CA2308275A1 - Procede et systeme permettant le codage et le traitement de facturations relatives a des prestations de services de medecine parallele - Google Patents

Procede et systeme permettant le codage et le traitement de facturations relatives a des prestations de services de medecine parallele Download PDF

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Publication number
CA2308275A1
CA2308275A1 CA002308275A CA2308275A CA2308275A1 CA 2308275 A1 CA2308275 A1 CA 2308275A1 CA 002308275 A CA002308275 A CA 002308275A CA 2308275 A CA2308275 A CA 2308275A CA 2308275 A1 CA2308275 A1 CA 2308275A1
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CA
Canada
Prior art keywords
code
alternative
provider
encoding
rvu
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Abandoned
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CA002308275A
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English (en)
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Jo Melinna Giannini
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Individual
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Individual
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Publication of CA2308275A1 publication Critical patent/CA2308275A1/fr
Abandoned legal-status Critical Current

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Classifications

    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q30/00—Commerce
    • G06Q30/04—Billing or invoicing
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/10—Office automation; Time management
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance

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  • Business, Economics & Management (AREA)
  • Engineering & Computer Science (AREA)
  • Strategic Management (AREA)
  • Accounting & Taxation (AREA)
  • Finance (AREA)
  • Development Economics (AREA)
  • Economics (AREA)
  • Marketing (AREA)
  • Theoretical Computer Science (AREA)
  • General Physics & Mathematics (AREA)
  • General Business, Economics & Management (AREA)
  • Physics & Mathematics (AREA)
  • Human Resources & Organizations (AREA)
  • Entrepreneurship & Innovation (AREA)
  • Tourism & Hospitality (AREA)
  • Quality & Reliability (AREA)
  • Operations Research (AREA)
  • Data Mining & Analysis (AREA)
  • Technology Law (AREA)
  • Medical Treatment And Welfare Office Work (AREA)
  • Data Exchanges In Wide-Area Networks (AREA)
  • Meter Arrangements (AREA)

Abstract

Ce système (10), qui permet de coder et de prendre en charge la facturation de prestateurs de soins de santé, consiste, plus précisément, en un réseau assisté par ordinateur codant, documentant et traitant les demandes de règlement (18) relatives à des actes médicaux spécifiques exécutés par des prestateurs de services de médecine parallèle (12) regroupés géographiquement et par spécialité. Ce système (10) utilise un ordinateur ayant accès à trois bases de données principales (14, 16, 20), permettant l'identification, le codage, et le calcul du coût moyen de ce type de service (58). Il en résulte l'établissement d'un code de facturation de services parallèles (ABC) pouvant être comparé et corrélé aux codes normalisés de l'industrie de l'assurance (40). Cette base de données ABC consiste en un ensemble de séries de termes et de sous-termes provenant des bases de données susmentionnées (14, 16, 20), constituant en l'occurrence, une liste type de pratiques de médecine parallèle (APT) (14), un descriptif normalisé d'actes médicaux relevant de la médecine parallèle (SAPD), une base de données de prestations de service (PD) et une unité de valeur relative (RVU). Chaque spécialité comporte sa propre liste de traitements donnant lieu à l'établissement des RVU, ce qui permet de constituer des séries de listes d'honoraires et de frais de traitement. Les codes PAT et SAPD sont mémorisés dans un fichier PD renfermant les coûts moyens de règlement de tous les prestateurs figurant dans un groupe prédéterminé. A l'aide de ces données la base PD crée la base ABC sous forme d'un code unique et détaillé renfermant tous les éléments de traitement liés à une visite faite à un patient. Grâce à ce système, les demandes de règlement (18) sont communiquées et transformées en code pertinent permettant la détermination du règlement.
CA002308275A 1997-10-30 1997-10-30 Procede et systeme permettant le codage et le traitement de facturations relatives a des prestations de services de medecine parallele Abandoned CA2308275A1 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/US1997/019419 WO1999023589A1 (fr) 1997-10-30 1997-10-30 Procede et systeme permettant le codage et le traitement de facturations relatives a des prestations de services de medecine parallele

Publications (1)

Publication Number Publication Date
CA2308275A1 true CA2308275A1 (fr) 1999-05-14

Family

ID=22261947

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002308275A Abandoned CA2308275A1 (fr) 1997-10-30 1997-10-30 Procede et systeme permettant le codage et le traitement de facturations relatives a des prestations de services de medecine parallele

Country Status (7)

