Abstract: The present invention provides a system and method capable of providing an estimated premium without extensive and repetitive questioning. The present invention utilizes unique assumptions to dramatically reduce the amount of information that must be provided by the customer. In one embodiment, the present invention utilizes a mainframe computer system, an application server, and an external rules management system to interact with the customer via an attractive graphic user interface. Once logged onto the website of the present invention, the customer may choose to engage in a fast quote process which utilizes assumptions, driver information, and vehicle information to assess the risk associated with insuring the customer and then calculates an estimated cost to insure.

Abstract: A system and method for receiving medical or other database information and pregrouping and extending that data include a data enhancement layer configured to generate additional stored dimensions capturing the data and relevant attributes. Data sources such as hospitals, laboratories and others may therefore communicate their clinical data to a central warehousing facility which may assemble and extend the resulting aggregated data for data mining purposes. Varying source format and content may be conditioned and conformed to a consistent physical or logical structure. The source data may be extended and recombined into additional related dimensions, pre-associating meaningful attributes for faster querying and storage. Users running analytics against the resulting medical or other datamarts may therefore access a richer set of related information as well as have their queries and other operations run more efficiently.

Abstract: A method of selling a health related product or service via the Internet provides a service provider system that includes a web server. The service provider system has members that purchase health related products and services through the service provider system. Applicants are enrolled in the service provider system as members. A product or service request message is received for a desired product or service from a member through a customer interface. The product or service request message includes a product or service identifier. The service provider system transmits a request for the desired product or service request to a supplier of the desired product or service. Points are recorded within a computer memory awarded to a member for purchases made by the member through the service provider system.

Abstract: A method and apparatus are provided for processing a message from a patient for one of a plurality of physicians through a web site. The method includes the steps of providing one or more web pages to the patient from the web site containing indicia of identity for each physician of the plurality of physicians and detecting selection by the patient of a physician of the plurality of physicians. The method further includes the steps of determining an information content of the message and routing the message based upon the determined information content and a predetermined routing criteria provided by the selected physician.

Abstract: The merchandise planning and development system includes a WWW server 33 for informing many and unspecified customers 31 to 3n of merchandise planning and development information about planning and/or development of new merchandise through the Internet 20, and a news server 35 for collecting the opinion information of the customers 31 to 3n looking up the merchandise planning information through the Internet 20. The WWW server 33 informs the customers 31 to 3n of the merchandise information suited to the needs of the customers on the basis of the opinion information by way of the Internet 20.

Abstract: The present invention provides a system and method, relating to the transfer of patient files over a secure, HIPAA compliant, patient file transfer and outpatient order system and a computer site therefore. The method includes obtaining and compiling a patient record pertaining to a patient; electronically inputting the patient record obtained into a secure computer database containing other patient records, allowing physician access to the patient record wherein the access includes allowing the physician to order outpatient services and send part of the patient information, including certain defined fields for a complete record and to send and receive referrals including certain defined fields for a complete record.

Abstract: A method of evaluating a permanent life insurance policy including the steps of accessing a policy illustration, establishing an effective life span of the policy illustration, identifying a first amount attributed to death benefit claims, identifying a second amount attributed to premium loads, identifying a third amount attributed to policy expenses, calculating a sum of the first, second and third amounts for a plurality of policy years, averaging the sum for each year throughout the effective life span, calculating a cash value of the policy illustration for the plurality of policy years, identifying a projected investment earnings forecast in the policy illustration, normalizing the projected investment earnings forecast, adding the project investment earnings to the cash value, and recalculating the current cash value of the policy illustration for the plurality of policy years.

Abstract: A system and method is provided for determining a probability that a member of a health plan has a disease or condition within one or more disease categories, by using data from the member's pharmacy claims. Logistic regression models are generated for each condition category using therapeutic drug categories, provider information, and/or other variables including member demographic information.

Abstract: A system and method for the efficient administration of health care plans, particularly as to the reduction and/or elimination of avoidable medical costs for select individuals who participate in the plan, is disclosed. Existing health care data is processed to determine an indication as to the relative desirability of an intervention in a plan participant's health care regimen. The data is also processed to determine the status of one or more flags, each of which potentially indicates the relative desirability of an intervention in a plan participant's health care regimen. A predictive model is used to determine the status of a flag relating to the likelihood of an insurance plan participant making a disability claim within a certain period of time. The information relating to desirability of an intervention in a plan participant's health care regimen, as well as a plan participant's medical information and claim history, is presented to case managers and/or health care providers in a user-friendly format.

Abstract: An improved method and system for developing a reinsurance administration system. Developers may build application programs for reinsurance administration with increased re-use of existing functionality and decreased development time. A business process framework may include common functionality for a plurality of business processes and a template for executing steps in the business processes. The common functionality may include behavior for GUI elements such as windows and buttons, error logging, and database commit and rollback transactions. One or more business process subclasses may be derived from abstract business process classes in the business process framework. One or more support processes in the business process framework may be specified for a business process. The support processes may include support processes for data or syntax validation, GUI, persistent data storage, security, and/or precondition checks.

