Response Message Normalization System
A method for normalizing messages received in response to transaction submissions is provided. The method includes receiving a plurality of messages regarding the outcome of transaction submissions; normalizing each received message; linking the normalized message to an internal message that reflects the meaning of the received message; and retaining the transaction-specific elements of the received message in a separate, distinct location.
1 . A tangible, non-transitory, computer readable medium which contains suitable programming instructions which, when executed by at least one computational device, causes the at least one computational device to perform a method for processing messages received from healthcare payers, the method comprising:
receiving a plurality of messages from a plurality of healthcare payers, wherein each message regards the outcome of a healthcare transaction submitted to one of the plurality of healthcare payers;
normalizing each of the plurality of received messages by extracting transaction-specific elements therefrom, thereby generating a plurality of corresponding normalized messages; and
linking each of the plurality of normalized messages to a standardized message that reflects the meaning of the received message corresponding to each normalized message.
2 . The method of claim 1 , wherein the healthcare transaction is an insurance claim.
3 . The method of claim 1 , further comprising:
retaining the transaction-specific elements of the received message in a separate location from the plurality of normalized messages.
4 . The method of claim 3 , wherein the separate location is a separate file.
5 . The method of claim 3 , wherein the separate location is a separate row, column or cell in a table.
6 . The method of claim 1 , wherein each message (a) is generated in response to an insurance claim submitted to one of the plurality of healthcare payers, and (b) regards the outcome of the insurance claim submission.
7 . The method of claim 5 , wherein each normalized message is recorded in a table and given a unique identifying ID.
8 . The method of claim 6 , wherein normalizing each of the plurality of received messages involves the application of a rules engine.
9 . The method of claim 1 , wherein the transaction-specific information from each received message is extracted and stored in a discrete location which is applicable to the message event.
10 . The method of claim 1 , wherein normalized messages not linked to a standardized message are placed in a workflow queue for further processing.
11 . The method of claim 1 , wherein each healthcare transaction is a rejected insurance claim, and wherein each of the plurality of messages contains at least one reason for the rejection of the insurance claim.
12 . The method of claim 11 , further comprising:
dividing each of the plurality of claims into a plurality of fields;
rendering the plurality of fields on a display; and
associating each of the standardized messages corresponding to a claim with one of said plurality of fields.
13 . The method of claim 12 , further comprising:
highlighting each field which has a standardized message associated with it.
14 . The method of claim 12 , further comprising:
automatically navigating to the first of said plurality of fields which has a standardized message associated with it.
15 . The method of claim 12 , wherein each of the plurality of fields is editable.
16 . The method of claim 12 , further comprising:
displaying the transaction specific elements extracted from a message with the standardized message associated with the message.
17 . The method of claim 12 , further comprising:
displaying an error correction icon which is associated with the standardized message, wherein the error correction icon is hotlinked to an entry in a knowledge database which explains how to correct the error.
18 . The method of claim 1 , further comprising:
linking each of the plurality of normalized messages to the message from which the normalized message was derived.
19 . The method of claim 18 , wherein linking each of the plurality of normalized messages to the original message from which the normalized message was derived includes creating a first hotlink between the normalized message and the corresponding original message.
20 . The method of claim 1 , further comprising:
linking each original message from which one of said plurality of normalized messages was derived to one of said standardized messages.
21 . The method of claim 20 , wherein linking each original message from which one of said plurality of normalized messages was derived to one of said standardized messages includes creating a first hotlink between the original message and the corresponding standardized message.
22 . A tangible, non-transitory, computer readable medium which contains suitable programming instructions which, when executed by at least one computational device, causes the at least one computational device to perform a method for establishing the linkage of a normalized message to an internal message, the method comprising:
articulating text manipulation logic for extracting transaction-specific information from a raw message to arrive at a normalized message;
matching normalized messages to internal messages;
establishing attributes of internal messages; and
establishing attributes of data fields.
23 . The method of claim 22 , wherein articulating the text manipulation logic for deriving normalized messages consists of creating reusable pattern-matching rules.
24 . The method of claim 22 , further comprising:
performing matching from a workflow queue.
25 . The method of claim 22 , further comprising:
searching for possible existing internal messages to which a normalized message might apply.
26 . The method of claim 22 , further comprising:
establishing a link from a normalized message to an existing internal message.
27 . The method of claim 22 , further comprising:
creating a new internal message; and
linking a normalized message to the new internal message.
28 . The method of claim 22 , further comprising:
establishing attributes of internal messages, including friendly message text, message type, message category, knowledgebase article address, and at least one data field.
29 . The method of claim 22 , further comprising:
establishing attributes of data fields, including claim form location, X12 transaction data field location, 277 transaction field identifier codes, and claim edit screen location.
30 . A method for processing messages received from healthcare payers, comprising:
receiving a plurality of messages from a plurality of healthcare payers, wherein each message regards the outcome of a healthcare transaction submitted to one of the plurality of healthcare payers;
normalizing each of the plurality of received messages by extracting transaction-specific elements therefrom, thereby generating a plurality of corresponding normalized messages; and
linking each of the plurality of normalized messages to a standardized message that reflects the meaning of the received message corresponding to each normalized message.