System and method for optimizing medical diagnosis, procedures and claims using a structured search space

Abstract

A system and method for optimizing medical diagnosis, procedures and reimbursement claims using a structured search space is described. The system may comprise: a master procedure list of alphanumeric codes that represent each of a plurality of medical procedures, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures; a value associated with each of the plurality of medical procedures; a list of ordered procedures listing medical procedures for a specific medical encounter; a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures; and a minimum total of the values associated with the medical procedures in the list of ordered procedures.

What is claimed is:  
     
         1 . A method of optimizing medical diagnosis, procedures and reimbursement claims using a structured search space, the method comprising: 
 listing alphanumeric codes that represent each of a plurality of medical procedures to produce a master procedure list, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures;    associating a value to each of the plurality of medical procedures;    listing medical procedures for a specific medical encounter to produce a list of ordered procedures;    building a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures; and    searching the search tree for the lowest total of values associated with the medical procedures in the list of ordered procedures.    
     
     
         2 . The method of  claim 1 , wherein the master procedure list also includes a short description of the represented medical procedure; a long description of the represented medical procedure, and a list of all simple procedure that make up all compound procedures.  
     
     
         3 . The method of  claim 1 , wherein the value associated with each of the plurality of medical procedures includes regional costs and fluctuations.  
     
     
         4 . The method of  claim 1 , wherein building a search tree includes: 
 matching compound procedures in the master procedure list to a plurality of simple procedures in the list of ordered procedure to produce a matched compound procedure;    eliminating the plurality of simple procedures from the ordered procedure list; and    adding the matched compound procedure to the ordered procedure list.    
     
     
         5 . The method of  claim 1 , wherein the method further includes eliminating duplicates of simple procedures in the list of ordered procedures.  
     
     
         6 . The method of  claim 1 , wherein the method is implemented on a palm sized computer.  
     
     
         7 . The method of  claim 1 , wherein the method is implemented on a general purpose computer.  
     
     
         8 . The method of  claim 1 , wherein the listing of the medical procedures is implemented by a medical professional at the medical encounter.  
     
     
         9 . A computer program for optimizing medical diagnosis, procedures and reimbursement claims using a structured search space, the computer program comprising: 
 instructions for listing alphanumeric codes that represent each of a plurality of medical procedures to produce a master procedure list, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures;    instructions for associating a value to each of the plurality of medical procedures;    instructions for listing medical procedures for a specific medical encounter to produce a list of ordered procedures;    instructions for building a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures; and    instructions for searching the search tree for the optimal total of values associated with the medical procedures in the list of ordered procedures.    
     
     
         10 . The computer program of  claim 9 , wherein the master procedure list also includes a short description of the represented medical procedure; a long description of the represented medical procedure, and a list of all simple procedure that make up all compound procedures.  
     
     
         11 . The computer program of  claim 9 , wherein the value associated with each of the plurality of medical procedures includes regional costs and fluctuations.  
     
     
         12 . The computer program of  claim 9 , wherein building a search tree includes: 
 instructions for matching compound procedures in the master procedure list to a plurality of simple procedures in the list of ordered procedure to produce a matched compound procedure;    instructions for eliminating the plurality of simple procedures from the ordered procedure list; and    instructions for adding the matched compound procedure to the ordered procedure list.    
     
     
         13 . The computer program of  claim 12 , wherein the computer program further includes instructions for eliminating duplicates of simple procedures in the list of ordered procedures.  
     
     
         14 . The computer program of  claim 9 , wherein the computer program is implemented on a palm sized computer.  
     
     
         15 . The computer program of  claim 9 , wherein the computer program is implemented on a general purpose computer.  
     
     
         16 . The computer program of  claim 9 , wherein the instructions for listing of the medical procedures is implemented by a medical professional at the medical encounter.  
     
     
         17 . A system for optimizing medical diagnosis, procedures and reimbursement claims using a structured search space, the system comprising: 
 a master procedure list of alphanumeric codes that represent each of a plurality of medical procedures, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures;    a value associated with each of the plurality of medical procedures;    a list of ordered procedures listing medical procedures for a specific medical encounter;    a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures; and    a minimum total of the values associated with the medical procedures in the list of ordered procedures.    
     
     
         18 . The system of  claim 17 , wherein the master procedure list also includes a short description of the represented medical procedure; a long description of the represented medical procedure, and a list of all simple procedure that make up all compound procedures.  
     
     
         19 . The system of  claim 17 , wherein the value associated with each of the plurality of medical procedures includes regional costs and fluctuations.  
     
     
         20 . The system of  claim 17 , wherein the system is implemented on a palm sized computer.  
     
     
         21 . The system of  claim 17 , wherein the system is implemented on a general purpose computer.