Conversational question generation system adapted for an insurance claim processing system
专利汇可以提供Conversational question generation system adapted for an insurance claim processing system专利检索，专利查询，专利分析的服务。并且A conversational question generation system dynamically generates conversational questions for insurance claim processing. The conversational question generation system includes various modules and graphical user interfaces that provide a streamlined mechanism for creating new conversational questions for insurance claim processing. The conversational question generation system may include various levels of usability that distinguish between a question programmer of the conversational question generation system and an insurance claim agent that uses the created conversational questions. In generating conversational questions, the conversational question generation system may include graphical user interfaces directed to the question details, the answer details, the question text, or other aspects of the conversational questions.，下面是Conversational question generation system adapted for an insurance claim processing system专利的具体信息内容。
I claim:
The following co-pending and commonly assigned U.S. patent applications have been filed on the same date as the present application: U.S. patent application Ser. No. 12/036,115, “A Rule Generation System Adapted for an Insurance Claim Processing System,” filed herewith, U.S. patent application Ser. No. 12/036,119, “Container Generation System for a Customizable Application,” filed herewith, and U.S. patent application Ser. No. 12/036,120, “Page Navigation Generation System for a Customizable Application”, filed herewith, all of which are herein incorporated by reference.
1. Technical Field
This application relates to processing insurance claims, and in particular, to a conversational question generation system for an insurance claim processing computer system.
2. Related Art
In processing insurance claims from an insurance customer, an insurance claim agent typically asks a variety of questions to the insurance customer. An insurance claim processing center typically employs an insurance claim processing computer system for processing insurance claims from insurance customers. The insurance claim processing computer system may be used by various employees at the claim processing center such as insurance claim agents. The insurance claim processing computer system may be configured to display various graphical user interfaces that an insurance claim agent uses when asking questions to an insurance customer and when the insurance claim agent receives answers to those questions.
In some circumstances, the insurance claim processing center desires to change various graphical user interfaces. However, an insurance claim processing computer system is usually extremely complex and requires an individual, such as a computer program developer, who has a skill set that includes the computer programming language in which the insurance claim processing computer system was written. Hence, the insurance claim processing center incurs additional burdens, including fees to the computer program developer and lag time, each time the insurance claim processing center desires to change the graphical user interfaces. In addition, when an insurance claim processing center does not have the personnel with the technical skill set to add or create questions using the insurance claim processing computer system, the insurance claim processing center realizes additional expenses in training or hiring the personnel with the requisite skill set.
Moreover, making modifications to existing insurance claim processing computer systems requires disabling access to and shutting down the systems connected to the insurance claim processing computer system. Hence, when the insurance claim processing center desires to change the graphical user interfaces, the insurance claim processing center must shut down the entire insurance claim processing computer system to add the question. This shutting down process results in downtime of the insurance claim processing center, which translates into lost revenue and lost worker productivity.
Accordingly, there is a need in the industry for a system that facilitates the dynamic generation of conversational questions to an insurance claim processing computer system.
A conversational question generation system dynamically generates conversational questions for an insurance claim processing computer system. The conversational questions may be used as part of an insurance claim processing computer system and presented on a graphical user interface or other communication interface. The conversational question generation system includes various modules and graphical user interfaces that provide a streamlined mechanism for creating new conversational questions or modifying pre-existing conversational questions for the insurance claim processing computer system. In addition, the conversational question generation system minimizes the need to learn a complicated computer language or syntax each time a conversational question is created. The conversational question generation system may include various levels of usability that distinguish between a question programmer of the conversational question generation system and an insurance claim agent that uses the created conversational questions.
A conversational question may have different parameters. For example, a conversational question may have question detail parameters, answer detail parameters, question text parameters, or other parameters. In generating conversational questions, the conversational question generation system may include graphical user interfaces directed to these various parameters.
In one implementation, the conversational question generation system includes a memory storage device in communication with various system components, such as a processor. The memory storage device stores a question database schema and a set of executable instructions that are executable by the processor. The question database schema defines the conversational question for display, and the question database schema is divided into additional database schemas. For example, the question database schema may include a question detail database schema, a question text database schema, or other additional database schemas.
