System and method for encrypting provider identifiers on medical service claim transactions
First Claim
Patent Images
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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Abstract
The present invention relates to a method and a system for collecting and providing reports of activities of medical service providers, while encrypting confidential information. Specifically, the present invention provides systems and methods for collecting and providing information from medical claim transactions without information for specifically identifying the particular medical service provider. The present invention also allows for correlation of medical claim transactions with providers'"'"' information without using information that can be used to specifically identify the particular medical service provider (provider identifier).
127 Citations
19 Claims
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1. A system comprising:
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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. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 12, 13)
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11. A computer-assisted method comprising:
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receiving, by one or more processors, 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; matching at least one of the received one or more encrypted medical provider identifiers with one or more encrypted medical provider identifiers stored at an 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; identifying an APK that is cross-referenced to a matched encrypted medical provider identifier according to the deterministic match; associating, using the APK that is cross-referenced in a 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. - View Dependent Claims (14, 15, 16, 17)
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18. A system comprising;
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one or more processors; and a non-transitory computer-readable medium coupled to the one or more processors having instructions stored thereon which, when executed by the one or more processors, cause the one or more processors to perform operations comprising; receiving, by the one or more processors, 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; matching at least one of the received one or more encrypted medical provider identifiers with one or more encrypted medical provider identifiers stored at an 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; identifying an APK that is cross-referenced to a matched encrypted medical provider identifier according to the deterministic match; associating, using the APK that is cross-referenced in a 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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19. A non-transitory computer-readable medium encoded with instructions that, when executed by one or more processors, cause the one or more processors to perform operations comprising:
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receiving 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; matching at least one of the received one or more encrypted medical provider identifiers with one or more encrypted medical provider identifiers stored at an 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; identifying an APK that is cross-referenced to a matched encrypted medical provider identifier according to the deterministic match; associating, using the APK that is cross-referenced in a 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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Specification