SYSTEMS AND METHODS FOR PROCESSING CLAIMS

Methods, systems and apparatuses, including computer programs encoded on computer storage media, are provided for processing claims using both unstructured and structured policy documents and claim data. Policy rules, benefit calculation formulae, necessary data points, and benefit requirements are...

Ausführliche Beschreibung

Gespeichert in:

Bibliographische Detailangaben
Hauptverfasser:	Wang, Wensu, Wang, Chun, Thielke, Patrick John
Format:	Patent
Sprache:	eng
Schlagworte:	CALCULATING COMPUTER SYSTEMS BASED ON SPECIFIC COMPUTATIONAL MODELS COMPUTING COUNTING DATA PROCESSING SYSTEMS OR METHODS, SPECIALLY ADAPTED FORADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORYOR FORECASTING PURPOSES ELECTRIC DIGITAL DATA PROCESSING PHYSICS SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE,COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTINGPURPOSES, NOT OTHERWISE PROVIDED FOR
Online-Zugang:	Volltext bestellen
Tags:	Tag hinzufügen Keine Tags, Fügen Sie den ersten Tag hinzu!

Beschreibung
Zusammenfassung:	Methods, systems and apparatuses, including computer programs encoded on computer storage media, are provided for processing claims using both unstructured and structured policy documents and claim data. Policy rules, benefit calculation formulae, necessary data points, and benefit requirements are extracted from policy documents. Unstructured claim data is converted to a structured form using natural language processing, information extraction, and AI techniques to identify and extract relevant information, including values for the data points and benefit conditions, then the combined structured data and converted unstructured data is processed to get all values for the data points and applicable benefit conditions. The relevant claim information is then further processed according to the policy rules and benefit calculation formulae to generate a benefit payment amount and entitled additional benefits.