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383 results about "Case management" patented technology

Automated Healthcare Risk Management System Utilizing Real-time Predictive Models, Risk Adjusted Provider Cost Index, Edit Analytics, Strategy Management, Managed Learning Environment, Contact Management, Forensic GUI, Case Management And Reporting System For Preventing And Detecting Healthcare Fraud, Abuse, Waste And Errors

InactiveUS20140081652A1Facilitate and enhance and implement multiple investigator decisionResource optimizationFinancePayment architectureLower riskMedical education
The Automated Healthcare Risk Management System is a real-time Software as a Service application which interfaces and assists investigators, law enforcement and risk management analysts by focusing their efforts on the highest risk and highest value healthcare payments. The system's Risk Management design utilizes real-time Predictive Models, a Provider Cost Index, Edit Analytics, Strategy Management, a Managed Learning Environment, Contact Management, Forensic GUI, Case Management and Reporting System for individually targeting, identifying and preventing fraud, abuse, waste and errors prior to payment. The Automated Healthcare Risk Management System analyzes hundreds of millions of transactions and automatically takes actions such as declining or queuing a suspect payment. Claim payment risk is optimally prioritized through a Managed Learning environment, from high risk to low risk for efficient resolution by investigators.
Owner:RISK MANAGEMENT SOLUTIONS

Methods and systems for compliance monitoring knowledge base

A knowledge base and methods for use in connection with a policy compliance monitoring system operative to determine exceptions to policies expressed by computer-executable policy statements. The system allows establishment, codification, and maintenance of enterprise policies, monitors electronic transactions of the enterprise from various and possibly heterogeneous data sources, detects exceptions to established policies, reports exceptions to authorized users such as managers and auditors, and / or provides a case management system for tracking exceptions and their underlying transactions. The knowledge base comprises extractor files that are utilized for extracting information from data sources for utilization in policy compliance monitoring, a mapper for normalizing data from the data sources against a system ontology and storing normalized data in a monitoring database, and computer-executable compliance policy statements used by a transaction analysis engine. The policy statements represent predetermined policies of the enterprise that apply to data stored in the monitoring database.
Owner:OVERSIGHT SYST INC

System and method for collecting and/or managing data for remote service providers

A system and a method collect and/or manage data for remote service providers via a network for integrating and/or for incorporating a lead generation web application and/or a call center system with a case management web application. A potential client inputs information and/or data into an online form of a website of a host to indicate a desire to retain the services from one of the remote service providers. The call center system communicates with the host and contacts the potential client based on the data and/or information from the online form to conduct an inquiry of the potential client. The call center system identifies a location of the potential client and transfers the potential client to a local service provider which is local with respect to the location of the potential client. The host provides the case management web application to the remote service providers and/or the local service provider for maintaining, for organizing and/or for managing a file of a retained client and/or the potential client. The case management web application is populated with the data and/or the information from the online form. The case management web application identifies and/or provides parameters for the file of the retained client based on the services of the local service provider. A payment center is accessed via the network, the host and/or the case management web application for processing a transaction associated with the retained client, the local service provider and/or the services of the local service provider. The host searches the file of the retained client to identify and/or to determine supplemental services which may be desired by the retained client.
Owner:ESTREET IP

Safety critical system-oriented automatic testing resource management method and platform

The invention relates to a safety critical system-oriented automatic testing resource management method and a safety critical system-oriented automatic testing resource management platform, which are applied to a huge safety critical system with a high requirement on safe reliability. In the method, a testing project is established after a user passes authentication, three management types, namely testing case management, testing process management and document management are set, and a user selects a corresponding management type to perform resource testing management. The platform has a qualification test (Qt) library-based client / server (C / S) framework on the basis of a management platform; a server is taken as a database; a client comprises a core module, a testing case management module, a testing process management module, a document management module and a Bug management module; and the tree structure and the entity type node data of testing resources and operation on the data are defined by the modules of the client. Uniform management on the automatic testing resources of the safety critical system is realized, and the resource management covers a testing stage from the time, so that the black box testing of the safety critical system is effectively supported.
Owner:BEIHANG UNIV

