Abstract: A method and system for analyzing historical medical provider billings to statistically establish a normative utilization profile. Comparison of a medical provider's utilization profile with a normative profile is enabled. Based on historical treatment patterns and a fee schedule, an accurate model of the cost of a specific medical episode can be created. Various treatment patterns for a particular diagnosis can be compared by treatment cost and patient outcome to determine the most cost-effective treatment approach. It is also possible to identify those medical providers who provide treatment that does not fall within the statistically established treatment patterns or profiles.
Type:
Grant
Filed:
June 23, 1994
Date of Patent:
September 17, 1996
Assignee:
Medicode, Inc.
Inventors:
Jerry G. Seare, Patricia A. Smith-Wilson, Kurt VanWagoner, Jean A. Mattey, Eileen K. Snyder, Candace C. Wahlstrom, Michelle Willis, Matthew R. Bentley, Steven J. Wenzbauer, Rodney Fredette, Vicki S. Sennett