Computer-implemented method for grouping medical claims with clinically representative dynamic clean periods

CAFC
  • US 7,620,560 B2
  • Filed: 03/25/2002
  • Issued: 11/17/2009
  • Est. Priority Date: 06/22/1995
  • Status: Active Grant
First Claim
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1. A computer-implemented method for grouping medical claims data, comprising the steps of:

  • a. grouping a plurality of medical claim data records to an episode of care having at least one defining characteristic, wherein the grouping is preformed by a computer processing unit;

    b. assigning a first clean period to the episode of care, the first clean period defined by a predefined time duration during which there is an absence of medical claim data having the at least one defining characteristic of the episode treatment group, wherein the grouping is performed by the computer processing unit; and

    c. resetting the first clean period to define a second clean period, the second clean period defining a second predefined time duration, wherein the first clean period is reset to the second clean period when later presented medical claim data having the at least one characteristic of the episode of care and falling within the first clean period is added to the episode of care, wherein the grouping is performed by the computer processing unit.

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