Abstract: Systems and methods are provided for automating the process of automatically determining appropriateness of surgical team services performed during a medical procedure. Clinical resource data with known surgical guideline indicator (SGIs) may be us used to generate and store a mapping of medical procedure codes to indications of the appropriateness of surgical team services corresponding to the medical procedure codes. A medical bill associated with an insurance claim may be analyzed to extract a medical procedure code corresponding to a surgical procedure, and an automated adjudication recommendation for the medical bill may be made based on the mapping between medical procedure codes and SGIs.

Abstract: A method, non-transitory computer readable medium, and apparatus that identifies one of a plurality of diagnostic mapping tables based on a diagnostic code associated with one of a plurality of data environment formats in an electronic claim. The diagnostic code associated with one of the plurality of data environment formats is correlated to at least one of a plurality of parts and laterality associated with another one of the plurality of data environment formats based on the identified one of the plurality of diagnostic code mapping tables. One of a plurality of assessment ratings is determined based on the diagnostic code the correlated one of the plurality of parts and the laterality, and a categorization table associated with the another one of the plurality of data environment formats. Execution of one of a plurality of actions on the electronic claim in response to the determined one of the plurality of assessment ratings for the diagnostic code is initiated.

Abstract: Systems and methods are provided for automating the process of automatically determining appropriateness of surgical team services performed during a medical procedure. Clinical resource data with known surgical guideline indicator (SGIs) may be us used to generate and store a mapping of medical procedure codes to indications of the appropriateness of surgical team services corresponding to the medical procedure codes. A medical bill associated with an insurance claim may be analyzed to extract a medical procedure code corresponding to a surgical procedure, and an automated adjudication recommendation for the medical bill may be made based on the mapping between medical procedure codes and SGIs.

Abstract: A method, non-transitory computer readable medium, and apparatus that identifies one of a plurality of diagnostic mapping tables based on a diagnostic code associated with one of a plurality of data environment formats in an electronic claim. The diagnostic code associated with one of the plurality of data environment formats is correlated to at least one of a plurality of parts and laterality associated with another one of the plurality of data environment formats based on the identified one of the plurality of diagnostic code mapping tables. One of a plurality of assessment ratings is determined based on the diagnostic code the correlated one of the plurality of parts and the laterality, and a categorization table associated with the another one of the plurality of data environment formats. Execution of one of a plurality of actions on the electronic claim in response to the determined one of the plurality of assessment ratings for the diagnostic code is initiated.

Abstract: An electronic marketplace includes a plurality of video game applications available for purchase. For each of the plurality of video game applications, the electronic marketplace may display a tile identifying the video game application, a payment object for initiating a purchase of the video game application, and a preview object to initiate viewing of a live broadcast of active gameplay of the video game application.

Abstract: The present invention is an apparatus, method and system for secure point-of-sale (POS) and biometric data/finger print identification communications technology and systems processing methods in the area of financial merchant transactions. The present invention may use either or both standalone biometrics and biometric/fingerprinting technology with a touch screen device or a portable/mobile wireless device to securely process merchant POS financial transactions.

Abstract: The present invention is an apparatus, system and method for personal banking and other activities that require secure communications. The present invention utilizes biometrics and/or finger printing technology on a touch screen or window to allow customers to securely process information. The method of the device can be used for financial or other secure transactions (e.g., point-of-sales) from a cell phone or other portable apparatus by first identifying the customer, and exchanging information using the highest encryption technology available.