Abstract: Methods and structure for automated insurance workflow processing. Methods include receipt of a document to be entered into the workflow processing system. The document is either received initially in digital form or is digitized into a digital form for further processing in the workflow system. Subsequent flow of the document through various review processes of the insurance entity is in electronic form. Interaction with third parties including individual agents, agencies and underwriters may also be conducted in digitized, electronic form. The workflow processes and systems automatically may generate a sequence of tasks to be performed associated with a new document entered in the system and may track progress of the tasks. A central may database maintain information regarding all such tasks and documents.

Abstract: A user-based monitoring system includes a remote user-based subsystem with at least one display and at least two microprocessor-based units in communication with each other. The microprocessor-based units are selected from a data management unit, a personal computer, a handheld device or a user monitoring device. The subsystem is configured to facilitate collection of user-related data. The system also has at least one central server remotely located from and configured for two-way communication with the user-based subsystem so that it can receive and deliver signal communications to and from the user-based subsystem. The system also has at least one authorized user computer remotely located from, and configured for two-way signal communication with, the central server to receive user-related data collected by a remote user-based subsystem and allow an authorized user to communicate with the central server. The system is suited, amongst others, for monitoring remotely the health of a system user.

Abstract: An insurance program that provides improved health care and longevity by emphasizing health improvement and maintenance. After a predetermined waiting period from the time health insurance is purchased, during which the health status of the insured is maintained or improved, the insured may link the health insurance policy with one or more other types of insurance policies, such as; life, disability, nursing home, etc. Throughout the life of the policy, portions of the premiums may be deposited in an escrow account, provided that the health of the insured is maintained or improved, which may be utilized to pay or help pay for the linked insurance and may also be utilized for retirement benefits.

Abstract: A method of dispensing a pharmaceutical product, the pharmaceutical product being associated with packaging having disposed thereon or therein coded data, at least some of the coded data being indicative of at least an identity of the pharmaceutical product. The method uses a computer system which receives indicating data from a sensing device, in responsive to sensing of the coded data. The computer system uses the indicating data and a dispensing database to determine at least one criterion for dispensing the pharmaceutical product. The computer system causes the pharmaceutical product to be dispensed if the at least one criterion is satisfied.

Abstract: The present invention relates to a system and method for automated extraction and display of past health care use to aid in predicting future health status. A system and method that converts raw medical and pharmacy claims data into Hierarchical Major Clinical Condition (HMCC) and Place of Treatment (POT) time-series data to facilitate the health assessment of a member's total clinical conditions and aid in predicting his or her future health status. The HMCC categories are organized in body systems and likely disease progression to permit both spatio-temporal digital signal processing and the development of a dynamical learning system. Each medical and pharmacy claim of the member is mapped onto one or more HMCC/POT-time cells. At the end of mapping, multiple entries in each HMCC-time cell are accumulated with the temporal resolution determined as a function of group size and temporal fidelity required for model building.

Abstract: A method of adaptively operating a medical triage system includes triaging a plurality of persons using a set of triage questions to select particular dispositions from a plurality of triage disposition. Triage-related data is acquired as a result of the triaging of the plurality of persons. The triage-related data is analyzed and the set of triage questions or the dispositions are modified based on the analysis of the triage-related data.

Abstract: The present invention provides a method and system for interfacing with a multi-level data structure by selecting a concept object stored in the multi-level data structure, displaying a first image representing the selected concept object, displaying one or more second images generally above the first image, and displaying a first connector connecting each second image to the first image. Whenever the selected concept object has one or more child concept objects, one or more third images are displayed generally below the first image, and a second connector is displayed connecting each third image to the first image. Whenever the selected concept object has one or more lateral concept objects, one or more fourth images are displayed generally on one or both sides of the first image, and a third connector is displayed connecting each fourth image to the first image.

Abstract: A communications and documentation system is disclosed that improves staff communication, education, and/or documentation. This system is interactive and integrates speech recognition, telephony, wireless, and/or database technologies, and innovative algorithms in a novel way that allows for assigning staff, scheduling staff activities, and data collection and reporting. The system also incorporates features that promote ease of use by persons who are not skilled at using technology.

Abstract: A system and method for assessing the severity of medication errors associated with intravenous administration is provided. A harm index database includes harm index values for various parameters of medication administration. A medication administration device may access this database and assess the overall harm index for particular errors in order to provide appropriate alerts based on the severity of the error. Further, assessment of the harm index value may be used retrospectively to provide reports of event logs that include an overall harm index value associated with each alert.

Abstract: The present invention provides a method and system for managing resources of an enterprise, in particular a healthcare enterprise. One aspect of the present invention provides a method and system for remote access and exchange of information for managing enterprise resources using a distributed computing environment such as the Internet or World Wide Web. The system provides real-time management of healthcare facility resources including clinical hours provided per patient per day.