Systems and methods for capturing data, creating billable information and outputting billable information
Methods, systems, and computer-readable media are provided for generating and outputting medical billing data. Data is captured by pervasive devices before, during, and after a patient encounter with a healthcare provider. Any unstructured data is transformed into usable structured data, and determinations, such as a service provided by the healthcare provider, are made based on that data as well as other stored data. Based on those determinations, billing data for billing claims related to the patient visit is generated and outputted to a payer of the claims. The billing data may include a medical code that is predicted by a billing model. Billing models may be created from data captured by the pervasive devices from patient visits and data in external data stores, such as electronic health records.
1. A system for generating and outputting data for billing claims using multiple data streams, the system comprising:
a plurality of pervasive devices for automatically capturing unstructured input data in real time during an encounter between a patient and a healthcare provider during a patient visit, the unstructured input data comprising video data and audio data;
one or more data stores, wherein the one or more data stores includes at least an electronic health record for the patient;
a non-transitory computer-readable medium for storing computer-executable instructions; and
a processor in communication with the plurality of pervasive devices, the one or more data stores, and the non-transitory computer-readable medium, the processor being operative with the computer-executable instructions to:
acquire the unstructured input data from the plurality of pervasive devices;
integrate the unstructured input data from the plurality of pervasive devices into structured data for the patient by encoding the unstructured input data from the plurality of pervasive devices using a clinical ontology;
based on the structured data automatically captured from the plurality of pervasive devices, automatically determining one or more of a position of the healthcare provider relative to the patient during the encounter, movements of the healthcare provider relative to the patient, and a position of the patient's body during the encounter;
based on the one or more determinations from the structured data captured from the plurality of pervasive devices, determine a service that is provided by the healthcare provider during the patient visit;
based on the service determined to be provided by the healthcare provider, generate billing data for one or more billing claims relating to the patient visit; and
outputting the billing data to a payer of the one or more billing claims.
2. The system of claim 1 , wherein the processor includes an input data manager that pre-processes the unstructured input data captured by the plurality of pervasive devices to protect the privacy of the healthcare provider and/or the patient.
3. The system of claim 1 , wherein the processor further receives input of one or more CPT codes for the patient visit.
4. The system of claim 3 , wherein the processor stores the structured data and the one or more CPT codes and associates the structured data with the CPT codes.