Thomas E. Lynn - Chapel Hill NC, US Thinzar Mra Nyun - Sudbury MA, US Lynn Anne Richards - Brooklyn Park MN, US Kimberly Sanborn - Sutton MA, US
Assignee:
OptumInsight, Inc. - Eden Prairie MN
International Classification:
G06Q 40/00
US Classification:
705 4, 705 2, 705 3
Abstract:
A system and computer-implemented method for grouping medical records implements a multi-level analysis of the records. The level of analysis for each record is determined based upon the time proximity of each record to the defining medical procedure or service (anchor procedure) to be analyzed. Once an anchor procedure is identified, claim records are processed to determine whether any of the records should be grouped with the anchor procedure into a procedure episode group (PEG). First, the date of service for each claim record is identified to determine whether the claim record falls within time window. The claim records falling within the window then are assessed to determine whether each claim record is sufficiently related to the anchor procedure (for example, by determining whether the diagnostic, procedure, or episode treatment group coding of each claim record is associated with the anchor procedure). The requisite level of relationship between the claim records and the anchor procedure depends upon the position of the records within the time window. Only those claim records having the requisite relationship level associated with the portion of the time window in which they fall are included in the PEG.
System And Method For Grouping Claim Records Associated With A Procedure
Thomas E. Lynn - Chapel Hill NC, US Thinzar Mra Nyun - Sudbury MA, US Lynn Anne Richards - Brooklyn Park MN, US Kimberly Sanborn - Sutton MA, US
Assignee:
OptumInsight, Inc. - Eden Prairie MN
International Classification:
G06Q 40/00
US Classification:
705 4, 705 2, 705 3
Abstract:
A system and computer-implemented method for grouping medical records implements a multi-level analysis of the records. The level of analysis is based upon the time proximity of each record to the defining medical procedure or service (anchor procedure) to be analyzed. Claim records are processed to determine whether any of the records should be grouped with the anchor procedure into a procedure episode group (PEG) using the date of service for each claim record and a level of relationship between the claim records and the anchor procedure. The requisite level of relationship between the claim records and the anchor procedure depends upon the position of the records within the time window. Claim records having the requisite relationship level associated with the portion of the time window in which they fall are included in the PEG.
System And Method For Grouping Claim Records Associated With A Procedure
Thomas E. Lynn - Chapel Hill NC, US Thinzar Mra Nyun - Sudbury MA, US Lynn Anne Richards - Brooklyn Park MN, US Kimberly Sanborn - Sutton MA, US
Assignee:
Ingenix, Inc. - Eden Prairie MN
International Classification:
G06F 17/30
US Classification:
707 9, 707E17001
Abstract:
A system and computer-implemented method for grouping medical records implements a multi-level analysis of the records. The level of analysis for each record is determined based upon the time proximity of each record to the defining medical procedure or service (anchor procedure) to be analyzed. Once an anchor procedure is identified, claim records are processed to determine whether any of the records should be grouped with the anchor procedure into a procedure episode group (PEG). First, the date of service for each claim record is identified to determine whether the claim record falls within time window. The claim records falling within the window then are assessed to determine whether each claim record is sufficiently related to the anchor procedure (for example, by determining whether the diagnostic, procedure, or episode treatment group coding of each claim record is associated with the anchor procedure). The requisite level of relationship between the claim records and the anchor procedure depends upon the position of the records within the time window. Only those claim records having the requisite relationship level associated with the portion of the time window in which they fall are included in the PEG.
System And Method For Grouping Claim Records Associated With A Procedure
- Eden Prairie MN, US Thinzar Mra Nyun - Sudbury MA, US Lynn Anne Richards - Brooklyn Park MN, US Kimberly Sanborn - Sutton MA, US
Assignee:
Optumlnsight, Inc. - Eden Prairie MN
International Classification:
G06F 19/00
US Classification:
705 3
Abstract:
A system and computer-implemented method for grouping medical records implements a multi-level analysis of the records. The level of analysis for each record is determined based upon the time proximity of each record to the defining medical procedure or service (anchor procedure) to be analyzed. Once an anchor procedure is identified, claim records are processed to determine whether any of the records should be grouped with the anchor procedure into a procedure episode group (PEG). First, the date of service for each claim record is identified to determine whether the claim record falls within time window. The claim records falling within the window then are assessed to determine whether each claim record is sufficiently related to the anchor procedure (for example, by determining whether the diagnostic, procedure, or episode treatment group coding of each claim record is associated with the anchor procedure). The requisite level of relationship between the claim records and the anchor procedure depends upon the position of the records within the time window. Only those claim records having the requisite relationship level associated with the portion of the time window in which they fall are included in the PEG.
Name / Title
Company / Classification
Phones & Addresses
15774 S La Grange Rd STE 268, Orland Park, IL 60462
Lynn Richards
Bath House Naturals, LLC Health & Medical Products - Scientifically Unproven · Beauty Supplies & Equipment · Skin Care · Health & Wellness
15774 S Ln Grange Rd STE 268, Orland Park, IL 60462 (708)7497813
Lynn Richards
CONGRESS FOR THE NEW URBANISM, INC Social Services Professional Organization · Architect
140 S Dearborn St SUITE 404, Chicago, IL 60603 (312)5517300, (312)3463323
OptumInsight since Oct 2010
BA Consultant, Advanced Analytics Research & Methods
Ingenix of UnitedHealth Group Apr 2010 - Oct 2010
Symmetry Product Delivery Manager
Education:
Viterbo University
Skills:
Requirements Gathering Requirements Analysis Business Process Improvement Business Analysis Sdlc Analytics Process Improvement Leadership Program Management Project Management Business Requirements Visio Business Intelligence
I am a Body By Vi - Promoter CVS Corporation - Photo Tech (2011)
Education:
Southmont High School
About:
I have just started into a new leg of my life and am very excited to be promoting and a 90 day Challenge. In this challenge I have within 2 weeks lost 11 pounds and 5 inches. Anyone who would like to ...
Maples Collegiate High School Winnipeg Palestinian Territory, Occupie 1982-1986, St. James Collegiate High School Winnipeg Palestinian Territory, Occupie 1986-1988
Community:
Curtis King, Jim Mcneill, Debby Anderson, Don Scott