SYSTEM AND METHOD FOR AUTOMATED CLAIMS DATA AUDITING

A system and method for automated claims data auditing. The system may include a memory device configured to store a plurality of audit questions associated with audit question metadata, to store a plurality tasks associated with task metadata, to store a plurality workflows associated with workflow...

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Bibliographische Detailangaben
Hauptverfasser: DEMARCHI SUZANNE R, LAKKAKULA VENKATA UMA, DORRIS J. SCOTT, SUNDAR VANI
Format: Patent
Sprache:eng
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Zusammenfassung:A system and method for automated claims data auditing. The system may include a memory device configured to store a plurality of audit questions associated with audit question metadata, to store a plurality tasks associated with task metadata, to store a plurality workflows associated with workflow metadata and to store a plurality surveys associated with survey metadata. The system may include a processor configured to generate an audit template based on at least a subset of the plurality of surveys and the plurality of tasks. The processor may further be configured to generate a copy of the audit template for use in a project. The system may include a receiver configured to receive assignment instructions associated with the project, wherein the assignment instructions assign resources to the project. The receiver may further be configured to receive claim data to be audited, wherein the processor may be configured to integrate the received claim data, the copy of the audit template, and the assignment instructions to create the project. The system may also include a publishing module configured to publish the project.