Publication number: 20250148542
Abstract: A computer-implemented method includes receiving, by one or more processors, Process Instruction (PI) information containing instructions for adjudicating a healthcare service request based on a primary fact source; dividing, by the one or more processors and using an Artificial Intelligence (AI) model, the instructions into one or more instruction sets; generating, by the one or more processors and the AI model, an input-output mapping for first ones of the one or more instruction sets having a complexity that does not satisfy a complexity threshold; generating, by the one or more processors and the AI model, code for second ones of the one or more instructions sets having the complexity that satisfies the complexity threshold; generating, by the one or more processors and the AI model, a validation input set for the input-output mapping and for the code; and applying, by the one or more processors and the AI model, the validation input set to the input-output mapping and the code to generate a validation ou
Type:
Application
Filed:
September 27, 2024
Publication date:
May 8, 2025
Inventors:
Vijaychandar Natesan, Pawan Kumar Pandey, Ramesh R. Ganesan, Rakesh P A, Jason Glackin, Maureen E. Calkins, Bruce E. Thompson, Christina Lynn Jay, Jerelyn P P, Vishal Gupta, Bakya Sri V, Shivangi Priyadarshini, Lila R. Muhammed, Tejaswi P, Guntupalli Sumanth Naga Deep, Prabhu Vincent, Chethan Rai, Srijan Agrawal