USRE49865EActiveUtility

Reconciliation of data across distinct feature sets

Assignee: IQVIA INCPriority: Mar 27, 2015Filed: Sep 21, 2021Granted: Mar 5, 2024
Est. expiryMar 27, 2035(~8.7 yrs left)· nominal 20-yr term from priority
G16H 20/10G16H 20/13G16H 40/67
62
PatentIndex Score
0
Cited by
7
References
44
Claims

Abstract

Methods, systems, and apparatus, including computer programs encoded on a computer storage medium, for linking a first electronic data set to a second set of data fields in a second electronic data set. Automatically identifying a prescribing physician identifier based on the linked first and second electronic data sets. Determining a relationship between a physician associated with the prescribing physician identifier and at least one of the approved entities based on comparing the prescribing physician identifier and identifiers of the one or more approved entities to a fourth set of data fields from a fourth electronic data set. Automatically generating an electronic notification indicating that a product sold by the merchant is eligible for the discount in response to determining a relationship between a physician and the at least one of the approved entities.

Claims

exact text as granted — not AI-modified
What is claimed is: 
     
       1. A computer-implemented method for reconciling data across electronic data sources with distinct feature sets, the method executed by one or more processors, and the method comprising:
 receiving, by a data reconciliation system, a first data set including:
 a first set of data fields, and 
 electronic prescription fulfillment data, 
 wherein the first set of data fields includes at least a merchant identifier for a merchant; 
 
 determining, by the data reconciliation system, a match between:
 a first data datum from a data field of the first set of data fields, and 
 a second datum from a data field of a second set of data fields, wherein:
 the second set of data fields is included in a second data set, 
 the second data set is distinct from the first data set, and 
 the second data set includes third-party prescription information; 
 
 
 generating, by the data reconciliation system, a linked database comprising links between the first data set and the second set of data fields, the links based on the match between the first datum and the second datum; 
 identifying, by the data reconciliation system, a physician identifier for a physician that prescribed a product provided by the merchant, wherein the physician identifier is automatically identified by analyzing the linked database to obtain information from corresponding data fields of the first and second data sets; 
 identifying, by the data reconciliation system, one or more entities having an approved relationship with the merchant, based on the merchant identifier; 
 generating, by the data reconciliation system, a confidence score that characterizes a relationship between the physician and an entity by comparing the physician identifier and a respective identifier for each of the one or more entities, based on information in the linked database; 
 determining, by the data reconciliation system, a confidence level that indicates information in the linked database accurately identifies products that are eligible to be obtained for a predefined amount, wherein the confidence level is determined based on the confidence score exceeding a threshold confidence score and the relationship between the physician and the entity, and 
 providing, by the data reconciliation system, an electronic notification that includes information indicating the product prescribed by the physician and provided by the merchant is eligible to be obtained for the predefined amount. 
 
     
     
       2. The method of  claim 1 , further comprising reconciling data from the first and second data sets with data from a plurality of other data sets to determine information related to a sale of the product, and
 wherein the electronic notification includes the information related to the sale of the product. 
 
     
     
       3. The method of  claim 1 , further comprising:
 determining the relationship between the physician associated with the physician identifier and the entity existed on a dispense date of the product, the dispense date included in datum from the first set of data fields. 
 
     
     
       4. The method of  claim 1 , further comprising determining, from data in a third electronic data set, that the approved relationship between the merchant and the one or more entities with which the physician has a relationship existed on a dispense date of the product, the dispense date included in datum from the first set of data fields. 
     
     
       5. The method of  claim 1 , wherein the electronic notification includes the confidence score, the confidence score indicating a likelihood that the product is eligible to be obtained for the predefined amount. 
     
     
       6. The method of  claim 5 , wherein the confidence score is determined based on a type of the relationship between the physician and one or more entities. 
     
     
       7. The method of  claim 5 , wherein the confidence score is determined based on a number of relationships that the physician has with approved entities. 
     
     
       8. The method of  claim 1 , wherein the second data set is a secure data set, the method further comprising accessing the second data set from a secure data repository. 
     
