Secure document exchange portal system with efficient user access
A method of implementing a secure exchange portal system for independent medical review, and classification tools and case-level physician review tools for use in such reviews, are disclosed.
1. A method of managing a secure exchange portal system for medical review, comprising:
receiving a data stream from at least a first source, wherein the data stream includes documents having data for a medical claim being evaluated under a medical review, and wherein the data stream includes at least two documents;
dividing the received data stream into a plurality of chunks, wherein the chunks include sets of documents having the data for the medical claim being evaluated;
individually encrypting at least two of the plurality of chunks, wherein individually encrypting each of the chunks includes generating one or more encryption keys for each chunk;
creating metadata for the at least two documents, wherein the metadata includes data for the encryption keys, wherein creating the metadata includes creating a first set of metadata and a second set of metadata, the first set of metadata being used to restrict access to at least one of the chunks to a first group of users and the second set of metadata being used to restrict access to at least one of the chunks to a second group of users, wherein the first group of users is different from the second group of users, and wherein the first group of users accesses a specific portion of the at least one of the documents using the first set of metadata; and
evaluating the medical claim based of the data for the medical claim in at least one of the plurality of chunks.
2. The method of claim 1 , wherein the first source comprises a plurality of paper documents converted into an electronic file.
3. The method of claim 1 , further comprising converting the data stream into a searchable format using character recognition.
4. The method of claim 1 , wherein the metadata further includes coded medical identifiers for the sets of documents having the data for the medical claim being evaluated.
5. The method of claim 1 , wherein the first group of users accesses the at least one of the plurality of chunks using a back-office system through an integration server.
6. The method of claim 1 , wherein evaluating the medical claim includes administering a worker's compensation claim based on the at least one of the plurality of chunks.
7. The method of claim 1 , wherein evaluating the medical claim includes resolving a worker's compensation claim based on the at least one of the plurality of chunks.
8. The method of claim 1 , further comprising compressing the plurality of chunks.
9. The method of claim 1 , further comprising providing a first access portal for the first group and a second access portal for the second group.
10. The method of claim 1 , wherein the metadata comprises a block size and an initialization vector.
11. A secure exchange portal system for medical review, comprising:
a receiving system implemented on one or more computer systems, wherein the receiving system receives a data stream from at least a first source, wherein the data stream includes documents having data for a medical claim being evaluated under a medical review, wherein the data stream includes at least two documents, and wherein the receiving system is configured to implement:
dividing the received data stream into a plurality of chunks, wherein the chunks include sets of documents having the data for the medical claim being evaluated;
individually encrypting at least two of the plurality of chunks, wherein individually encrypting each of the chunks includes generating one or more encryption keys for each chunk;
creating metadata for the at least two document, wherein the metadata includes data for the encryption keys, wherein creating the metadata includes creating a first set of metadata and a second set of metadata, the first set of metadata being used to restrict access to at least one of the chunks to a first group of users and the second set of metadata being used to restrict access to at least one of the chunks to a second group of users, wherein the first group of users is different from the second group of users and wherein the first group of users accesses a specific portion of the at least one of the documents using the first set of metadata; and
evaluating the medical claim based on the data for the medical claim in at least one of the plurality of chunks.
12. A non-transitory, computer-readable storage medium comprising program instructions stored thereon, wherein the program instructions, when executed on one or more computers, cause the one or more computers to implement a receiving system configured to:
receiving a data stream from at least a first source, wherein the data stream includes documents having data for a medical claim being evaluated under an independent medical review, and wherein the data stream includes at least two documents;
dividing the received data stream into a plurality of chunks, wherein the chunks include sets of documents having the data for the medical claim being evaluated;
individually encrypting at least two of the plurality of chunks, wherein individually encrypting each of the chunks includes generating one or more encryption keys for each chunk;
creating metadata for the at least two documents, wherein the metadata includes data for the encryption keys, wherein creating the metadata includes creating a first set of metadata and a second set of metadata, the first set of metadata begin used to restrict access to at least one of the chunks to a first group of users and the second set of metadata being used to restrict access to at least one of the chunks to a second group of users, wherein the first group of users is different from the second group of users, and wherein the first group of users accesses a specific portion of the at least one of the documents using the first set of metadata; and
evaluating the medical claim based on the data for the medical claim in at least one of the plurality of chunks.
13. The system of claim 11 , wherein the receiving system is further configured to implement evaluating the medical claim based on the data for the medical claim in at least one of the plurality of chunks.
14. The system of claim 11 , wherein the receiving system is further configured to implement evaluating the medical claim includes resolving a worker's compensation claim based on the at least one of the plurality of chunks.
15. The system of claim 11 , wherein the metadata further includes coded medical identifiers for the sets of documents having the data for the medical claim being evaluated.
16. The system of claim 11 , wherein the receiving system is further configured to implement providing a first access portal for the first group and a second access portal for the second group.
17. The storage medium of claim 12 , further comprising evaluating the medical claim based on the data for the medical claim in at least one of the plurality of chunks.
18. The storage medium of claim 12 , further comprising evaluating the medical claim includes resolving a worker's compensation claim based on the at least one of the plurality of chunks.
19. The storage medium of claim 12 , wherein the metadata further includes coded medical identifiers for the sets of documents having the data for the medical claim being evaluated.
20. The storage medium of claim 12 , further comprising providing a first access portal for the first group and a second access portal for the second group.