Country Link
EP (1) EP1025522A4 (fr)
JP (1) JP2001522099A (fr)
KR (1) KR100509613B1 (fr)
AU (1) AU747160B2 (fr)
CA (1) CA2308275A1 (fr)
NO (1) NO319050B1 (fr)
WO (1) WO1999023589A1 (fr)

Families Citing this family (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6973441B1 (en) * 2001-01-10 2005-12-06 Lsi Logic Corporation Method and apparatus for managing accounts payable
EP1378752A4 (fr) * 2001-04-13 2004-08-04 Chugai Pharmaceutical Co Ltd Procede permettant de quantifier l'expression d'antigenes
WO2006105607A1 (fr) * 2005-04-07 2006-10-12 Hermes Precisa Pty Limited Procede et systeme de transfert de donnees
KR100991688B1 (ko) 2008-10-31 2010-11-03 한국수력원자력 주식회사 원자력발전소 노형별 용량별 특성에 따른 계획예방정비 공정관리 표준화 방법
US11080790B2 (en) 2009-09-24 2021-08-03 Guidewire Software, Inc. Method and apparatus for managing revisions and tracking of insurance policy elements
KR101282244B1 (ko) 2012-02-13 2013-07-10 한국수력원자력 주식회사 원자력발전소 설비의 예방/고장 정비정보 관리 시스템 및 그 방법
CN109545369B (zh) * 2018-10-27 2024-06-18 平安医疗健康管理股份有限公司 基于数据处理的糖尿病资质认证方法、设备及服务器

Family Cites Families (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4491725A (en) * 1982-09-29 1985-01-01 Pritchard Lawrence E Medical insurance verification and processing system
US4667292A (en) * 1984-02-16 1987-05-19 Iameter Incorporated Medical reimbursement computer system
US4858121A (en) * 1986-12-12 1989-08-15 Medical Payment Systems, Incorporated Medical payment system
US5018067A (en) * 1987-01-12 1991-05-21 Iameter Incorporated Apparatus and method for improved estimation of health resource consumption through use of diagnostic and/or procedure grouping and severity of illness indicators
US5070452A (en) * 1987-06-30 1991-12-03 Ngs American, Inc. Computerized medical insurance system including means to automatically update member eligibility files at pre-established intervals
US4916611A (en) * 1987-06-30 1990-04-10 Northern Group Services, Inc. Insurance administration system with means to allow an employer to directly communicate employee status data to centralized data storage means
US4987538A (en) * 1989-04-27 1991-01-22 Western Medical Consultants Automated processing of provider billings
US5191522A (en) * 1990-01-18 1993-03-02 Itt Corporation Integrated group insurance information processing and reporting system based upon an enterprise-wide data structure
US5225976A (en) * 1991-03-12 1993-07-06 Research Enterprises, Inc. Automated health benefit processing system
US5519607A (en) * 1991-03-12 1996-05-21 Research Enterprises, Inc. Automated health benefit processing system
US5301105A (en) * 1991-04-08 1994-04-05 Desmond D. Cummings All care health management system
US5359509A (en) * 1991-10-31 1994-10-25 United Healthcare Corporation Health care payment adjudication and review system
US5307262A (en) * 1992-01-29 1994-04-26 Applied Medical Data, Inc. Patient data quality review method and system
US5325293A (en) * 1992-02-18 1994-06-28 Dorne Howard L System and method for correlating medical procedures and medical billing codes
US5594638A (en) * 1993-12-29 1997-01-14 First Opinion Corporation Computerized medical diagnostic system including re-enter function and sensitivity factors
US5652842A (en) * 1994-03-01 1997-07-29 Healthshare Technology, Inc. Analysis and reporting of performance of service providers
US5557514A (en) * 1994-06-23 1996-09-17 Medicode, Inc. Method and system for generating statistically-based medical provider utilization profiles

Also Published As

Publication number Publication date
JP2001522099A (ja) 2001-11-13
EP1025522A1 (fr) 2000-08-09
KR20010031684A (ko) 2001-04-16
KR100509613B1 (ko) 2005-08-22
AU4919897A (en) 1999-05-24
EP1025522A4 (fr) 2003-04-02
NO20002175L (no) 2000-06-13
WO1999023589A1 (fr) 1999-05-14
NO319050B1 (no) 2005-06-06
AU747160B2 (en) 2002-05-09
NO20002175D0 (no) 2000-04-27

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Legal Events

Date Code Title Description
EEER Examination request
FZDE Discontinued
FZDE Discontinued

Effective date: 20091030

FZDE Discontinued

Effective date: 20091030