APPARATUSES, METHODS, AND COMPUTER PROGRAM PRODUCTS FOR CUSTOMIZED PRICING OF CLAIMS FOR REIMBURSEMENT

摘要

Apparatuses, methods, and computer program products are provided for pricing claims for reimbursement within a claim pricing software application presented in a graphical user interface. In particular, a software application is described in which a processing logic for processing claims is visible to the user, and the user is able to interact with and manipulate various parts of the processing logic to develop customized payment methodologies that reflect payor-provider contractual relationships and negotiated terms for reimbursement. Accordingly, input is received from the user via input fields of the graphical user interface that define a payment methodology of the claims for reimbursement, where the input comprises selection of predefined code portions (including variables and functions) to define a customized payment methodology for pricing the claim.