US 12,462,929 B2
Revenue cycle workforce management
Brian Streich, Kansas City, MO (US); Kelley Bergstrom, Kansas City, KS (US); Mark Sullivan, Kansas City, KS (US); and Michael D. Myers, Kansas City, KS (US)
Assigned to CERNER INNOVATION, INC., Kansas City, KS (US)
Filed by CERNER INNOVATION, INC., Kansas City, KS (US)
Filed on Jan. 18, 2024, as Appl. No. 18/415,756.
Application 18/415,756 is a continuation of application No. 16/731,422, filed on Dec. 31, 2019, granted, now 11,894,128.
Prior Publication US 2024/0153621 A1, May 9, 2024
This patent is subject to a terminal disclaimer.
Int. Cl. G06Q 10/00 (2023.01); G06N 5/04 (2023.01); G06Q 10/0631 (2023.01); G06Q 10/0637 (2023.01); G06Q 10/0639 (2023.01); G06Q 10/105 (2023.01); G16H 40/20 (2018.01)
CPC G16H 40/20 (2018.01) [G06N 5/04 (2013.01); G06Q 10/063112 (2013.01); G06Q 10/0637 (2013.01); G06Q 10/06398 (2013.01); G06Q 10/105 (2013.01)] 19 Claims
OG exemplary drawing
 
1. One or more non-transitory computer storage media having computer-executable instructions embodied thereon, that when executed, perform operations, the operations comprising:
tracking revenue cycle inventory for a client from one or more data stores associated with the client, the revenue cycle inventory including data corresponding to patients from preregistration through final payment of a balance;
analyzing, at a surveillance system, data records within the revenue cycle inventory to automatically identify disruptions that occurred while processing the data records, wherein a workstream data column that defines a type for the disruptions is generated based at least in part on the data records, and wherein type of disruptions include suppressions, edit failures, and denials in a revenue cycle;
utilizing inventory input to identify and recommend a correction for a particular identified disruption,
wherein an action item data column is generated based at least in part on the inventory input and the data records to describe the disruption and the correction,
wherein the correction includes one of a process design, a configuration, or a change in workflow, and
wherein the inventory input includes pair agreements of the claims that define reimbursement terms for the client;
receiving workforce input comprising properties of associates from a workforce, wherein the properties of associates in the workforce input includes one or more of (i) type of education, (ii) type of technical training, (iii) specialty, and (iv) past outcomes from addressing one or more different types of the disruptions;
automatically assigning a portion of the disruptions to an associate of the workforce, wherein the portion is selected based at least in part on the properties of the associate, and based at least in part on the pair agreements;
receiving audit information for the associate corresponding to performance of the associate for handling the different types of the disruptions within a revenue cycle management system;
automatically scaling up or down the portion of the disruptions assigned to the associate based on the audit information;
generating and displaying, in an interactive user interface of a client device, a dashboard that identifies the portion of the disruptions assigned to the associate;
generating and displaying, in the interactive user interface of the client device, a recommendation for the associate to execute the correction identified for each of the disruptions in the assigned portion and a user-selectable option to select from among the disruptions; and
upon receiving an interaction via the dashboard on the client device that selects a first disruption in the assigned portion using the user-selectable option, generating and displaying a screen display in the interactive user interface of the client device that provides details from the action item data column that correspond to the first disruption in the interactive user interface.