreased distance from a geographic location of the health care provider, relative to other distances of other candidates from the health care provider;

comparing (i) an amount of distance between the geographic location of the identified candidate and the starting location of the health care provider, to (ii) the radial distance;

confirming, and based on comparing, that the geographic location of the identified candidate is within the radial distance; and

causing a call to be placed to the identified candidate to promote scheduling of the health risk assessment between the identified candidate and the health care provider at a time that is associated with the selected slot.

7. The one or more machine-readable hardware storage devices of claim 6, wherein the operations further comprise:

retrieving a priority call queue, with the priority call queue specifying an order in which calls are placed to candidates in accordance with distances between geographic locations of the candidates and the geographic location of the health care provider;

wherein identifying the candidate comprises identifying a candidate ranked first in the priority call queue.

8. The one or more machine-readable hardware storage devices of claim 6, wherein the operations further comprise:

repeating the actions of selecting a slot, applying the geo-dialing algorithm, identifying a candidate and causing a call to be placed until each of the slots in the scheduling information is populated with scheduling information.

9. The one or more machine-readable hardware storage devices of claim 6, wherein the identified candidate is a first identified candidate, the amount of distance is a first amount of distance, and wherein the operations further comprise:

determining that a second amount of distance between a geographic location of a second identified candidate and the starting location of the health care provider is greater than the radial distance;

determining that the second identified candidate is ineligible to be seen by the health care provider; and

replacing the ineligible candidate with another candidate who is associated with a geographic location that is a decreased distance from the geographic location of the health care provider, relative to other distances of other candidates from the health care provider.

10. The one or more machine-readable hardware storage devices of claim 6, wherein the operations further comprise:

receiving acceptance information specifying that the candidate has scheduled the health risk assessment;

updating the selected slot with identifying information for the candidate to schedule the health care provider to perform the health risk assessment at a time associated with the selected slot;

updating the geographic location of the health care provider to be the geographic location of the candidate who scheduled the appointment;

selecting another slot from the scheduling information, with the selected other slot being a next slot in the scheduling information;

for the selected other slot,

identifying another candidate with a geographic location that is a decreased distance from the updated geographic location of the health care provider, relative to other distances of other candidates from the health care provider; and

causing a call to be placed to the identified other candidate.

11. An electronic system comprising:

one or more processing devices; and

one or more machine-readable hardware storage devices storing instructions that are executable by the one or more processing devices to perform operations comprising;

identifying, in a data repository, (i) information indicative of a health care provider who is assigned to a pre-defined calling, and (ii) radius information indicative of a radial distance from a starting location that the health care provider will travel to perform a health risk assessment;

accessing scheduling information that comprises a plurality of time slots, wherein each time slot corresponds to a time for the health care provider to perform the health risk assessment;

automatically selecting a particular slot from the scheduling information;

determining that a particular candidate is required to be prioritized in scheduling of health risk assessments;

retrieving, from the data repository, a distance offset value that is associated with the particular candidate, with the distance offset value specifying an amount by which a distance between a geographic location of the particular candidate and a geographic location of the health care provider is decreased to promote scheduling of a health risk assessment for the particular candidate before scheduling of health risk assessments for other clients;

for the selected slot,

computing distances between geographic locations of candidates and the geographic location of the health care provider;

applying the distance offset value to a computed distance for the particular candidate;

decreasing, based on applying the distance offset value, an amount of the computed distance between the geographic location of the health care provider and the geographic location for the particular candidate; and

increasing, based on the decreased computed distance, a priority of the particular candidate for scheduling with the health care provider;

applying a geo-dialing algorithm to computed distances with applied one or more distance offset values and candidate information that is indicative of one or more members of one or more health plans who are candidates for scheduling in the selected time slot;

identifying, based on application of the geo-dialing algorithm, a candidate with a geographic location that is a decreased distance from a geographic location of the health care provider, relative to other distances of other candidates from the health care provider;

comparing (i) an amount of distance between the geographic location of the identified candidate and the starting location of the health care provider, to (ii) the radial distance;

confirming, and based on comparing, that the geographic location of the identified candidate is within the radial distance; and

causing a call to be placed to the identified candidate to promote scheduling of the health risk assessment between the identified candidate and the health care provider at a time that is associated with the selected slot.

12. The electronic system of claim 11, wherein the operations further comprise:

retrieving a priority call queue, with the priority call queue specifying an order in which calls are placed to candidates in accordance with distances between geographic locations of the candidates and the geographic location of the health care provider;

wherein identifying the candidate comprises identifying a candidate ranked first in the priority call queue.

13. The electronic system of claim 11, wherein the operations further comprise:

repeating the actions of selecting a slot, applying the geo-dialing algorithm, identifying a candidate and causing a call to be placed until each of the slots in the scheduling information is populated with scheduling information.

14. The electronic system of claim 11, wherein the identified candidate is a first identified candidate, the amount of distance is a first amount of distance, and wherein the operations further comprise:

determining that a second amount of distance between a geographic location of a second identified candidate and the starting location of the health care provider is greater than the radial distance;

determining that the second identified candidate is ineligible to be seen by the health care provider; and

replacing the ineligible candidate with another candidate who is associated with a geographic location that is a decreased distance from the geographic location of the health care provider, relative to other distances of other candidates from the health care provider.

15. The electronic system of claim 11, wherein the operations further comprise:

receiving acceptance information specifying that the candidate has scheduled the health risk assessment;

updating the selected slot with identifying information for the candidate to schedule the health care provider to perform the health risk assessment at a time associated with the selected slot;

updating the geographic location of the health care provider to be the geographic location of the candidate who scheduled the appointment;

selecting another slot from the scheduling information, with the selected other slot being a next slot in the scheduling information;

for the selected other slot,

identifying another candidate with a geographic location that is a decreased distance from the updated geographic location of the health care provider, relative to other distances of other candidates from the health care provider; and

causing a call to be placed to the identified other candidate.