Abstract: Tools and techniques are provided for analyzing health care procedure related transactions of a health care entity. The method can include creating a linked data items file, by a transaction analysis computer system, derived from a combination of a charge description master (CDM) file containing CDM data items, an order entry system (OES) file containing OES data items, and a CDM-to-OES cross-reference data file. The linked data items file can be analyzed by reading linked line items, analyzing its CDM data portion, analyzing its OES data portion, and/or comparing the linked CDM data portion to the linked OES data portion for determining similarities or differences between the CDM and OES data portions.

Abstract: Computer-implemented tools, techniques, and algorithms are provided for meeting financial targets in connection with medical procedures (e.g., surgical operations) performed by a healthcare entity. A method for restructuring classification of multiple medical procedures for a healthcare entity may be provided in which medical procedure data including charge related data are collected in association with multiple patient encounters for a medical procedure. A data model is created from the collected data and a predetermined number of procedure charge levels are generated each in association with an acuity resource value range. Each medical procedure is then reclassified into one of the procedure charge levels in accordance with at least one level assignment rule. This reclassification can then be processed to determine whether it results in a predetermined desired data distribution and/or meets financial targets for the medical procedure charge data.

Abstract: A computer-assisted method for uniformly pricing chargeable items in a healthcare provider's chargeable item database is disclosed. The method applies uniform pricing to identical or related chargeable items. A system for uniformly pricing related chargeable items is also disclosed.

Abstract: A computer-assisted method for uniformly pricing chargeable items in a healthcare provider's chargeable item database is disclosed. The method applies uniform pricing to identical or related chargeable items. A system for uniformly pricing related chargeable items is also disclosed.

Abstract: A computer-assisted method for uniformly pricing chargeable items in a healthcare provider's chargeable item database is disclosed. The method applies uniform pricing to identical or related chargeable items. A system for uniformly pricing related chargeable items is also disclosed.

Abstract: The invention is a system that reviews, approves, and implements updates to a primary database that houses a business's chargeable items. A duplicate database has a duplicate of each data entry in the primary database. Prior to implementation, the update is reviewed for compliance with regulatory and local standards and preapproved updates by using the duplicate database as a point of reference. The management service may revise the update before implementing the update into the primary database. Preferably any update that is implemented into the primary database is validated to confirm that the implemented update matches the approved update.

Abstract: A computer-assisted method for hierarchically pricing chargeable items in a healthcare provider's chargeable item database is disclosed. The method applies hierarchical pricing to related chargeable items. A system for hierarchically pricing related chargeable items is also disclosed.

Abstract: A computer-assisted method for uniformly pricing chargeable items in a healthcare provider's chargeable item database is disclosed. The method applies uniform pricing to identical or related chargeable items. A system for uniformly pricing related chargeable items is also disclosed.

Abstract: A computer-assisted method for hierarchically pricing chargeable items in a healthcare provider's chargeable item database is disclosed. The method applies hierarchical pricing to related chargeable items. A system for hierarchically pricing related chargeable items is also disclosed.

Abstract: A computer-coded software instructions capable of being executed by a conventional computer microprocessor to perform information processing on pre-existing medical billing record information, preferably consisting of hospital or individual doctor Medicare billing records. The software contains at least one set of instructions for receiving, converting, sorting and storing input information from the pre-existing medical billing records into a form suitable for processing. The software contains at least one set of instructions for processing the input medical billing record information, preferably to identify potential Medicare "72 hour billing rule" violations. This processing is preferably performed by comparing each input medical billing record containing dates of medical inpatient admission and discharge to each input medical billing record containing a date of medical outpatient service.

Abstract: The present invention provides a computerized method for ranking items based upon the interrelationship of the volumes and revenues and payment methodologies of items sold. First a base rank value is determined based upon the measured distribution of item volume, item revenue and the payor methodology mix. A weighted value is then determined by the computer system for each item by high and low assigned values which are then normalized and sorted to provide a normalized ranking. The pricing of each item is based upon the normalized ranking. The method of the present invention is used to determine what items should increase in price, what items should decrease in price, and what items should remain constant according to each item's relative value to net income.