US 12,327,623 B2
System and method for processing medical claims
Joseph Guaneri, Brookfield, CT (US); Daniel Posnack, Brookfield, CT (US); Peter Arn, Brookfield, CT (US); Wendy Para, Brookfield, CT (US); S. Adam Hacking, Brookfield, CT (US); Micheal Mueller, Brookfield, CT (US); Jonathan Greene, Brookfield, CT (US); and Steven Mason, Brookfield, CT (US)
Assigned to ROM Technologies, Inc., Brookfield, CT (US)
Filed by ROM TECHNOLOGIES, INC., Brookfield, CT (US)
Filed on Jan. 13, 2021, as Appl. No. 17/147,642.
Application 17/147,642 is a continuation in part of application No. 17/021,895, filed on Sep. 15, 2020, granted, now 11,071,597.
Claims priority of provisional application 63/028,392, filed on May 21, 2020.
Claims priority of provisional application 62/910,232, filed on Oct. 3, 2019.
Prior Publication US 2021/0142893 A1, May 13, 2021
Int. Cl. G16H 20/30 (2018.01); A63B 24/00 (2006.01); G06Q 10/10 (2023.01); G06Q 40/08 (2012.01); G16H 10/60 (2018.01); G16H 40/20 (2018.01); G16H 40/67 (2018.01); G16H 50/70 (2018.01); G16H 70/20 (2018.01)
CPC G16H 20/30 (2018.01) [A63B 24/0062 (2013.01); G06Q 10/10 (2013.01); G16H 10/60 (2018.01); G16H 40/20 (2018.01); G16H 40/67 (2018.01); G16H 50/70 (2018.01); G16H 70/20 (2018.01); A63B 2225/20 (2013.01); G06Q 40/08 (2013.01)] 26 Claims
OG exemplary drawing
 
1. A computer-implemented system for processing medical claims, comprising:
an electromechanical device configured to be manipulated by a user while the user performs a treatment plan;
a patient interface associated with the electromechanical device and configured to present telemedicine information associated with a telemedicine session; and
one or more processors configured to:
generate one or more machine learning models trained to determine healthcare services provided during the telemedicine session based on device-generated information generated by the electromechanical device while the user performs the treatment plan;
determine, by using the one or more machine learning models and based on the device-generated information, device-based coding information; and
transmit the device-based coding information to a claim adjudication server,
wherein the one or more processors are further configured to generate the one or more machine learning models using training data comprising: historical device-generated information; historical device-based coding information; historical reviewed coding information; historical computer-based determinations on whether the historical reviewed coding information can be reconciled with the historical device-based coding information; and historical human-based determinations on whether the historical reviewed coding information has been reconciled with the historical device-based coding information.