The executable instructions may define multiple graphical user interfaces for display to an insurance claim agent or other user. In some implementations, the various graphical user interfaces are connected such that a question and answer session between an insurance claim agent and an insurance customer follows a logical progression based on the answers the insurance claim agent receives.
In one implementation, the graphical user interfaces include a question detail parameter module, a question text module, and an answer detail parameter module. The values received by the graphical user interfaces may be passed to a question generation module that uses the received values to generate the conversational question. The generated conversational question may be represented by the entries of the question detail database schema and the entries of the question text database schema.
While the embodiments described herein relate to insurance claim processing, the modules and other systems described may be adopted for any system that uses databases, Internet technologies, or graphical user interfaces.
The innovation may be better understood with reference to the following drawings and description. The components in the figures are not necessarily to scale, emphasis instead being placed upon illustrating the principles of the invention. Moreover, in the figures, like-referenced numerals designate corresponding parts throughout the different views.
The conversational question generation system 102 may generate many different types of conversational questions. In one implementation, the conversational question generation system 102 generates different types of conversational questions. The conversational questions may capture data from a graphical user interface, such as an internet browser, or from an integration interface. Other questions may allow a user, such as an employee of the insurance claim processing center, to navigate through the insurance claim processing computer system or to an external Internet web site. Another question type may display static question text to a user. Table 1 identifies examples of the types of questions that the user may create and the questions corresponding control type. In general, a control type corresponds to the data type of the displayed conversational question.
As explained in greater detail below, each conversational question type has a set of parameters that the conversational question generation system 102 may set at run time. The parameters specify how the conversational question's control should display, whether the conversational question should perform data validation, and any other parameters that can be set to a control.
The conversational question generation system 102 may be in communication with multiple insurance claim processing center employee client computers 122-126 through a network 120. The insurance claim processing center employee client computers 122-126 may include a developer client computer 122, a question programmer client computer 124 and an insurance claim agent client computer 126. The client computers 122-126 may have different types of access levels for accessing the conversational question generation system 102. For example, the developer client computer 122 may have the highest tier access level, the question programmer client computer 124 may have a mid-tier access level, and the insurance claim agent 126 may have the lowest tier access level.
The different access levels may grant different types of access to the conversational question generation system 102. For example, the highest tier access level may grant access to modify the executable instruction sets 114, the conversational question master database schema 118, or any other components 104-118 of the conversational question generation system 102. In contrast, the mid-tier access level may restrict access to activities relating to conversational questions, such as generating conversational questions, modifying conversational questions, or removing conversational questions from the conversational question database 116. Finally, the lowest tier access level may restrict access to displaying conversational questions and providing answers to conversational questions.
Furthermore, the different access levels may be further subdivided into additional access levels. For example, the mid-tier access level may distinguish between basic users and advanced users. In general, the conversational question generation system 102 assigns a basic user to be a business analyst with limited exposure to technology and the advanced user who has solid understanding of the supporting technology of the insurance claim processing computer system. In one implementation, the conversational question generation system 102 permits an advanced user to set any property of the conversational question when creating and editing the conversational question. In contrast, the conversational question generation system 102 limits the basic user such that the basic user may only enter a subset of the properties on each control type. In addition, the lowest tier access level and the highest tier access level may distinguish between different types of users accessing the conversational question generation system 102.
The question detail database schema 202 includes multiple question detail entries that define the parameters for the conversational question. Table 2 below shows one implementation of the question detail database schema 202. Table 2 includes a column for entries names, the type of data stored by the entry, whether the entry is initially set to a null value, whether the entry is used as a primary key, and whether the entry is used as a foreign key. Alternative arrangements of the question detail database schema 202 are also possible. For example, the question detail database schema 202 may include more or less entries than shown in Table 2.
Each of the entries of the question detail database schema 202 corresponds to a parameter of a question detail parameter for the conversational question. The N_QUESTION_ID entry represents a conversational question identifier parameter that is a unique identifier for the conversational question. The conversational question identifier parameter for the N_QUESTION_ID entry may be generated by the conversational question generation system 102 or by the insurance claim processing computer system.
