Abstract: Systems, methods, and computer-readable media automate determination of a risk category for low body mass index associated with issuance of a life insurance policy.

Abstract: Systems, methods, and computer-readable media automate determination of a risk category for hepatitis associated with issuance of a life insurance policy.

Abstract: A medical payment system is described in which a provider of medical goods and/or services submits, via telephone or other communications medium, a request for payment amount determination for a patient encounter. A price determination system determines which of a plurality of fee schedules negotiated by the provider applies to the patient encounter and calculates, based at least in part on information entered by the provider, a payment amount for the encounter, which it communicates to at least the provider. In one embodiment, the provider receives the payment amount information while the patient is at the point of service. In one embodiment, the provider may use the system to submit a claim for payment by at least one responsible party.

Abstract: Systems, methods, and computer-readable media automate determination of a risk category for low cholesterol associated with issuance of a life insurance policy.

Abstract: A method of and a system for development of health care information Systems (HIS) are disclosed. The method includes providing software programming interfaces for development of application modules, communication interfaces for establishing communication between various modules, and resource management interfaces for allocation of resources such as memory. The system comprises of a server with a health care middleware operating system (HMOS). The HMOS is designed as a multi-tier architecture with 3 tiers namely, application tier, domain services tier, and Foundations tier.

Abstract: Systems and methods are disclosed providing a database comprising a compendium of at least one of patient treatment history; orthodontic therapies, orthodontic information and diagnostics; employing a data mining technique for interrogating said database for generating an output data stream, the output data stream correlating a patient malocclusion with an orthodontic treatment; and applying the output data stream to improve a dental appliance or a dental appliance usage.

Abstract: Method and system for providing dynamically generated orthodontic profile and associated treatment information including receiving an orthodontic condition and one or more related treatment goal options, retrieving a predetermined set of parameters associated with the orthodontic condition and the one or more related treatment goal options, determining a weighted parameter associated with each of the one or more treatment goal options for the orthodontic condition, and generating treatment plan information for the orthodontic condition based on the determined weighted parameter are provided.

Abstract: Method and system for receiving one or more dentition conditions of a patient, associating a first set of one or more treatment goals based on the one or more dentition conditions, generating a case difficulty assessment based on the one or more treatment goals, detecting a modification to the case difficulty assessment, retrieving a second set of one or more treatment goals associated with the modified case difficulty assessment, and displaying the second set of one or more treatment goals are provided.

Abstract: A personalized health information discovery and presentation system is presented. The system has an input device, a subject-profile module, an information database, an alignment module, a solutions module, an integration engine, a plan module, a graphical user interface, and a processor. The input device allows a user to enter a personalized subject-profile, the subject-profile module receives the subject-profile and converts it into a recognized health profile. The health information database comprises a library of health information, and the alignment module aligns the recognized health profile with relevant health information. The solution's module parses the relevant information into information subsets, and the integration engine integrates the information; identifies conflicting health information, contraindications, or health warnings; creates notifications; and compiles data for presentation to the user.

Abstract: Systems, methods, and computer-readable media to automate reconsideration of a cardiac risk category associated with issuance of a life insurance policy may provide an indication of a best potential risk category or rate class that would be available if at least one action is completed by a life insurance applicant.

Abstract: An apparatus, method, and computer program product for maintaining data regarding the compliance of vendors with insurance requirements of a number of nations.

Abstract: Method and system for providing dynamically generated orthodontic profile and associated treatment information is provided.

Abstract: A plan of countersuit insurance provided to professionals, possibly as part of or along with their professional liability insurance, deters frivolous professional malpractice claims. The plan of insurance pays legal costs of countersuits for improper prosecution when a frivolous claim has been made and, preferably, tried to a judgment for the accused professional, and an objective review concludes that the claim was frivolous. The objective review may include initiating a disciplinary proceeding against any expert witness before a professional society to which the witness belongs, for violation of the code of conduct imposed by the society on its members. Ordinarily, such a proceeding would not be initiated unless an initial review indicated at least a possibility of frivolousness, and therefore of success in the proceeding. The outcome of the proceeding could be treated as conclusive proof of frivolousness, or could be treated as just another factor in a frivolousness determination.

