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Conceptual-driven classification for coding advise in health insurance reimbursement

Conceptual-driven classification for coding advise in health insurance reimbursement. Presenter : JHOU, YU-LIANG Authors : Sheng- Tun Li , Chih-Chuan Chen , Fernando Huang 2011 , AIM. Outlines. Motivation Objectives Methodology Experimental Result Conclusions Comments.

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Conceptual-driven classification for coding advise in health insurance reimbursement

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  1. Conceptual-driven classification for coding advise in health insurance reimbursement Presenter : JHOU, YU-LIANGAuthors : Sheng-Tun Li , Chih-Chuan Chen , Fernando Huang 2011, AIM

  2. Outlines • Motivation • Objectives • Methodology • Experimental Result • Conclusions • Comments

  3. Motivation • In Taiwanese hospitals, discharge summaries are analyzed by disease classification specialists . • However , when workloads are heavyor the analyzing is being done by novice personnel, the process may lead to incorrect reimbursement and economic loss.

  4. Objectives This paper developed an ICD code advisory system (ICD-AS) that performs conceptual clustering of discharge summaries , improve the correctness and quality of the process

  5. System Architecture

  6. Preprocess

  7. Feature extraction Attribute selection : Term weighting:

  8. Fuzzy formal concept analysis

  9. Evaluation

  10. Experiments result

  11. System evaluation

  12. System evaluation

  13. System evaluation

  14. Conclusions The method help disease classification specialists understanding of the relationships between medicalterms , reducing the possibility of error that may decrease monetary income for hospitals.

  15. Comments I think thesystem effective support specialists to classify and reducing the appear of error. Applications - Text mining - Information retrieval

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