MUMBAI, India, May 29 -- Intellectual Property India has published a patent application (202641064086 A) filed by Venkata Akhilesh Ranga Reddy, Hyderabad, Telangana, on May 21, for 'adaptive health insurance claims processing and real-time member-provider data reconciliation system for payer operations.'
Inventor(s) include Venkata Akhilesh Ranga Reddy.
The application for the patent was published on May 29, under issue no. 22/2026.
According to the abstract released by the Intellectual Property India: "An adaptive health insurance claims processing and reconciliation system for payer operations is disclosed. The system comprises a member data acquisition module, a provider data integration module, a claims intake interface, a real-time reconciliation engine, an intelligent claims adjudication engine, and a payment orchestration module. The system dynamically synchronizes member records and provider records in real time using adaptive validation algorithms and machine learning models. The invention further includes fraud analytics mechanisms configured to identify duplicate claims, anomalous billing patterns, unauthorized procedures, and policy inconsistencies. The system enables automated healthcare claim adjudication, predictive fraud detection, policy compliance verification, and reimbursement orchestration. The invention improves operational efficiency, reduces claim processing delays, enhances fraud mitigation, and supports scalable healthcare insurance payer operations across distributed healthcare ecosystems."
Disclaimer: Curated by HT Syndication.
