METHODS FOR MORE ACCURATELY MANAGING PROCESSING OF MEDICAL BILL DATA AND DEVICES THEREOF
Methods, non-transitory computer readable media, and computing apparatus that assist with more accurately managing processing of medical bill data includes identifying previously submitted bill data associated with received medical bill data from a client based on one or more service data parameters in the received medical bill data and the identified previously submitted bill data. The received medical bill data is determined to be erroneous medical bill data based on the identified previously submitted bill data and a time period between the previously submitted bill data and the received medical bill data. The received medical bill data is classified as a follow-up procedure bill data when the received medical bill data is determined to be an erroneous medical bill data. Compensation data is restricted for the received medical bill data classified as the follow-up procedure bill data.
1 . A method for more accurately managing processing of medical bill data, the method comprising:
identifying, by the insurance data management computing apparatus, previously submitted bill data associated with received medical bill data from a client based on one or more service data parameters in the received medical bill data and the identified previously submitted bill data;
determining, by the insurance data management computing apparatus, when the received medical bill data is erroneous medical bill data based on the identified previously submitted bill data and a time period between the previously submitted bill data and the received medical bill data;
classifying, by the insurance data management computing apparatus, the received medical bill data as a follow-up procedure bill data when the received medical bill data is determined to be an erroneous medical bill data; and
restricting, by the insurance data management computing apparatus, compensation data for the received medical bill data classified as the follow-up procedure bill data.
2 . The method as set forth in claim 1 wherein the received medical bill data is determined to be the erroneous medical bill data when a service date of received medical bill data is within the time period of the identified previously submitted bill data.
3 . The method as set forth in claim 1 further comprising determining, by the insurance data management computing apparatus, when the received medical bill data is associated with a surgical procedure prior to determining when the medical bill data is the erroneous medical bill data.
4 . The method as set forth in claim 1 further comprising, determining, by the insurance data management computing apparatus, when the received medical bill data is a compensable medical bill data.
5 . The method as set forth in claim 1 further comprising identifying, by the insurance data management computing apparatus, a service code, the service date, a service description and service provider data from the received medical bill data and the identified one or more previously submitted bill data.
6 . The method as set forth in claim 1 wherein the service data comprises the service code, the service date, the service description and service provider data.
7 . A non-transitory computer readable medium having stored thereon instructions for more accurately managing processing of medical bill data comprising executable code, which when executed by at least one processor, cause the processor to:
identify previously submitted bill data associated with received medical bill data from a client based on one or more service data parameters in the received medical bill data and the identified previously submitted bill data;
determine when the received medical bill data is erroneous medical bill data based on the identified previously submitted bill data and a time period between the previously submitted bill data and the received medical bill data;
classify the received medical bill data as a follow-up procedure bill data when the received medical bill data is determined to be an erroneous medical bill data; and
restrict compensation data for the received medical bill data classified as the follow-up procedure bill data.
8 . The medium as set forth in claim 7 wherein the received medical bill data is determined to be the erroneous medical bill data when a service date of received medical bill data is within the time period of the identified previously submitted bill data.
9 . The medium as set forth in claim 7 further comprising determine when the received medical bill data is associated with a surgical procedure prior to determining when the medical bill data is the erroneous medical bill data.
10 . The medium as set forth in claim 7 further comprises determine when the received medical bill data is a compensable medical bill data.
11 . The medium as set forth in claim 7 further comprising, identifying a service code, the service date, a service description and service provider data from the received medical bill data and the identified one or more previously submitted bill data.
12 . The medium as set forth in claim 7 wherein the service data comprises the service code, the service date, the service description and service provider data.
13 . An insurance data management computing apparatus comprising:
a processor; and
a memory coupled to the processor which is configured to be capable of executing programmed instructions comprising and stored in the memory to:
identify previously submitted bill data associated with received medical bill data from a client based on one or more service data parameters in the received medical bill data and the identified previously submitted bill data;
determine when the received medical bill data is erroneous medical bill data based on the identified previously submitted bill data and a time period between the previously submitted bill data and the received medical bill data;
classify the received medical bill data as a follow-up procedure bill data when the received medical bill data is determined to be an erroneous medical bill data; and
restrict compensation data for the received medical bill data classified as the follow-up procedure bill data.
14 . The apparatus as set forth in claim 13 wherein the received medical bill data is determined to be the erroneous medical bill data when a service date of received medical bill data is within the time period of the identified previously submitted bill data.
15 . The apparatus as set forth in claim 13 wherein the processor is further configured to be capable of executing the stored programmed instructions to determine when the received medical bill data is associated with a surgical procedure prior to determining when the medical bill data is the erroneous medical bill data.
16 . The apparatus as set forth in claim 13 wherein the processor is further configured to be capable of executing the stored programmed instructions to determine when the received medical bill data is a compensable medical bill data.
17 . The apparatus as set forth in claim 13 wherein the processor is further configured to be capable of executing the stored programmed instructions to identifying a service code, the service date, a service description and service provider data from the received medical bill data and the identified one or more previously submitted bill data.
18 . The apparatus as set forth in claim 13 wherein the service data comprises the service code, the service date, the service description and service provider data.