Inventors:
Jerry G. Seare - Sandy UT, US
Patricia A. Smith-Wilson - Herriman UT, US
Kurt Van Wagoner - Centerville UT, US
Jean Andrea Mattey - Westlake OH, US
Eileen K. Snyder - Sandy UT, US
Candace C. Wahlstrom - Twin Falls ID, US
Michelle Willis - Sandy UT, US
Matthew R. Bentley - South Jordan UT, US
Assignee:
Ingenix, Inc. - Eden Prairie MN
International Classification:
A61B 5/00, G06F 19/00
Abstract:
A method and system for analyzing historical medical provider billings to statistically establish a normative utilization profile. Comparison of a medical provider's utilization profile with a normative profile is enabled. Based on historical treatment patterns and a fee schedule, an accurate model of the cost of a specific medical episode can be created. Various treatment patterns for a particular diagnosis can be compared by treatment cost and patient outcome to determine the most cost-effective treatment approach. It is also possible to identify those medical providers who provide treatment that does not fall within the statistically established treatment patterns or profiles.