The full-text of the patent can be found at https://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=11,315,196.PN.&OS=PN/11,315,196&RS=PN/11,315,196
The abstract states: “Disclosed embodiments include generating invalid insurance claims based on category pairs from a category matrix derived from a set of known valid insurance claims, wherein an individual invalid insurance claim comprises at least one of: (i) a diagnosis code from a first category of a category pair and a procedure code from a second category of the category pair not in the first category or (ii) a procedure code from the first category of the category pair and a diagnosis code from the second category of the category pair not in the first category. Some embodiments also include generating a training dataset comprising (i) valid insurance claims from the set of known valid insurance claims and (ii) the invalid insurance claims, and using the training dataset to train an Artificial Intelligence/Machine Learning Engine to classify insurance claims as valid or invalid.”
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