Abstract: A system may receive a proposed medical diagnosis of a patient, and automatically identify potential medical services to be performed with respect to the patient. The identified medical services may be deemed relevant to the proposed medical diagnosis, which the system may determine from a customizable decision table. Further, the system may receive selection of a potential medical service from the identified potential medical services, and present an automated, real-time indication regarding paying entity/plan coverage and estimated cost and/or quality metrics for the selected medical service based on the patient and paying entity/plan of the patient. In addition, the system may facilitate selection of a lab/facility to perform the selected medical service.

Abstract: A system may receive a proposed medical diagnosis of a patient, and automatically identify potential medical services to be performed with respect to the patient. The identified medical services may be deemed relevant to the proposed medical diagnosis, which the system may determine from a customizable decision table. Further, the system may receive selection of a potential medical service from the identified potential medical services, and present an automated, real-time indication regarding paying entity/plan coverage and estimated cost and/or quality metrics for the selected medical service based on the patient and paying entity/plan of the patient. In addition, the system may facilitate selection of a lab/facility to perform the selected medical service.

Abstract: There is provided an insurance claim processing system. An agent converts a data point from a first format into a uniform format. The data point represents data from an insurance claim. A collector receives the data point in the uniform format and sends the data point to a data store. The data point is a member of a plurality of data points in the uniform format in the data store. An analyzer retrieves the plurality of data points from the data store and produces a metric from the plurality of data points.

Abstract: The process of the present invention is an emulation process for automatically making changes and/or revisions to computer data files from a database of file records stored in a computer. The process includes the steps of identifying the events that occur while accomplishing a given task, recording in memory the operation of a human operator interacting with a graphical user interface of a computer to form one or more emulated responses to each event representing event handlers for performing the task, forming a collection of events for such task and a collection of the recorded emulated event handlers corresponding to each event for such task, selecting a batch of file records that require changes and/or revisions from the database of file records, loading a specified task and the recorded collection of events and emulated event handlers for such task into a computer; and executing the task on each selected file record by matching each emulated event handler in memory to a given event.