Inventors:
Lorri Atkins - Fall City WA, US
Mike DeTolla - Issaquah WA, US
Murray Rice - Seattle WA, US
Jeffery Wajda - Medford OR, US
Igor Tur - Issaquah WA, US
International Classification:
G06Q 50/22
Abstract:
A computerized tool to aid health care workers determine whether health care services proposed for a patient are consistent with policies of a health care facility and adequately justified by documentation, reducing the burden on health care workers of obtaining reimbursement for the services. The tool receives information relating to a diagnosis and risk factors, which may be used to justify planned health care services. Potentially omitted information may be identified based on a disparity between documented risk factors and an assessment provided by a health care worker or a to disparity between identified risk factors and a documented diagnosis. Further, the tool may identify a disparity between proposed services and diagnosis and documented risk, prompting a user to provide more documentation of risk, if appropriate. The tool is configurable such that the comparisons can be based on compliance with policies of a specific health care facility where it is used.