Machine learning risk factor identification and mitigation system

摘要

A system performing machine learning to predict and identify claims that have a high likelihood of migrating across a predetermined risk threshold and to generate intervention strategies to mitigate the likelihood of migration. The processing system includes a computer server, database engine, computer programming instructions, network connectivity, associated claims, payment, medical, pharmacy and other relevant data, a plurality of statistical and machine learning algorithms and a method for electronically displaying and attaching the results to a business process. The system will use all available data to analyze the medical treatment pattern of a claimant and based on automated findings make recommendations as to appropriate interventions to positively impact claims costs.