Universal claims formatter

• US 6,484,178 B1
• Filed: 12/30/1999
• Issued: 11/19/2002
• Est. Priority Date: 12/30/1999
• Status: Expired due to Fees

• Current Assignee: Parish Road Ventures Incorporated
• Original Assignee: The Merallis Company
• Inventors: Reinholdt, Daniel Robert, Julian, Gary, Bence, Gene Philip Jr., Welcome, Edward Daniel Jr., Peet, John L., Kenney, William Raymond
• Primary Examiner(s): Von Buhr, Maria N.
• Application Number:
  US09/475,476
• Time in Patent Office: 1,055 Days
• Field of Search: 707/100-102, 707/4, 707/513, 707/523, 707/530, 707/531, 709/246
• US Class Current: 1/1
• CPC Class Codes: G06F 16/116 Details of conversion of file system types or formats
• CPC Class Codes: Y10S 707/99942 Manipulating data structure, e.g. compression, compaction, compilation

Abstract

An inventive method and computer system convert known or unknown input file formats to a common file format with a reduced amount of human intervention and greater speed, in comparison to prior-art methods and products. The conversion involves the viewing, by an operator, of a given input file; the determination as to whether or not the format of the input file matches a known format; the specification of data coordinates within each record in the input file; and the conversion of the input file to the common file format. Newly created file formats may be stored and used as existing file formats. A “garbage collection” module automatically removes extraneous unprintable characters and helps to standardize the control character formats, prior to matching.

Claims

1. A method of formatting input files having multiple records into a common file format, said method comprising the steps of:

viewing information about a source submitting an input file containing data records in a format used by the source;

examining the submitted input file and determining parameters of the format of the data records of the submitted input file, further comprising the sub-step of;

choosing whether or not to perform a garbage collection function in which control characters are removed, added, or modified;

finding a known data format, stored in a format database, that most closely matches the format used by the source;

aligning the data contained in a given record of the input file with a standard format, thus creating a format corresponding to that used by the source; and

if the resulting format is different from all other formats stored in the format database, permitting the saving of the resulting format in the format database as a new format.

2. The method as set forth in claim 1, further comprising the step of:

associating the source with a particular format and saving this information in a source database.

3. The method as set forth in claim 2, further comprising the steps of:

receiving a subsequent input file from a source with which a format has already been associated;

receiving information identifying the source;

using the received information to search a database of sources to determine the format associated with the source;

retrieving the format associated with the source from the format database; and

batch-processing the input file to convert records in the input file to the common format, using the retrieved format.

4. The method as set forth in claim 1, further comprising, prior to the step of viewing information, the step of:

searching a source database to determine if information exists about the source submitting the input file.

5. The method as set forth in claim 1, further comprising the steps of:

batch processing the input file using the resulting format, thus converting the data records in the file to a common format; and

viewing the results of the batch processing to determine whether or not the resulting format gives acceptable results.

6. The method as set forth in claim 5, wherein the step of batch processing further comprises the step of:

producing at least one file of statistical and aggregate information about the batch processing and about the data.

7. The method as set forth in claim 6, wherein the step of viewing the results further comprises the steps of:

viewing the at least one file of statistical and aggregate information; and

viewing at least one data record formatted into the common format.

8. The method as set forth in claim 1, wherein the step of finding a known data format further comprises the step of:

providing an option of using either the data format found or a default data format.

9. The method as set forth in claim 8, wherein the step of aligning further comprises the steps of:

applying the data format chosen in the step of providing an option to at least partially align a data record of the input file; and

manually performing further alignment.

10. The method as set forth in claim 1, further comprising the step of:

if the steps of viewing, examining, finding and aligning fail to provide an acceptable data format, writing a separate “

scrubber”

program to perform conversion of files from the particular source to the common file format.

11. The method as set forth in claim 1, wherein each record comprises an insurance claim.

12. The method as set forth in claim 11, wherein each insurance claim is a health insurance claim.

13. A computer system implementing the method of claim 1.

14. A computer-readable medium comprising program modules that implement the method of claim 1.

15. A computer system that converts input file formats into a single common file format, said input file containing at least one data record in an input file format, said computer system comprising:

a computer; and

a computer-readable medium, the computer-readable medium having software embodied thereon comprising;

a View Office Information module, providing a system operator with the ability to view information about a source submitting an input file;

an Examine Test Claim File module, allowing the system operator to view data from the input file, the Examine Test Claim File module further comprising;

a Garbage Collection module, providing for the removal, addition and modification of control characters in a data record;

a Find Closest Match module, automatically searching a known format database for a format that most closely matches the format of the data records of the input file;

an Align Claim Data module, providing the system operator with the capability of modifying the format found by the Find Closest Match module to create a newly-created format tailored to the source'"'"'s input file format; and

a Save Office Format module, allowing the system operator to save the newly-created format in the known format database.

16. The computer system as set forth in claim 15, wherein the Save Office Format module comprises:

an Associate Format sub-module that associates the source with a particular format and saves this information in a source database.

17. The computer system as set forth in claim 16, wherein the software further comprises:

a Move Engine, said Move Engine including modules to receive a subsequent input file from a source with which a format has already been associated;

to receive information identifying the source;

to use the received information to search the source database to determine the format associated with the source;

to retrieve the format associated with the source from the known format database; and

to batch-process the input file to convert records in the input file to the common format, using the retrieved format.

18. The computer system as set forth in claim 15, wherein software further comprises:

a Search Source Database module that determines if information about the source of the input file already exists in a source database.

19. The computer system as set forth in claim 15, wherein the software further comprises:

a Run Claim Edits module that performs batch processing of the input file using the newly-created format to convert the data records in the input file to the common format and that allows the system operator to view results of the batch processing to determine whether or not the newly-created format gives acceptable results.

20. The computer system of claim 19, wherein results of the batch processing include at least one file of statistical and aggregate information about the batch processing and about the data.

21. The computer system of claim 20, wherein the results viewed by the system operator include at least one file of statistical and aggregate information and at least one data record formatted into the common format.

22. The computer system of claim 15, wherein the Find Closest Match module provides the system operator with an option of using either the data format found thereby or a default data format.

23. The computer system of claim 22, wherein the Align Claim Data module comprises:

a sub-module that applies the data format chosen in the Find Closest Match module to at least partially align a data record of the input file; and

a sub-module that permits the system operator to manually perform further alignment.

24. The computer system of claim 15, wherein each record represents an insurance claim.

25. The computer system of claim 24, wherein each insurance claim is a health insurance claim.

26. The computer system as set forth in claim 15, the software further comprising:

a Format Data module, invoked by the Align Claim Data module, which formats a data record from the input file according to the newly-created format to create a display in a standard format.

27. The computer system as set forth in claim 26, wherein the software further comprises:

a Run Claim Edits module that performs batch processing of the input file using the newly-created format to convert the data records in the input file to the common format, said batch processing invoking a Move Engine sub-module that performs the conversion.