Abstract: Computer-implemented systems and methods are provided for analyzing healthcare-related entity performance. In one implementation, a method is implemented with one or more processors and includes receiving a request that includes one or more filter selections and accessing a data structure including information that specifies a plurality of categories of healthcare-related interactions associated with multiple healthcare-related entities. The method also includes identifying a set of categories from the plurality of categories based on the one or more filter selections and processing the information of the identified categories to provide performance information of one or more entities of the multiple healthcare-related entities in accordance with the one or more filter selections. The method further includes generating a user interface that includes the performance information indicating a performance of the one or more entities.

Abstract: Techniques are provided for querying medical claims data. In an embodiment, responding to selection of a health care fraud scheme template from among a plurality of health care fraud scheme templates by displaying a partial query statement defined by the selected health care fraud scheme template; and based on a parameter indicated by the selected health care fraud template, displaying at least one interface control element embedded within the partial query statement. An input indicating the value for the parameter of the partial query statement is received. Generating a converted query in a database querying language that a particular database system is configured to interpret based at least on the partial query statement, the parameter, and the specified value for the parameter. The particular database system is caused to execute the converted query to identify query results comprising health care data based on the converted query.

Abstract: Computer-implemented systems and methods are provided for analyzing healthcare-related entity performance. In one implementation, a method is implemented with one or more processors and includes accessing a data structure including information that specifies healthcare-related interactions and identifying, from the data structure, a first set of interactions associated with a first healthcare-related entity. The method also includes identifying, from the data structure, a second set of interactions associated with one or more filter selections and processing the information of the identified first and second set of interactions to provide performance information of the first healthcare-related entity and one or more healthcare-related entities associated with the one or more filter selections.

Abstract: Computer-implemented systems and methods are provided for analyzing healthcare-related entity performance. In one implementation, a method is implemented with one or more processors and includes receiving a request that includes one or more filter selections and accessing a data structure including information that specifies a plurality of categories of healthcare-related interactions associated with multiple healthcare-related entities. The method also includes identifying a set of categories from the plurality of categories based on the one or more filter selections and processing the information of the identified categories to provide performance information of one or more entities of the multiple healthcare-related entities in accordance with the one or more filter selections. The method further includes generating a user interface that includes the performance information indicating a performance of the one or more entities.