Patents by Inventor Raphael N'Gouan

Raphael N'Gouan has filed for patents to protect the following inventions. This listing includes patent applications that are pending as well as patents that have already been granted by the United States Patent and Trademark Office (USPTO).

  • Routing claims from automatic adjudication system to user interface
    Patent number: 11481846
    Abstract: A claim adjudication system including an automatic adjudication pipeline that uses pipeline rules to automatically adjudicate a claim associated with a benefit plan at one or more stages. The automatic adjudication pipeline can redirect the claim to a user interface for manual review when a pipeline rule associated with a manual review condition is triggered. The user interface can present information about the claim relevant to the manual review condition in an integrated format, including highlighting the reasons for the manual review. A user can evaluate the claim in the user interface and provide user input that addresses the manual review condition, and the claim can be routed back to the automatic adjudication pipeline. The user input can also be used as training data for machine learning to adjust pipeline rules that are used to automatically process claims and to redirect future claims for manual review.
    Type: Grant
    Filed: May 16, 2019
    Date of Patent: October 25, 2022
    Assignee: CollectiveHealth, Inc.
    Inventors: Nicholas Halpern-Manners, Thomas Bedingten, Andrew Chang, Yulia Eskin, Erica Leigh Horowitz, Chetan Subramanya Ithal, Asif Khalak, Sergio Martinez-Ortuno, Raphael N'Gouan, John George O'Leary, Izac Benjamin Milstein Ross, Xiaowen Ye, Heather Grates, Irene Victoria Tollinger, Henning Chiv
  • ROUTING CLAIMS FROM AUTOMATIC ADJUDICATION SYSTEM TO USER INTERFACE
    Publication number: 20200364797
    Abstract: A claim adjudication system including an automatic adjudication pipeline that uses pipeline rules to automatically adjudicate a claim associated with a benefit plan at one or more stages. The automatic adjudication pipeline can redirect the claim to a user interface for manual review when a pipeline rule associated with a manual review condition is triggered. The user interface can present information about the claim relevant to the manual review condition in an integrated format, including highlighting the reasons for the manual review. A user can evaluate the claim in the user interface and provide user input that addresses the manual review condition, and the claim can be routed back to the automatic adjudication pipeline. The user input can also be used as training data for machine learning to adjust pipeline rules that are used to automatically process claims and to redirect future claims for manual review.
    Type: Application
    Filed: May 16, 2019
    Publication date: November 19, 2020
    Inventors: Nicholas Halpern-Manners, Thomas Bedington, Andrew Chang, Yulia Eskin, Erica Leigh Horowitz, Chetan Subramanya Ithal, Asif Khalak, Sergio Martinez-Ortuno, Raphael N'Gouan, John George O'Leary, Izac Benjamin Milstein Ross, Xiaowen Ye, Heather Grates, Irene Victoria Tollinger, Henning Chiv