     
       9. The method of  claim 1 , wherein the predefined amount is a government mandated transaction amount that is associated with a third data set that is a government maintained data set. 
     
     
       10. A system comprising:
 one or more processors; and a data store coupled to the one or more processors having instructions stored thereon which, when executed by the one or more processors, causes the one or more processors to perform operations comprising: 
 receiving, by a data reconciliation system, a first data set including:
 a first set of data fields, and 
 electronic prescription fulfillment data, 
 wherein the first set of data fields includes at least a merchant identifier for a merchant; 
 
 determining, by the data reconciliation system, a match between:
 a first data datum from a data field of the first set of data fields, and 
 a second datum from a data field of a second set of data fields, wherein:
 the second set of data fields is included in a second data set, 
 the second data set is distinct from the first data set, and 
 the second data set includes third-party prescription information; 
 
 
 generating, by the data reconciliation system, a linked database comprising links between the first data set and the second set of data fields, the links based on the match between the first datum and the second datum; 
 identifying, by the data reconciliation system, a physician identifier for a physician that prescribed a product provided by the merchant, wherein the physician identifier is automatically identified by analyzing the linked database to obtain information from corresponding data fields of the first and second data sets; 
 identifying, by the data reconciliation system, one or more entities having an approved relationship with the merchant, based on the merchant identifier; 
 generating, by the data reconciliation system, a confidence score that characterizes a relationship between the physician and an entity by comparing the physician identifier and a respective identifier for each of the one or more entities, based on information in the linked database; 
 determining, by the data reconciliation system, a confidence level that indicates information in the linked database accurately identifies products that are eligible to be obtained for a predefined amount, wherein the confidence level is determined based on the confidence score exceeding a threshold confidence score and the relationship between the physician and the entity, and 
 providing, by the data reconciliation system, an electronic notification that includes information indicating the product prescribed by the physician and provided by the merchant is eligible to be obtained for the predefined amount. 
 
     
     
       11. The system of  claim 10 , wherein the operations further comprise reconciling data from the first and second data sets with data from a plurality of other data sets to determine information related to a sale of the product, and
 wherein the electronic notification includes the information related to the sale of the product. 
 
     
     
       12. The system of  claim 10 , wherein the operations further comprise:
 determining the relationship between the physician associated with the physician identifier and the entity existed on a dispense date of the product, the dispense date included in datum from the first set of data fields. 
 
     
     
       13. The system of  claim 10 , wherein the operations further comprises:
 determining, from data in a third electronic data set, that the approved relationship between the merchant and the one or more entities with which the physician has a relationship merchant existed on a dispense date of the product, the dispense date included in datum from the first set of data fields. 
 
     
     
       14. The system of  claim 10 , wherein the electronic notification includes the confidence score, the confidence score indicating a likelihood that the product is eligible to be obtained for the predefined amount. 
     
     
       15. The system of  claim 14 , wherein the confidence score is determined based on a type of the relationship between the physician and one or more entities. 
     
     
       16. The system of  claim 14 , wherein the confidence score is determined based on a number of relationships that the physician has with approved entities. 
     
     
       17. The system of  claim 10 , wherein the second data set is a secure data set, the method further comprising accessing the second data set from a secure data repository. 
     
     
       18. A non-transient computer readable medium storing instructions that, when executed by one or more processors, cause the one or more processors to perform operations comprising:
 receiving, by a data reconciliation system, a first data set including:
 a first set of data fields, and 
 electronic prescription fulfillment data, 
 wherein the first set of data fields includes at least a merchant identifier for a merchant; 
 
 determining, by the data reconciliation system, a match between:
 a first data datum from a data field of the first set of data fields, and 
 a second datum from a data field of a second set of data fields, wherein,
 the second set of data fields is included in a second data set, 
 the second data set is distinct from the first data set, and 
 the second data set includes third-party prescription information; 
 
