Provider portal

• US 9,836,580 B2
• Filed: 03/21/2014
• Issued: 12/05/2017
• Est. Priority Date: 03/21/2014
• Status: Active Grant

• Current Assignee: Palantir Technologies Incorporated
• Original Assignee: Palantir Technologies Incorporated
• Inventors: Fendell, Sam, Thompson, James
• Primary Examiner(s): Amelunxen, Barbara Joan
• Application Number:
  US14/222,364
• Publication Number:
  US 20150269334A1
• Time in Patent Office: 1,355 Days
• Field of Search: 705 2, 705 3, 705 4, 705 30, 707754
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G06Q 50/22 Social work or social welfare, e.g. community support activities or counselling services
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• 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 40/67 for remote operation

Abstract

Various systems and methods are provided that graphically allow health insurance company personnel to identify patient diagnoses that are not accounted for by the health insurance company. Furthermore, the various systems and methods graphically allow health insurance company personnel to identify patients that have not submitted claims for documented ailments or conditions. Thus, the health insurance company may be able to improve its chances of receiving transfer payments from other health insurance companies and/or receiving higher star ratings.

Claims

1. A computing system configured to process a large amount of dynamically updating data, the computing system comprising:

a network interface coupled to a data network for receiving and transmitting one or more packet flows;

a display device;

a computer processor;

main memory; and

a computer readable storage medium storing a plurality of program instructions configured for execution by the computer processor, wherein the plurality of program instructions are read into the main memory and accessed by the computer processor for execution in order to cause the computing system to;

access medical data associated with a plurality of patients from a physical computing device associated with a medical facility over the data network;

access a plurality of medical claims, wherein each medical claim corresponds to at least one of the plurality of patients and is associated with one of a plurality of healthcare providers;

determine a first set of medical claims in the plurality of medical claims and a second set of medical claims in the plurality of medical claims;

generate and display, on the display device, a user interface comprising a provider window and a claim adjustment window, wherein the provider window depicts a selectable list of one or more of the plurality of healthcare providers;

receive a selection of a first healthcare provider in the list of healthcare providers; and

in response to the selection of the first healthcare provider, read a first program instruction in the plurality of program instructions into the main memory for access by the computer processor, wherein execution of the first program instruction by the computer processor causes the display device to;

display, in the claim adjustment window, one or more medical claims in the first set of medical claims that are each associated with the first healthcare provider,

display, in the provider window, a plurality of stacked bar graphs associated with a corresponding plurality of healthcare providers, wherein a first stacked bar graph in the plurality of stacked bar graphs is associated with the first healthcare provider, wherein each stacked bar graph in the plurality of stacked bar graphs comprises a first box and a second box,

wherein a width of the first box is based on a number of medical claims in the first set of medical claims associated with the respective healthcare provider, and

wherein a width of the second box is based on a number of the medical claims in the second set of medical claims associated with the respective healthcare provider,

receive an indication of a selection of a first medical claim in the one or more medical claims,

in response to reception of the indication of the selection of the first medical claim,

no longer display, in the claim adjustment window, the first medical claim, and

cause the width of the first box of the first stacked bar graph to decrease from a first width to a second width less than the first width to reflect a reduced number of medical claims in the first set of medical claims that are associated with the first healthcare provider, and

display an interactive element associated with a first patient in the plurality of patients, wherein the interactive element is configured to automatically initiate a communication between the computing system and a physical computing device associated with the first patient when selected.

2. The computing system of claim 1, wherein the program instructions are further configured to cause the computing system to determine a first set of patients in the plurality of patients that have not submitted, during a first period of time, a claim for reimbursement for a treatment of an ailment identified as affecting the respective patient, wherein the user interface is further configured to display, in a gaps in care window in the user interface for each user in the first set of patients that is associated with the first healthcare provider, a notification to contact the respective patient.

3. The computing system of claim 2, wherein the program instructions are further configured to cause the computing system to receive a selection of a first notification to contact the first patient in the first set of patients, wherein the user interface is further configured to display, in the gaps in care window, a schedule window that overlaps at least a portion of the first notification, wherein the schedule window comprises an option to indicate that an appointment has been scheduled with the first patient and an option to indicate that the appointment with the first patient has been completed.

4. The computing system of claim 3, wherein the gaps in care window comprises a new window and a scheduled appointment window, wherein the new window comprises the first notification, and wherein the user interface is further configured to display, in the scheduled appointment window and not the new window, the first notification in connection with a selection of the option to indicate that the appointment has been scheduled with the first patient.

5. The computing system of claim 2, wherein the gaps in care window comprises a first notification to contact the first patient in the first set of patients and a notification number associated with the first notification that indicates a number of reasons to contact the first patients.

6. The computing system of claim 5, wherein the user interface is further configured to display, in the gaps in care window, a second notification to contact the first patient and a third notification to contact the first patient in connection with a selection of the first notification.

7. The computing system of claim 1, wherein each stacked bar graph comprises information displayed using a logarithmic scale.

8. The computing system of claim 1, wherein the user interface comprises a sort button, and wherein the sort button, when selected, causes the claim adjustment window to display the one or more medical claims in the first set of medical claims in one of an alphabetical order, an order based on date, or an order based on importance of the respective medical claim.

9. The computing system of claim 1, wherein the plurality of program instructions are read into the main memory and accessed by the computer processor for execution in order to cause the computing system to, in response to a selection of the interactive element, read a second program instruction in the plurality of program instructions into the main memory for access by the computer processor, wherein execution of the second program instruction by the computer processor causes the network interface to initiate the communication between the computing system and the physical computing device associated with the first patient.

