Medical claim database relationship processing

摘要

A method for processing relationships in a medical claims database using a computerized system having a processor and a non-transitory memory includes storing multi-field medical claim data and multi-field insurance claim data in a relational electronic database. The insurance claim data corresponds to at least a portion of the medical claim data. A worklist template is defined using at least one filter and at least one multiplier. The at least one filter excludes at least a portion of the medical claim data, and the at least one multiplier defines a weighted value applicable to at least one field of the multi-field medical claim data. The processor converts the medical claim data into standardized values by applying the at least one multiplier to at least one field of the multi-field medical claim data. A biller worklist is assigned based on a hierarchy of the standardized values.