Abstract
The following quote was obtained by the news editors from the background information supplied bythe inventors: “Patients and health care providers may seek authorization for medical treatments prior toperforming the medical treatments. For instance, pre-certification (e.g., pre-authorization) is a process forobtaining approval to receive a particular medical service, treatment, and/or prescription medication. Giventhe numerous documents needed to be reviewed in order to provide an approval for the medical treatment,systems have been implemented to automate aspects of the pre-certification process, which helps expeditethe overall process. For instance, by using a rules engine that comprises a plurality of rules, systemsmay be able to provide automation to aspects of the pre-certification process to obtain an approval for apatient faster. But, these automated pre-certification processes are not completely robust at this time forthe numerous different types of medical procedures that require pre-certification nor are they able to takeinto account the complexity associated with each patient’s individual circumstances and situations prior toproviding approval. Accordingly, there exists a need for a technical solution to supplement the autonomouspre-certification approval systems in order to improve the automated pre-certification process.”
NETL
NSTL