Conceptual-driven classification for coding advise in health insurance reimbursement
description
Transcript of Conceptual-driven classification for coding advise in health insurance reimbursement
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Intelligent Database Systems Lab
Presenter : JHOU, YU-LIANG
Authors : Sheng-Tun Li , Chih-Chuan Chen , Fernando Huang
2011, AIM
Conceptual-driven classification for coding advise in health insurance
reimbursement
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Intelligent Database Systems Lab
Outlines
MotivationObjectivesMethodology Experimental ResultConclusionsComments
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Intelligent Database Systems Lab
Motivation• In Taiwanese hospitals, discharge summaries are analyzed by
disease classification specialists .
• However , when workloads are heavy or the analyzing is being done by novice personnel, the process may lead to incorrect reimbursement and economic loss.
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Intelligent Database Systems Lab
ObjectivesThis paper developed an ICD code advisory system (ICD-AS) that performs conceptual clustering of discharge summaries , improve the correctness and quality of the process
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Intelligent Database Systems Lab
System Architecture
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Intelligent Database Systems Lab
Preprocess
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Intelligent Database Systems Lab
Feature extraction
Term weighting :
Attribute selection :
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Intelligent Database Systems Lab
Fuzzy formal concept analysis
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Intelligent Database Systems Lab
Evaluation
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Intelligent Database Systems Lab
Experiments result
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Intelligent Database Systems Lab
System evaluation
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Intelligent Database Systems Lab
System evaluation
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Intelligent Database Systems Lab
System evaluation
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Intelligent Database Systems Lab
Conclusions
The method help disease classification specialists
understanding of the relationships between medical
terms , reducing the possibility of error that may
decrease monetary income for hospitals.
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Intelligent Database Systems Lab
CommentsI think the system effective support specialists to classify and reducing the appear of error.
Applications - Text mining - Information retrieval