Abstract: A method and computing apparatus for automatically identifying whether or not one or more identified injuries are related to the insurance claim which has been submitted is described. The method and computing apparatus identify injury data in an electronic medical claim data associated with a claimant based diagnosis code data, uses a classifier to determine an association between the identified injury data represented by the diagnosis code data and the initial injury data represented by the initial diagnosis code data is identified when historical claim data is determined to be present for the claimant.

Abstract: A method and computing apparatus for automatically identifying whether or not one or more identified injuries are related to the insurance claim which has been submitted is described. The method and computing apparatus identify injury data in an electronic medical claim data associated with a claimant based diagnosis code data, uses a classifier to determine an association between the identified injury data represented by the diagnosis code data and the initial injury data represented by the initial diagnosis code data is identified when historical claim data is determined to be present for the claimant.

Abstract: Methods, non-transitory computer readable media, and computing apparatus that assist with more accurately managing processing of medical bill data includes identifying previously submitted bill data associated with received medical bill data from a client based on one or more service data parameters in the received medical bill data and the identified previously submitted bill data. The received medical bill data is determined to be erroneous medical bill data based on the identified previously submitted bill data and a time period between the previously submitted bill data and the received medical bill data. The received medical bill data is classified as a follow-up procedure bill data when the received medical bill data is determined to be an erroneous medical bill data. Compensation data is restricted for the received medical bill data classified as the follow-up procedure bill data.

Abstract: Disclosed technology includes identifying injury data in an electronic medical claim data associated with a claimant based diagnosis code data present in the electronic medical claim data. Presence of historical claim data including initial injury data represented by initial diagnosis code data associated with the claimant for the electronic medical claim data is determined. At least one type of clinical correlation of a plurality of clinical correlations between the identified injury data represented by the diagnosis code data and the initial injury data represented by the initial diagnosis code data is identified when historical claim data is determined to be present for the claimant. Claim processing guidance data to process the electronic medical claim data is provided based on the identified at least one type of correlation between the identified injury data represented by the diagnosis code data and the initial injury data represented by the initial diagnosis code data.

Abstract: Methods, non-transitory computer readable media, and computing apparatus that assist with more accurately managing processing of medical bill data includes identifying previously submitted bill data associated with received medical bill data from a client based on one or more service data parameters in the received medical bill data and the identified previously submitted bill data. The received medical bill data is determined to be erroneous medical bill data based on the identified previously submitted bill data and a time period between the previously submitted bill data and the received medical bill data. The received medical bill data is classified as a follow-up procedure bill data when the received medical bill data is determined to be an erroneous medical bill data. Compensation data is restricted for the received medical bill data classified as the follow-up procedure bill data.