| Emergis Inc. Patent applications |
| Patent application number | Title | Published |
|---|
| 20100211415 | MODIFYING CONTAINERIZED PROCESSING LOGIC FOR USE IN INSURANCE CLAIM PROCESSING - A system and method for modifying benefit coverage including a plurality of benefit codes of an insurance plan, the insurance plan for use in adjudicating one or more insurance claims. The system and method including accessing a set of benefit codes structured in a plurality of benefit containers including a primary benefit container and a plurality of secondary benefit containers, each of the plurality of secondary benefit containers being coupled to the primary benefit container by a respective benefit container reference, each of the plurality of secondary benefit containers containing one or more benefit codes adapted for processing a claim content of the one or more insurance claims, each of the one or more benefit codes being coupled to their respective secondary benefit container by a respective benefit reference, the set of benefit codes defining a benefit hierarchy. Also included is selecting the primary benefit container for inclusion in the insurance plan, and then modifying the benefit hierarchy by performing at least one of adding an additional benefit container reference to the primary benefit container, modifying a container benefit parameter of at least one of the benefit container references, or deleting at least one of the existing benefit container references. The modified insurance plan in then stored in a memory; such that the stored modified insurance plan is adapted for subsequent use in adjunction of appropriate insurance claims received by an adjudication system. | 08-19-2010 |
| 20100211414 | TOOL FOR GENERATING CONTAINERIZED PROCESSING LOGIC FOR USE IN INSURANCE CLAIM PROCESSING - A system and method for configuring a set of adjudication rules for use in processing an insurance claim. The method and system comprise defining an adjudication rule and defining a secondary rule container and coupling the adjudication rule to the secondary rule container by a rule reference associated with the content of the secondary rule container. Also implemented is defining a primary rule container and coupling the secondary rule container to the primary rule container by a container reference associated with the content of the primary rule container, the adjudication rule, the containers, and the rule and container reference defining a rule hierarchy for representing the set of adjudication rules. | 08-19-2010 |
| 20100211413 | REVISING CONTAINERIZED PROCESSING LOGIC FOR USE IN INSURANCE CLAIM PROCESSING - A system and method for revising one or more hierarchies of an insurance plan, the insurance plan for use in adjudicating one or more insurance claims. The method and system comprising obtaining one or more claims from a claims queue, the claims queue for storing claims selected for review. The system and method comprising accessing at least one of a set of benefit codes or a set of adjudication rules associated with the insurance plan of the obtained one or more claims, wherein at least some of the set of benefit codes or the set of adjudication rules are structured in a plurality of containers. The system and method comprising reconfiguring selected content of the at least one of a set of benefit codes or the set of adjudication rules in view of identified reasons for review of the one or more claims; and storing the reconfigured at least one of a set of benefit codes or the set of adjudication rules in a memory for subsequent use as at least one of a redeployed version of the insurance plan or a revised said at least one of a set of benefit codes or the set of adjudication rules for use in development of other insurance plans for adjudication of claims other than the one or more claims obtained from the claims queue; wherein the revised insurance plan, once deployed, is adapted for use by an adjudication engine for processing insurance claims received by the adjudication engine. | 08-19-2010 |
| 20100211412 | INSURANCE CLAIM PROCESSING USING CONTAINERIZED PROCESSING LOGIC - A system and method for processing insurance claims using a set of adjudication rules. The method and system comprises receiving a claim for processing, such that the received claim having claim content including a claim date. Also provided is a database configured for accessing the set of adjudication rules appropriate to the received claim, the set of adjudication rules structured in containers including a primary rule container and secondary rule containers, each of the secondary rule containers being coupled to the primary rule container by a respective container reference, each of the secondary rule containers containing one or more adjudication rules adapted for processing the claim content of the received claim, each of the one or more adjudication rules being coupled to their respective secondary container by a respective rule reference, the set of adjudication rules defining a rule hierarchy. | 08-19-2010 |