10. The computing system of claim 1, wherein medical claims in the first set of medical claims that are associated with a second patient comprise claims for reimbursement for treatment of a first ailment, and wherein the first ailment is not identified by an entity as affecting the second patient.

11. A computer-implemented method of processing a large amount of dynamically updating data, the computer-implemented method comprising:

as implemented by one or more computer systems comprising a computer processor, a display device, and main memory, the one or more computer systems configured with specific executable instructions,

accessing medical data associated with a plurality of users;

accessing a plurality of user claims, wherein each user claim corresponds to at least one of the plurality of users and is associated with one of a plurality of healthcare providers;

determining, based on the accessed medical data, a first set of user claims in the plurality of user claims and a second set of user claims in the plurality of user claims;

generating and displaying, on the display device, a user interface comprising a provider window and a claim adjustment window, wherein the provider window depicts a selectable list of one or more of the plurality of healthcare providers;

receiving a selection of a first healthcare provider in the list of healthcare providers; and

in response to the selection of the first healthcare provider, reading a first program instruction in the plurality of program instructions into the main memory for access by the computer processor, wherein execution of the first program instruction by the computer processor causes the display device to;

display, in the claim adjustment window of the user interface, one or more user claims in the first set of user claims that are each associated with the first healthcare provider,

display, in the provider window, a plurality of stacked bar graphs associated with a corresponding plurality of healthcare providers, wherein a first stacked bar graph in the plurality of stacked bar graphs is associated with the first healthcare provider, wherein each stacked bar graph in the plurality of stacked bar graphs comprises a first box and a second box,

wherein a width of the first box is based on a number of user claims in the first set of user claims associated with the respective healthcare provider, and

wherein a width of the second box is based on a number of the user claims in the second set of user claims associated with the respective healthcare provider,

receive an indication of a selection of a first medical claim in the one or more medical claims,

in response to reception of the indication of the selection of the first medical claim,

no longer display, in the claim adjustment window, the first medical claim, and

cause the width of the first box of the first stacked bar graph to decrease from a first width to a second width less than the first width to reflect a reduced number of medical claims in the first set of medical claims that are associated with the first healthcare provider, and

display an interactive element associated with a first patient in the plurality of patients, wherein the interactive element is configured to automatically initiate a communication between the computing system and a physical computing device associated with the first patient when selected.

12. The method of claim 11, further comprising:

determining a first set of users in the plurality of users that have not submitted, during a first period of time, a claim for reimbursement for a treatment of an ailment identified as affecting the respective user; and

updating a gaps in care window in the user interface, for each user in the first set of users that is associated with the first healthcare provider, to include a notification to contact the respective user.

13. The method of claim 11, wherein user claims in the first set of user claims that are associated with a second user comprise claims for reimbursement for treatment of a first ailment, and wherein the first ailment is not identified by an entity as affecting the second patient.

14. The method of claim 11, wherein each stacked bar graph comprises information displayed using a logarithmic scale.

15. The method of claim 11, further comprising receiving a selection of a first notification to contact the first user in the first set of patients, wherein the user interface is further configured to display a schedule window that overlaps at least a portion of the first notification, and wherein the user interface comprises an option to indicate that an appointment has been scheduled with the first user and an option to indicate that the appointment with the first user has been completed.

16. A non-transitory computer-readable medium comprising one or more program instructions recorded thereon, the instructions configured for execution by a computing system comprising one or more processors in order to cause the computing system to:

access medical data associated with a plurality of users;

access a plurality of user claims, wherein each user claim corresponds to at least one of the plurality of users and is associated with one of a plurality of healthcare providers;

determine a first set of users claims in the plurality of user claims and a second set of user claims in the plurality of user claims;

generate and display, on a display device, a user interface comprising a selectable list of one or more of the plurality of healthcare providers;

receive a selection of a first healthcare provider in the list of healthcare providers; and

in response to the selection of the first healthcare provider, read a first program instruction in the plurality of program instructions into main memory for access by the one or more processors, wherein execution of the first program instruction by the one or more processors causes the display device to;

display, in the user interface, one or more user claims in the first set of user claims that are each associated with the first healthcare provider,

display, in the user interface, a plurality of stacked bar graphs associated with a corresponding plurality of healthcare providers, wherein a first stacked bar graph in the plurality of stacked bar graphs is associated with the first healthcare provider, wherein each stacked bar graph in the plurality of stacked bar graphs comprises a first box and a second box,

wherein a width of the first box is based on a number of user claims in the first set of user claims associated with the respective healthcare provider, and

wherein a width of the second box is based on a number of the user claims in the second set of user claims associated with the respective healthcare provider,

receive an indication of a selection of a first medical claim in the one or more medical claims,

in response to reception of the indication of the selection of the first medical claim,

no longer display, in the claim adjustment window, the first medical claim, and

cause the width of the first box of the first stacked bar graph to decrease from a first width to a second width less than the first width to reflect a reduced number of medical claims in the first set of medical claims that are associated with the first healthcare provider, and

display an interactive element associated with a first patient in the plurality of patients, wherein the interactive element is configured to automatically initiate a communication between the computing system and a physical computing device associated with the first patient when selected.

17. The medium of claim 16, wherein the instructions are further configured to cause the computing system to:

determine a first set of users in the plurality of users that have not submitted, during a first period of time, a claim for reimbursement for a treatment of an ailment identified as affecting the respective user; and

update the user interface, for each user in the first set of users that is associated with the first healthcare provider, to include a notification to contact the respective user.

18. The medium of claim 16, wherein user claims in the first set of user claims that are associated with a second user comprise claims for reimbursement for treatment of a first ailment, and wherein the first ailment is not identified by an entity as affecting the second patient.

19. The medium of claim 16, wherein each stacked bar graph comprises information displayed using a logarithmic scale.