Abstract: Identifying and quantifying a professional relationship between a practitioner and a clinic. A method includes identifying a clinic associated with a practitioner by assessing claims processed by the practitioner, identifying the clinic that are processed by the practitioner, and calculating a total quantity of claims processed by the practitioner. The method includes quantifying a relationship between the practitioner and the clinic based on the quantity of clinic claims and the total quantity of claims.

Abstract: Matching healthcare groups and healthcare systems based on billed claims and calculating capture of billed procedures for healthcare groups and systems. A method includes identifying one or more office practitioners billing carrier claims comprising a certain office billing identifier and identifying one or more procedure practitioners associated with facility claims for procedures performed under a certain procedure billing identifier. The method includes identifying a common practitioner billing carrier claims comprising the certain office billing identifier and associated with facility claims for procedures performed under the certain procedure billing identifier. The method includes generating an office-procedure pair by matching the certain office billing identifier with the certain procedure billing identifier based on an existence of the common practitioner.

Abstract: Determining cohesion of healthcare systems and facilities based on billed claims. A method includes determining a target procedure billing identifier associated with one or more of a healthcare system or a healthcare facility and identifying a practitioner associated with a facility claim comprising the target procedure billing identifier. The method includes identifying a plurality of facility claims billed by the practitioner over a time period and calculating a proportion of the plurality of facility claims that comprise the target procedure billing identifier.

Abstract: Systems, methods, and devices for identifying and quantifying an employment relationship between a practitioner and a facility. A method includes identifying carrier claims processed by a practitioner for procedures performed through a facility and matching the carrier claims to the facility to generate matched claims. The method includes calculating a percentage of outpatient claims based on a percentage of office claims performed by the practitioner that did not occur at the facility. The method includes calculating a level of confidence that the practitioner is employed by the facility based on the matched claims and the percentage of outpatient claims.

Abstract: Identifying ownership of a healthcare clinic based on enrollment information. A method includes identifying a plurality of practitioners associated with a clinic and calculating a proportion of the plurality of practitioners that are enrolled under a healthcare group based on enrollment information stored in an enrollment database. The method includes determining whether the proportion satisfies a threshold proportion of practitioners enrolled under the healthcare group and imputing a group ID associated with the healthcare group to the clinic if the proportion satisfies the threshold proportion.