 
 generating, by the data reconciliation system, a linked database comprising links between the first data set and the second set of data fields, the links based on the match between the first datum and the second datum; 
 identifying, by the data reconciliation system, a physician identifier for a physician that prescribed a product provided by the merchant, wherein the physician identifier is automatically identified by analyzing the linked database to obtain information from corresponding data fields of the first and second data sets; 
 identifying, by the data reconciliation system, one or more entities having an approved relationship with the merchant, based on the merchant identifier; 
 generating, by the data reconciliation system, a confidence score that characterizes a relationship between the physician and an entity by comparing the physician identifier and a respective identifier for each of the one or more entities, based on information in the linked database; 
 determining, by the data reconciliation system, a confidence level that indicates information in the linked database accurately identifies products that are eligible to be obtained for a predefined amount, wherein the confidence level is determined based on the confidence score exceeding a threshold confidence score and the relationship between the physician and the entity, and providing, by the data reconciliation system, an electronic notification that includes information indicating the product prescribed by the physician and provided by the merchant is eligible to be obtained for the predefined amount. 
 
     
     
       19. The medium of  claim 18 , wherein the operations further comprise reconciling data from the first and second data sets with data from a plurality of other data sets to determine information related to a sale of the product, and
 wherein the electronic notification includes the information related to the sale of the product. 
 
     
     
       20. The medium of  claim 18 , wherein the operations further comprise:
 determining the relationship between the physician associated with the physician identifier and entity existed on a dispense date of the product, the dispense date included in datum from the first set of data fields. 
 
     
     
       21. A computer system-implemented method comprising:
 determining, by one or more processors of the computer system, a relationship between (i) a first data record of a first data set, the first data record containing first data indicative of a prescription, the first data including a merchant identifier of a merchant, and (ii) a second data record of a second data set, the second data record containing second data indicative of the prescription, including matching data from a data field of the first data record set to data from a data field of the second data record;   analyzing, by the one or more processors, the first data record and the second data record to identify a physician identifier for a physician associated with the prescription;   identifying, by the one or more processors and based on the merchant identifier contained in the first data record and the physician identifier, an entity having an relationship with both the merchant and the physician;   generating, by the one or more processors, a confidence score characterizing the relationship between the entity and the physician by comparing the physician identifier and an identifier for the entity;   determining, by the one or more processors, a confidence level indicating that information in the first data set and second data set accurately identify products that are eligible for a predefined amount, including determining the confidence level based on the confidence score exceeding a threshold and based on the relationship between the physician and the entity; and   generating, by the one or more processors, an electronic notification indicating that a product prescribed by the physician and provided by the merchant is eligible to be obtained for the predefined amount.   
     
     
       22. The computer system-implemented method of claim 21, comprising storing, in a database of the computer system, data indicative of the relationship between the first data record and the second data record. 
     
     
       23. The computer system-implemented method of claim 22, comprising generating a link, in the database, between the first data record and the second data record. 
     
     
       24. The computer system-implemented method of claim 21, in which identifying an entity having a relationship with both the merchant and the physician comprises accessing a third data set containing third data indicative of information about eligibility for the predefined amount and entities eligible to obtain products for the predefined amount. 
     
     
       25. The computer system-implemented method of claim 24, comprising reconciling data records of the first data set and data records of the second data set with data records of the third data set. 
     
     
       26. The computer system-implemented method of claim 21, comprising determining the confidence score based on a number of relationships that the physician has with entities. 
     
     
       27. The computer system-implemented method of claim 21, comprising determining the confidence score based on a type of the relationship between the physician and each of one or more entities. 
     
     
       28. The computer system-implemented method of claim 21, comprising accessing the second data set from a secure data repository. 
     
     
       29. A non-transitory computer readable medium storing instructions to cause a computer system to:
 determine, by one or more processors of the computer system, a relationship between (i) a first data record of a first data set, the first data record containing first data indicative of a prescription, the first data including a merchant identifier of a merchant, and (ii) a second data record of a second data set, the second data record containing second data indicative of the prescription, including matching data from a data field of the first data record set to data from a data field of the second data record;   analyze, by the one or more processors, the first data record and the second data record to identify a physician identifier for a physician associated with the prescription;   identify, by the one or more processors and based on the merchant identifier contained in the first data record and the physician identifier, an entity having an relationship with both the merchant and the physician;   generate, by the one or more processors, a confidence score characterizing the relationship between the entity and the physician by comparing the physician identifier and an identifier for the entity;   determine, by the one or more processors, a confidence level indicating that information in the first data set and second data set accurately identify products that are eligible for a predefined amount, including determining the confidence level based on the confidence score exceeding a threshold and based on the relationship between the physician and the entity; and   generate, by the one or more processors, an electronic notification indicating that a product prescribed by the physician and provided by the merchant is eligible to be obtained for the predefined amount.   
     
