Abstract: A system and method for rules-driven adjudication is disclosed. The system includes a storage includes a rule library having a plurality of rules, each rule being in a human-readable format and including a first data tag, a comparator, a comparison value, and a result. The system also includes a rules manager configured to receive and store a new rule. The system includes a rules evaluator configured to receive an adjudication request having a data object associated with a data tag, and evaluate the request and create a primary determination by applying a first rule to the request, and further applying a first subsequent rule and all logically adjacent rules until all logically adjacent rules have been exhausted and the primary determination is an indefinite outcome or the applying of a final rule returns an outcome that becomes the primary determination.

Abstract: A system and method for on-demand data cleansing is disclosed. The system includes a processor and a volatile memory including a data object having a plurality of data fields, each field having a tag and a value. The system also includes a cleansing module stored in the volatile memory and executed by the processor. The cleansing module includes a library having a plurality of tag-operation pairs. The cleansing module is configured to receive a pointer locating the data object within volatile memory, and further configured to, for each data field, look up the tag of the data field among the library tags, and execute the operation paired with the matching library tag on the value of the field, modifying the value of the data field while it is stored in volatile memory. The cleansing module is configured to execute the operation in near real-time, and at runtime.

Abstract: A system for configuring an adaptive computer cluster is disclosed. The system includes a cluster configuration server communicatively coupled to a cluster hosting environment through a network, the cluster configuration server having a processor and a memory. The memory includes a plurality of inert containers and a configuration tool configured to receive at least one procedure having a trigger event and at least one task and further configured to instruct the cluster hosting environment to instantiate the adaptive computer cluster based upon the at least one procedure and using the plurality of inert containers. The instantiation instructions include instructions to instantiate, within the cluster hosting environment, an API gateway container, a storage container, a distributed computing master node container, at least one solution-specific container, and an orchestrator container.

Abstract: A method for healthcare revenue cycle management is disclosed, and includes receiving a transaction proposal at a first peer within a permissioned blockchain network (PBN). The transaction proposal includes a patient identity and a query, the query being a determination of unknown value to be made by a second organization of a plurality of organizations. Each organization of the plurality represents, within the PBN, one of a healthcare payer and a healthcare provider. The method also includes identifying a smart contract associated with the query and defined to automatically adjudicate the query. The method also includes invoking the smart contract in at least one endorsing peer, and receiving, from each endorsing peer, a proposed transaction response. The method further includes automatically adjudicating the query by executing chaincode on a second peer, operating on the required information to assign a value to the determination, then updating the immutable ledger.

Abstract: A blockchain network control system and method is disclosed. The system includes a processor coupled to a storage comprising a plurality of network entity definitions each defining a different network entity that make up a target network architecture for a permissioned blockchain network. The system also includes a control object communicatively coupled to an ordering service and a plurality of organizations. The plurality of organizations was established by the blockchain network control system by instantiating the organizational membership service provider, registering and enrolling each peer node within each organization, storing the cryptographic identity generated for the peer node, and then instantiating the plurality of peer nodes.

Abstract: A system and method for data aggregation and process automation is disclosed. The method includes receiving a first data object from a first integration point through a first smart adapter, identifying an appropriate rules library from a plurality of rules libraries using a rules engine, the appropriate rules library being identified using the first data object, and applying the appropriate rules library through the rules engine. The rules are applied by instructing a transformation module to transform the first data object into a transformed data object, instructing a validation module to validate at least one of the first data object and the transformed data object, and instructing an aggregation module to perform a statistical analysis on one of the first data object and the transformed data object. Finally, the method includes sending the transformed data object to a second integration point associated with a second smart adapter.

Abstract: A system and method for rules-driven adjudication is disclosed. The system includes a storage includes a rule library having a plurality of rules, each rule being in a human-readable format and including a first data tag, a comparator, a comparison value, and a result. The system also includes a rules manager configured to receive and store a new rule. The system includes a rules evaluator configured to receive an adjudication request having a data object associated with a data tag, and evaluate the request and create a primary determination by applying a first rule to the request, and further applying a first subsequent rule and all logically adjacent rules until all logically adjacent rules have been exhausted and the primary determination is an indefinite outcome or the applying of a final rule returns an outcome that becomes the primary determination.

Abstract: A data aggregation and process automation (DAPA) system is disclosed. The DAPA system includes an authentication module, a monitoring module, an intelligent automation module, and a transformation module. The authentication module is configured to initiate authenticated communication with a plurality of servers, and includes an authentication storage having a plurality of authentication credentials and routing information. The monitoring module is configured to monitor a first server for a first change event and monitor a second server for a second change event. The first change event results in the receipt of a first data object and the second change event results in the receipt of a second data object. The intelligent automation module is configured to identify the second server, request a service, and submit an update data object to the first server. The transformation module is configured to transform data objects from one format into another.

Abstract: A system and method for on-demand data cleansing is disclosed. The system includes a processor and a volatile memory including a data object having a plurality of data fields, each field having a tag and a value. The system also includes a cleansing module stored in the volatile memory and executed by the processor. The cleansing module includes a library having a plurality of tag-operation pairs. The cleansing module is configured to receive a pointer locating the data object within volatile memory, and further configured to, for each data field, look up the tag of the data field among the library tags, and execute the operation paired with the matching library tag on the value of the field, modifying the value of the data field while it is stored in volatile memory. The cleansing module is configured to execute the operation in near real-time, and at runtime.

Abstract: A system for configuring an adaptive computer cluster is disclosed. The system includes a cluster configuration server communicatively coupled to a cluster hosting environment through a network, the cluster configuration server having a processor and a memory. The memory includes a plurality of inert containers and a configuration tool configured to receive at least one procedure having a trigger event and at least one task and further configured to instruct the cluster hosting environment to instantiate the adaptive computer cluster based upon the at least one procedure and using the plurality of inert containers. The instantiation instructions include instructions to instantiate, within the cluster hosting environment, an API gateway container, a storage container, a distributed computing master node container, at least one solution-specific container, and an orchestrator container.