CLAIM ANALYSIS WITH DEEP LEARNING

Embodiments relate to system for automatically predicting payer response to claims. In an embodiment, the system receives claim data associated with a claim. The system identifies a set of claim features of the claim data, and generates an input vector with at least a portion of the set of claim fea...

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Bibliographische Detailangaben
Hauptverfasser:	Ganapathi, Hariraam Varun, Atwal, Andrew, Kim, Byung-Hak
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
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Beschreibung
Zusammenfassung:	Embodiments relate to system for automatically predicting payer response to claims. In an embodiment, the system receives claim data associated with a claim. The system identifies a set of claim features of the claim data, and generates an input vector with at least a portion of the set of claim features. The system applies the input vector to a trained model. A first portion of the neural network is configured to generate an embedding representing the input vector with a lower dimensionality than the input vector. A second portion of the neural network is configured to generate a prediction of whether the claim will be denied based on the embedding. The system provides the prediction for display on a user interface of a user device. The prediction may further include denial reason codes and a response date estimation to indicate if, when, and why a claim will be denied.