     
       30. The non-transitory computer readable medium of claim 29, in which the instructions cause the computer system to store, in a database of the computer system, data indicative of the relationship between the first data record and the second data record. 
     
     
       31. The non-transitory computer readable medium of claim 30, in which the instructions cause the computer system to generate a link, in the database, between the first data record and the second data record. 
     
     
       32. The non-transitory computer readable medium of claim 29, in which identifying an entity having a relationship with both the merchant and the physician comprises accessing a third data set containing third data indicative of information about eligibility for the predefined amount and entities eligible to obtain products for the predefined amount. 
     
     
       33. The non-transitory computer readable medium of claim 32, in which the instructions cause the computer system to reconcile data records of the first data set and data records of the second data set with data records of the third data set. 
     
     
       34. The non-transitory computer readable medium of claim 29, in which the instructions cause the computer system to determine the confidence score based on a number of relationships that the physician has with entities. 
     
     
       35. The non-transitory computer readable medium of claim 29, in which the instructions cause the computer system to determine the confidence score based on a type of the relationship between the physician and each of one or more entities. 
     
     
       36. The non-transitory computer readable medium of claim 29, in which the instructions cause the computer system to access the second data set from a secure data repository. 
     
     
       37. A computer system comprising:
 one or more processors coupled to a memory, the one or more processors and memory configured to:
 determine, by the one or more processors, a relationship between (i) a first data record of a first data set, the first data record containing first data indicative of a prescription, the first data including a merchant identifier of a merchant, and (ii) a second data record of a second data set, the second data record containing second data indicative of the prescription, including matching data from a data field of the first data record set to data from a data field of the second data record; 
 analyze, by the one or more processors, the first data record and the second data record to identify a physician identifier for a physician associated with the prescription; 
 identify, by the one or more processors and based on the merchant identifier contained in the first data record and the physician identifier, an entity having an relationship with both the merchant and the physician; 
 generate, by the one or more processors, a confidence score characterizing the relationship between the entity and the physician by comparing the physician identifier and an identifier for the entity; 
 determine, by the one or more processors, a confidence level indicating that information in the first data set and second data set accurately identify products that are eligible for a predefined amount, including determining the confidence level based on the confidence score exceeding a threshold and based on the relationship between the physician and the entity; and 
 generate, by the one or more processors, an electronic notification indicating that a product prescribed by the physician and provided by the merchant is eligible to be obtained for the predefined amount. 
   
     
     
       38. The computer system of claim 37, in which the one or more processors and memory are configured to store, in a database of the computer system, data indicative of the relationship between the first data record and the second data record. 
     
     
       39. The computer system of claim 38, in which the one or more processors and memory are configured to generate a link, in the database, between the first data record and the second data record. 
     
     
       40. The computer system of claim 37, in which identifying an entity having a relationship with both the merchant and the physician comprises accessing a third data set containing third data indicative of information about eligibility for the predefined amount and entities eligible to obtain products for the predefined amount. 
     
     
       41. The computer system of claim 40, in which the one or more processors and memory are configured to reconcile data records of the first data set and data records of the second data set with data records of the third data set. 
     
     
       42. The computer system of claim 37, in which the one or more processors and memory are configured to determine the confidence score based on a number of relationships that the physician has with entities. 
     
     
       43. The computer system of claim 37, in which the one or more processors and memory are configured to determine the confidence score based on a type of the relationship between the physician and each of one or more entities. 
     
     
       44. The computer system of claim 37, in which the one or more processors and memory are configured to access the second data set from a secure data repository.

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