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System and method for encrypting provider identifiers on medical service claim transactions

  • US 9,141,758 B2
  • Filed: 01/08/2010
  • Issued: 09/22/2015
  • Est. Priority Date: 02/20/2009
  • Status: Active Grant
First Claim
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1. A system comprising:

  • one or more data storage devices storing one or more databases, wherein the one or more databases include;

    a specialty database storing anonymous practitioner keys (APKs), each cross-referenced to a medical specialty and a geographic location of a corresponding medical provider; and

    an encrypted database storing encrypted medical provider identifiers, each encrypted using a one-way encryption with no inverse function from the one-way encryption and each cross-referenced to an anonymous practitioner key; and

    one or more processors configured to;

    receive de-identified medical claim transaction data, wherein the received de-identified medical claim transaction data includes one or more encrypted medical provider identifiers that are encrypted using the one-way encryption with no inverse function to recover from the one-way encryption;

    match at least one of the received one or more encrypted medical provider identifiers with one or more encrypted medical provider identifiers stored at the encrypted database;

    wherein a match is a deterministic match determined by an exact correspondence between at least one of the received one or more encrypted medial provider identifiers and one or more encrypted medical provider identifiers stored at the encrypted database;

    identify an APK that is cross-referenced to a matched encrypted medical provider identifier according to the deterministic match;

    associate, using the APK that is cross-referenced in the specialty database to a medical specialty and a geographic location of a corresponding medical provider the medical specialty and the geographic location of the medical provider to whom the APK has been assigned and who has provided a service as described by the de-identified medical claim transaction data; and

    determining a total number of services provided by the medical provider in the medical specialty and in the geographic location.

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