Abstract: Method and system for providing an orthodontic profile indexing and treatment plan including comparing an initial patient condition in each of a plurality of dentition categories with one or more reference conditions in each of the plurality of dentition categories, wherein each of the one or more reference conditions has a corresponding representation, selecting at least one reference condition in one or more of the plurality of dentition categories, where each selected reference condition is similar to the initial patient condition in a same dentition category, and generating a patient identifier based on the corresponding representations of each selected reference condition is provided.

Abstract: A robust process for automating the tuning and maintenance of decision-making systems is described. A configurable multi-stage mutation-based evolutionary algorithm optimally tunes the decision thresholds and internal parameters of fuzzy rule-based and case-based systems that decide the risk categories of insurance applications. The tunable parameters have a critical impact on the coverage and accuracy of decision-making, and a reliable method to optimally tune these parameters is critical to the quality of decision-making and maintainability of these systems.

Abstract: A robust system for automating the tuning and maintenance of decision-making systems is described. A configurable multi-stage mutation-based evolutionary algorithm optimally tunes the decision thresholds and internal parameters of fuzzy rule-based and case-based systems that decide the risk categories of insurance applications. The tunable parameters have a critical impact on the coverage and accuracy of decision-making, and a reliable method to optimally tune these parameters is critical to the quality of decision-making and maintainability of these systems.

Abstract: A method for controlling healthcare claim payment losses including accessing information about a claim after a payer is prepared to pay, but prior to payment, evaluating the information including at least one of determining indications of fraud, validating service coding and editing as indicated, identifying possible payment discounts, and developing analytics indicative of risk for future claims, and providing loss control recommendations based at least partially on the evaluation, prior to paying the claim. Also a loss control system for healthcare claims with a loss control engine and a database in communication with the loss control engine, wherein the loss control engine accesses information about healthcare claims from the database after the claims have been processed for payment and wherein the loss control engine further analyses the claims for potential cost savings and returns a loss control recommendation for each claim to the database before payment of the respective claim.

Abstract: A system and method for consolidating edits that facilitate alteration of information of a medical claim. The method includes accessing an edit list. Words of two or more edits of the edit list to determine similarity therebetween may be compared. A new edit based on the similarity between the edits may be formed. In one embodiment, the similarity may be semantic similarity. The method may further include computing a value indicative of the degree of similarity of the words of the edits. Objects may be utilized in the process of consolidating the edits.

Abstract: System and methods for processing a drug prescription transaction are configured to identify and resolve any issue or problem associated with the transaction during one or more early stages of processing. System and methods of processing the transaction handle prescription and customer data entry, pharmacy inventory check, prescription refill authorization check and/or insurance adjudication review well in advance of production and quality assurance stages by identifying and resolving any issue or problem. Prescription fulfillment is prioritized and estimated prescription pick-up times are predicted based on one or more outcomes of such early stage processing. Customers can be provided with realistic and relatively accurate prescription pick up times that a pharmacy can efficiently and consistently meet as a result of fulfillment prioritization. Further, system and methods for determining a staffing schedule for a workflow process requiring different skill levels during different operaton times is provided.

Abstract: A system extrapolates and interpolates patient fluid intake or output parameter values and associated cumulative values over variable time intervals from a reduced set of stored fluid parameter values affecting fluid cumulative volume computation or rate of fluid intake or output computation. The extrapolation and interpolation function accomodates drip (continuing) fluid volumes as well as supplemental (non-continuing e.g., bolus) fluid volumes. A patient medical parameter data processing system provides patient medical parameter data for trend indicative display covering a time period comprising user selectable patient parameter acquisition time intervals. The system includes an acquisition processor for receiving data identifying, for a continuing infusion, rate of volume of fluid infusion into a patient, a fluid type identifier and a start time and start date of said continuing infusion.