A method comprises receiving, at a first entity, an insurance claim for a health care service provided to a person by a provider; providing the claim from the first entity to an editing service, wherein the editing service is configured to edit the claim in accordance with information associated with a second entity and generate an edited claim, wherein the second entity is different than the first entity; receiving, at the first entity, the edited claim from the editing service; and determining, at the first entity, a payment to be made to the provider based on the edited claim. This method may be performed during the claim's adjudication cycle in realtime, not retrospectively.

A method comprises receiving, at a first entity, an insurance claim for a health care service provided to a person by a provider; providing the claim from the first entity to an editing service, wherein the editing service is configured to edit the claim in accordance with information associated with a second entity and generate an edited claim, wherein the second entity is different than the first entity; receiving, at the first entity, the edited claim from the editing service; and determining, at the first entity, a payment to be made to the provider based on the edited claim. This method may be performed during the claim's adjudication cycle in realtime, not retrospectively.

A method, apparatus and computer program product are provided for generating a predefined sized vector representative of a healthcare claim including a variable number of service lines. A neural network is trained to identify hierarchical relationships between claim lines and services lines and to represent the relationships in the predefined sized vector. The predefined sized vector may be used to make predictions regarding adjudication, such as probability of denial (claim-level or service-level), days to pay, probability of being paid as a diagnosis related group (DRG), allowed amount, and/or denial reason. Predictions may also be made from the predefined sized vector relating to the likelihood and/or identification of missing procedure codes.

A method, apparatus and computer program product are provided for generating a predefined sized vector representative of a healthcare claim including a variable number of service lines. A neural network is trained to identify hierarchical relationships between claim lines and services lines and to represent the relationships in the predefined sized vector. The predefined sized vector may be used to make predictions regarding adjudication, such as probability of denial (claim-level or service-level), days to pay, probability of being paid as a diagnosis related group (DRG), allowed amount, and/or denial reason. Predictions may also be made from the predefined sized vector relating to the likelihood and/or identification of missing procedure codes.

A computer-implemented method for deploying database management tools is disclosed. The method may comprise: receiving user data sets including biological data, previous medical history data, or previous schema data for users; determining one or more groups; receiving a first user data set of a first user; identifying a first group for the first user; generating a plurality of schema plans for the first group; identifying a first schema including a first treatment; determining a schedule; transmitting first electronic content; receiving a signal comprising updated information for the first user; parsing the updated information; and modifying the schema based on the parsed updated information.

A computer-implemented method for deploying database management tools is disclosed. The method may comprise: receiving user data sets including biological data, previous medical history data, or previous schema data for users; determining one or more groups; receiving a first user data set of a first user; identifying a first group for the first user; generating a plurality of schema plans for the first group; identifying a first schema including a first treatment; determining a schedule; transmitting first electronic content; receiving a signal comprising updated information for the first user; parsing the updated information; and modifying the schema based on the parsed updated information.

A computing device may include a memory and a processor configured to cooperate therewith to operate a virtual share exchange (VSE) platform by establishing member sharing accounts on the VSE platform for respective members of the VSE platform for sharing payment of member healthcare bills across a plurality of the member sharing accounts, establishing healthcare provider accounts on the VSE platform for healthcare providers issuing the member healthcare bills, and receiving member healthcare bills issued by the healthcare providers and establishing a virtual bill account on the VSE platform for each member healthcare bill submitted for payment sharing. The virtual bill account may be externally addressable through a routing number and a unique account number associated therewith. The processor may further electronically transfer funds between the sharing accounts and to the healthcare provider that issued the member healthcare bill using the externally addressable routing number and unique account number.

Medical monitoring systems and methods for reducing the frequency of notifications of transient alarms are disclosed. A medical monitoring system can collect a signal representative of the physiological condition of a patient and can determine a physiological parameter using the collected signal. The medical monitoring system can detect an alarm condition for the physiological parameter. The medical monitoring system can then delay notification of the alarm condition until it persists for a predetermined alarm notification delay time.

Medical monitoring systems and methods for reducing the frequency of notifications of transient alarms are disclosed. A medical monitoring system can collect a signal representative of the physiological condition of a patient and can determine a physiological parameter using the collected signal. The medical monitoring system can detect an alarm condition for the physiological parameter. The medical monitoring system can then delay notification of the alarm condition until it persists for a predetermined alarm notification delay time.

A medical communication protocol translator can be configured to facilitate communication between medical devices that are programmed to communicate with different protocol formats. The medical communication protocol translator can receive an input message formatted according to a first protocol format from a first medical device and to output an output message formatted according to a second protocol format supported by a second medical device using a set of translation rules. For example, a medical communication protocol translator can receive an input message from a hospital information system formatted according to a first HL7 protocol format and output an output message formatted according to a second HL7 protocol format based on a comparison with the set of translation rules.