Abstract: An automatic medical coding system is provided. The system parses features of natural language diagnosis and procedure information. The features are compared to elements of a medical coding system. Medical codes corresponding to medical coding system elements that match features of the diagnosis and procedure information are mapped to the received diagnosis and procedure information. The mapped medical code is assigned a score reflecting the estimated reliability of the mapped medical code based on the amount of manipulation of the received diagnosis and procedure information leading to the match. The scored medical code may be submitted to a workflow making use of medical codes. The scored medical code may optionally be presented to a user for review prior to further utilization of the scored medical code.

Abstract: An automatic medical coding system is provided. The system parses features of natural language diagnosis and procedure information. The features are compared to elements of a medical coding system. Medical codes corresponding to medical coding system elements that match features of the diagnosis and procedure information are mapped to the received diagnosis and procedure information. The mapped medical code is assigned a score reflecting the estimated reliability of the mapped medical code based on the amount of manipulation of the received diagnosis and procedure information leading to the match. The scored medical code may be submitted to a workflow making use of medical codes. The scored medical code may optionally be presented to a user for review prior to further utilization of the scored medical code.

Abstract: A preauthorization knowledgebase system. The preauthorization knowledgebase system parses relevant information from an order submitted by a health care provider and compares that information against a set of rules used to determine whether preauthorization is required for a medical service specified in the order. The rules are arranged into various hierarchical levels from payer level to procedure level. Even if the order is incomplete, the preauthorization knowledgebase system checks as many of the hierarchical levels as possible with the information provided. The preauthorization knowledgebase system returns a result indicating whether preauthorization is required for the order and, optionally, the hierarchical level(s) requiring preauthorization.