Abstract: A payment integrity system that processes data, including data associated with a biometric technology. The system includes a discovery module to receive insurance records from a source of data, which includes the data associated with the biometric technology, the records providing information that pertain to at least one transaction. The discovery module includes a query component and an artificial intelligence engine to process the records to identify a second subset of the records having anomalous information, and provide a second analysis output indicative of the second subset. The system also includes an audit module to determine whether to instruct the artificial intelligence engine to analyze the records according to the outputs. The system facilitates resolution of a claim payment based on the first analysis output and the second analysis output.
Type:
Grant
Filed:
February 13, 2012
Date of Patent:
November 12, 2013
Assignee:
Accenture Global Services Limited
Inventors:
Michael Scott Hartley, Leana Rachelle Wallace, Lisa Marie Henning, Nicholas Francisco Howell, Sanjay Mathur
Abstract: A payment integrity system that processes data, including data associated with a biometric technology. The system includes a discovery module to receive insurance records from a source of data, which includes the data associated with the biometric technology, the records providing information that pertain to at least one transaction. The discovery module includes a query component and an artificial intelligence engine to process the records to identify a second subset of the records having anomalous information, and provide a second analysis output indicative of the second subset. The system also includes an audit module to determine whether to instruct the artificial intelligence engine to analyze the records according to the outputs. The system facilitates resolution of a claim payment based on the first analysis output and the second analysis output.
Type:
Grant
Filed:
December 13, 2010
Date of Patent:
February 28, 2012
Assignee:
Accenture Global Services Limited
Inventors:
Michael Scott Hartley, Leana Rachelle Wallace, Lisa Marie Henning, Nicholas Francisco Howell, Sanjay Mathur