The N_APPLICATION_ID entry represents a conversational question application identification parameter whose value is a unique identifier for the application to which the conversational question is assigned. For example, the N_APPLICATION_ID entry may indicate that the conversational question is assigned to a first notice of loss application of the insurance claim processing center. As another example, the N_APPLICATION_ID entry may indicate that the conversational question is assigned to an underwriting application of the insurance claim processing center.
The N_ORG_ENTITY_ID entry represents an organization entity identification parameter whose value is a foreign key to the organization entity identification number of the employee who created the conversational question.
The N_CONV_QUESTION TEXT_ID entry represents a question text identifier parameter whose value is a globally unique identifier (GUID) to the question text database schema 204 for the question text of the conversational question. The N_CONV_QUESTION TEXT_ID identifies the question text associated with the conversational question.
The M_QUES_XML_NM entry represents a conversational question name parameter whose value is a unique name that represents the name of the conversational question. In one implementation, the M_QUES_XML_NM entry stores a parameter value that is an XML Schema Element name. The parameter value stored by the M_QUEST_XML_NM entry may be used by more than one database or other data repository in the insurance claim processing computer system.
The C_STORAGE_TYP entry represents a storage type parameter whose value indicates the type of data to be answered. Although the conversational question may support many different types of answers, the types of answers may include “modeled data,” which is information retrieved from an identified table and column or a code/decode value from the database. The type of answer may also be “answer data,” which is user defined information. In one implementation, “answer data” type answers are stored according to the received answer database schema 206. “Modeled data” type answers may be stored according to the received answer database schema 206, but “modeled data” type answers may be used to evaluate other expressions supported by the insurance claim processing computer system. The answer data may be retrieved from the database as requested, thereby ensuring data integrity and providing the most up-to-date information.
The C_DATA_TYP entry represents an answer data type parameter whose value indicates the answer data type to the insurance claim processing computer system. In one implementation, the parameter value stored by the C_DATA_TYPE entry identifies a conversational question type, such as one of the conversational question types previously discussed with reference to Table 1.
The T_DATA_TYP_DETAIL entry represents an answer detail entry that identifies an answer detail system parameter value formatted according to a predetermined system format. Each of the conversational questions types may have answer detail parameters, and each of the conversational question types may have answer detail parameters that are different from one another. In one implementation, the predetermined system format is a string format represented as a series of alphanumeric characters. Alternatively, or in addition, the predetermined system format may represent key value pairs corresponding to answer detail system parameter values.
The C_PAGE_DISPLAY_TYP entry represents a display type parameter whose value indicates the scope of the conversational question and its associated answer as they pertain to predetermined display and navigation rules of the insurance claim processing computer system. The C_PAGE_DISPLAY_TYP entry may store many different types of display type parameter values including “multi page,” “child page,” “single,” and other display type parameter values. In one implementation, a display type parameter value of “multi page” indicates that the conversational question and answer are used on multiple graphical user interfaces displayed to a user of the insurance claim processing computer system. A “child page” parameter value indicates that the conversational question and answer are used on a previously defined graphical user interface including the children of the previously defined graphical user interface. A parameter value of “single” indicates that the conversational question and its answer are used on a single graphical user interface.
The C_PART_IN_DISC_IND entry represents a discrepancy parameter whose value indicates whether the conversational question is used as part of an error or discrepancy message of the insurance claim processing computer system. As one example, the value of the C_PART_IN_DISC_IND may be “true” where the conversational question is used as part of a discrepancy message or “false” where the conversational question is not used as part of a discrepancy message.
The C_APPL_ACCESS entry represents a code accessible parameter whose value indicates whether the conversational question is accessed by code within the business process of the application, and if the application may be checked before data storage type, or other conversational question detail parameters may be changed, or if the conversational question is to be removed.
The C_PART_IN_NAV_IND entry represents a navigation parameter whose value indicates whether the conversational question participates in a navigation rule that describes the flow of the graphical user interfaces of the insurance claim processing computer system. The navigation parameter may be used to signal to a user that the answer to a question will affect the presentation of graphical user interfaces.
