UnitedHealth Group has filed a patent for a method that uses a series of Boolean events to detect faults in a process. The method involves obtaining a series of Boolean events indicating timely or untimely reimbursement for overpayments, determining the number of switch events, calculating an expected number of switch events, and generating a score based on these values. If the score exceeds a threshold, an alert is generated. GlobalData’s report on UnitedHealth Group gives a 360-degree view of the company including its patenting strategy. Buy the report here.
According to GlobalData’s company profile on UnitedHealth Group, content recommendation models was a key innovation area identified from patents. UnitedHealth Group's grant share as of June 2023 was 1%. Grant share is based on the ratio of number of grants to total number of patents.
Method for detecting faults in a reimbursement process
A recently filed patent (Publication Number: US20230206196A1) describes a method and computing system for analyzing a series of Boolean events to identify faults in a process. The method involves obtaining a series of Boolean events, where each event has either a first value indicating timely reimbursement for an overpayment or a second value indicating untimely reimbursement. The method then determines the actual number of switch events, which are changes from the first value to the second value or vice versa, and the expected number of switch events for the series. Based on these values, a confidence interval is determined, and a score is calculated to indicate a fault in the process. If the score exceeds a threshold, an alert is generated.
The patent also describes additional features and variations of the method. For example, the expected number of switch events can be determined based on the total number of Boolean events in the series. The score can be calculated using the Agresti-Coull method. The series of Boolean events can be ordered in time, and the service being analyzed can be a healthcare service provided by a healthcare provider.
Furthermore, the patent discusses a scenario where multiple series of Boolean events are analyzed to identify systemic faults. In this case, a metric is determined to indicate a systemic fault affecting multiple event series within a specific time period. The metric is calculated based on the total number of second values (indicating untimely reimbursement) in each time window, the total number of Boolean events in each time window, and the population second value rate. P-values are then calculated for each time window, and if they are below a threshold, it indicates the presence of a systemic fault.
The patent also includes a description of a computing system that can implement the method. The system includes a communication unit to obtain the Boolean events and one or more processors to perform the analysis and generate alerts based on the calculated scores.
Overall, this patent presents a method and computing system for analyzing Boolean events to identify faults in a process, particularly in the context of healthcare reimbursement. The method allows for the detection of individual faults as well as systemic faults affecting multiple event series.