DYNAMIC TOPOLOGICAL SYSTEM AND METHOD FOR EFFICIENT CLAIMS PROCESSING

1 . A healthcare claims processing apparatus, comprising:

a computer system having a processor and a memory;

a database associated with the computer system that stores one of more claims records;

a claims processing component that generates a compressed representation of the one of more claims records, the compressed representation having a plurality of nodes which with a claim record is associated, partitions the compressed representation into one or more neighborhood of nodes and determines, using a classifier, a status of a particular claim, wherein the status is one of denied, overpaid and underpaid.

2 . The apparatus of claim 1 , wherein the compressed representation is a simplical complex.

3 . The apparatus of claim 2 , wherein the claims processing component converts the one of more claims records into a feature matrix before generating the compressed representation of the one of more claims records.

4 . The apparatus of claim 1 , wherein the claims processing component trains one or more classifiers for each neighborhood of nodes.

5 . The apparatus of claim 4 , wherein the claims processing component selects a best classifier from the trained classifiers for a particular neighborhood of nodes wherein the particular claim is associated with the particular neighborhood of nodes.

6 . The apparatus of claim 1 , wherein the claims processing component gathers the status of the claim and feeds back the status of the claim.

7 . A method for healthcare claims processing, comprising:

obtaining one of more claims records;

generating a compressed representation of the one of more claims records, the compressed representation having a plurality of nodes which with a claim record is associated;

partitioning the compressed representation into one or more neighborhood of nodes; and

determining, using a classifier, a status of a particular claim, wherein the status is one of denied, overpaid and underpaid.

8 . The method of claim 7 , wherein the compressed representation is a simplical complex.

9 . The method of claim 8 further comprising converting the one of more claims records into a feature matrix before generating the compressed representation of the one of more claims records.

10 . The method of claim 7 , wherein determining using the classifier further comprises training one or more classifiers for each neighborhood of nodes.

11 . The method of claim 10 , wherein determining using the classifier further comprises selecting a best classifier from the trained classifiers for a particular neighborhood of nodes wherein the particular claim is associated with the particular neighborhood of nodes.

12 . The method of claim 7 further comprising gathering the status of the claim and feeding back the status of the claim.

13 . A healthcare system, comprising:

a computer system having a processor and a memory;

a health marketplace system hosted by the computer system;

a database associated with the computer system that stores one of more claims records;

a claims processing component that generates a compressed representation of the one of more claims records, the compressed representation having a plurality of nodes which with a claim record is associated, partitions the compressed representation into one or more neighborhood of nodes and determines, using a classifier, a status of a particular claim, wherein the status is one of denied, overpaid and underpaid.

14 . The system of claim 13 , wherein the compressed representation is a simplical complex.

15 . The system of claim 14 , wherein the claims processing component converts the one of more claims records into a feature matrix before generating the compressed representation of the one of more claims records.

16 . The system of claim 13 , wherein the claims processing component trains one or more classifiers for each neighborhood of nodes.

17 . The system of claim 16 , wherein the claims processing component selects a best classifier from the trained classifiers for a particular neighborhood of nodes wherein the particular claim is associated with the particular neighborhood of nodes.

18 . The system of claim 13 , wherein the claims processing component gathers the status of the claim and feeds back the status of the claim.