Systems and methods for providing assistance in an emergency

Systems and methods for providing a notification of an emergent condition. The systems and methods comprise a mobile device application executing on the processor of the user device, and communicating with a server system over a telecommunications network, which generally comprises the public Internet. The mobile device user includes a “dead man's switch” control, which begins the emergency notification process if released. The emergency alert process uses a central case management server to provide a uniform interface into key data, reducing the need for operators to provide information verbally.
Owner:NOONLIGHT INC

Advisory systems and methods

A method, computer program product and computer platform for delivering allowing an advisory services provider to provide advisory services to an organisation is described. Information relating to a plurality of different topics is accessible over a computer network by a plurality of end users of the organisation. Access to the information by the end users is monitored. It is determined when information relating to a topic identified as being high risk or complicated has been accessed by an end user. The method then ensures that a communication between the end user and an individual authorised to advise on the topic is initiated to allow advice to be provided to the end user. The advisory services platform can include a content delivery module operable to provide a website to the end users and also operable to monitor and track access to the information by end users. A call and case management module can interact with the content delivery module to record details of communications between the end users and call coordinators and / or advisors.
Owner:ADVISERPLUS BUSINESS SOLUTIONS

Electronic exchange and settlement system for cash letter adjustments for financial institutions

InactiveUS20020128964A1FinanceBilling/invoicingElectronic tradingNet settlement
An electronic exchange system is provided for input and processing of cash letter adjustments between financial institutions and their customers. The system includes a central processor or centralized exchange mechanism and established rules and procedures for operation of the exchange and centralized hardware and software that is accessible through internet or intranet connections. Data for cash letter adjustments are entered to the system by means of standardized electronic formats which may be created from a desktop application or through an electronic interface to the user's mainframe case management system. At a predetermined time, the processor completes the settlement of each of the adjustment transactions and sends the settlement requirements to each of the participating banks or financial institutions. The system also creates a net settlement file in conformity with the "Enhanced Net Settlement" requirements of the Federal Reserve Bank to provide a net settlement of those adjustments through a participant's reserve account at the host Federal Reserve Bank or through a correspondent settling on the participant's behalf at the Federal Reserve Bank. The system also provides an electronic medium for the exchange of informational requests and responses to those requests. The system provides a database of all participants with detailed contact information for each participating financial institution.
Owner:THE CLEARING HOUSE PAYMENTS

Intelligent identity authentication system

InactiveCN107172049ASimplify the certification processGuarantee authentication securityTransmissionRisk levelRisk Control
The invention provides an intelligent identity authentication system. The intelligent identity authentication system comprises an authentication client SDK, an authentication server SDK, an authentication service proxy device, an authentication server, an authentication analysis engine and a cloud service platform, wherein the authentication client SDK is used for acquiring client information of authenticated users; the authentication server SDK is used for checking service strategies, and executing and forwarding information of an authentication client; the authentication service proxy device is used for providing a server reverse proxy when the authentication server SDK cannot implement an authentication function; the authentication server is used for managing the service strategies, authentication modes and cases, and displaying authentication analysis results; the authentication analysis engine is used for performing risk analysis based on a risk control model, wherein the risk analysis includes the steps of performing risk level scoring based on predefined rules and implementing big data analysis in combination with a big data analysis engine; and the cloud service platform dynamically adjusts identity authentication modes and requirements according to risk analysis results of the authentication server and the authentication analysis engine, performs identity authentication for the users, and returns an authentication result to the authentication analysis engine. According to the intelligent identity authentication system provided by the invention, an appropriate identity authentication mode can be selected for the users based on a risk analysis method.
Owner:北京信安世纪科技股份有限公司
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