公开(公告)号：US07363240B1

公开(公告)日：2008-04-22

申请号：US10084326

申请日：2002-02-28

Applicant: Vincent Armentano ,  Carol Demumbrum ,  Russell Steingiser ,  Stanley Grivers, Jr. ,  Lisa Lawton ,  Julie Morgan

Inventor： Vincent Armentano ,  Carol Demumbrum ,  Russell Steingiser ,  Stanley Grivers, Jr. ,  Lisa Lawton ,  Julie Morgan

IPC: G06Q40/00 ,  G06Q10/00 ,  A61B5/00

CPC classification number: G06Q10/087 ,  G06F19/00 ,  G06Q10/06 ,  G06Q40/08 ,  G06Q50/22

Abstract: The present invention relates to a method and system for enhanced medical triage in managed care plans that streamlines the conventional medical triage process and referral logic, sends only those insurance claims to an integrated case management system that require medical intervention, matches claims to the right resource at the right time, reduces the time needed to review lost time cases, lessens the number of unnecessary referrals or re-referrals, and further tailors the assignment process of medical insurance claims to medical personnel based on specific market and/or employer dedication.

Abstract translation: 本发明涉及一种在管理型医疗计划中加强医疗分诊的方法和系统，其简化了常规医疗分诊过程和转诊逻辑，仅将那些保险索赔发送到需要医疗干预的综合病例管理系统，将权利要求与正确的资源相匹配 在合适的时间缩短审查失踪时间案件所需的时间，减少不必要的转介或重新转介的次数，并根据具体的市场和/或雇主的奉献精神进一步调整医疗保险索赔的转让过程。