METHOD AND APPARATUS FOR QUEUE-BASED CLUSTER ANALYSIS

摘要

Methods and apparatus for identifying and analyzing clusters of medical billing claims in a queue to identify a shared root cause issue including remittance issues for the medical billing claims in the cluster. Exemplary methods and apparatus involve grouping each of the plurality of medical billing claims into clusters based on predetermined cluster patterns that include at least one attribute, validating the clusters using predetermined criteria to determine if the clusters should be analyzed, discarded, and/or marked for further analysis, collecting information about each of the medical billing claims in clusters, and determining a root cause issue for the medical billing claims in the clusters based on the collected information. Other exemplary methods and apparatus involve comparing an expected open rate to an actual open rate for at least one payer to identify at least one bump as a timepoint during the predetermined time range when the actual open rate exceeds the expected open rate. Identified bumps are categorized as a particular category of remittance issue based, at least in part, on a pattern of remittance during the predetermined time range. A user interface displays the pattern of remittance to a user to enable the user to determine an appropriate action to correct an underlying cause of the detected remittance issues.