The D_EFFECTIVE entry represents an activation parameter whose value indicates the effective calendar date of the conversational question. Similarly, the D_EXPIRATION entry represents an expiration parameter whose value indicates the expiration date of the conversational question. In one implementation, the D_EFFECTIVE entry indicates the calendar day on which the insurance claim processing computer system should begin displaying the conversational question, and the D_EXPIRATION entry indicates the calendar day on which the insurance claim processing computer system should stop displaying the conversational question.
The C_EXT_INTGR_USAGE entry represents an external integration usage parameter whose value indicates whether the conversational question and its corresponding answer will have an external integration usage. In general, external integration usage refers to the use of an outside vendor. One example of external integration usage is sending data to an outside vendor that schedules appointments for auto claim estimates. Such data may include the model of the car, its location and time the claimant is available to bring the car in for service. The external integration service may then send a response, representing an external integration input, to the insurance claim processing computer system. In one implementation, the parameter values for the C_EXT_INTGR_USAGE entry include “Input,” “Output,” and “NA.” An “Input” parameter value indicates that the conversational question is used as input for integration; an “Output” parameter value indicates that the conversational question is returned as output from integration; and, an “NA” parameter value indicates that the conversational question is used as neither as input nor output.
The M_EXT_INTGR_NM entry represents an external integration name parameter whose value indicates the external integration name content used in evaluation or transformation. The M_EXT_INTGR_NM entry may be used when the C_EXT_INTGR_USAGE has a parameter value of “Input” or “Output.”
The M_QUES_XML_NM_UC entry represents a conversational question search name parameter whose value indicates a search name for the conversational question. In one implementation, the search name is an uppercase character XML string. However, the M_QUES_XML_NM_UC entry may also store a parameter value of alphanumeric characters, an integer, or any other value.
The M_EXT_INTGR_NM_UC entry represents an integration search name parameter whose value indicates a search name of the conversational question integration name. In one implementation, the search name is an uppercase character XML string. However, the M_EXT_INTGR_NM_UC entry may also store a parameter value of alphanumeric characters, an integer, or any other value.
The C_ANSWER_ONLY_IND entry represents an answer-only parameter whose value indicates whether the conversational question is a question/answer conversational question or an answer-only conversational question. In one implementation, a question/answer conversational question is a question displayed to a user to which a user provides an answer. An answer-only conversational question is a conversational question that is not displayed to a user and does not have associated question text. An answer only question may be displayed to a user but its value may not be changed. The answer only question value is normally set by external integration input.
The question detail database schema 202 may also have computer system entries that represent parameters whose values are generated by the insurance claim processing computer system. For example, the C_RCD_DEL entry, the D_CREATE_TS entry, the D_LAST_UPDT_TS entry, the N_LAST_MOD entry, the N_LAST_UPDT entry, the N_SYSTEM_MOD entry, and the C_QUESTION_NBR entry are examples of entries that have parameter values that are automatically generated by the insurance claim processing computer system. In general, the parameter values for these entries are set in a database layer. The C_RCD_DEL entry indicates whether a question has been logically deleted. For example, where the question has not been deleted, the parameter value is “N”; where the user logically deletes the question, the parameter value is “Y.” The C_QUESTION_NBR entry is automatically generated when a question is created. The insurance claim processing computer system maintains a sequence of numbers of using with the C_QUESTION_NBR entry. In other implementations, the question detail database schema 202 may have more than or less than the number of computer system entries shown in Table 2.
The C_RCD_DEL entry represents a deleted parameter whose value identifies if the conversational question is marked as deleted. In one implementation, the conversational question is logically deleted from the conversational question database 116 and not physically deleted from the conversational question database 116. However, in other implementations, the conversational question may be physically deleted from the conversational question database 116.
The D_CREATE_TS entry represents an added calendar date parameter whose value indicates a calendar date for when the conversational question was added to the table. The D_LAST_UPDT_TS entry represents an updated calendar date parameter whose value indicates when the conversational question was last updated. The N_LAST_MOD entry represents a user parameter whose value indicates the user that last updated or created the conversational question in the conversational question database 116. The N_LAST_UPDT entry represents a parameter whose value changes every time a record is modified. In one implementation, the N_LAST_UPDT is updated by the insurance claim processing computer system and is used by optimistic locking. The N_SYSTEM_MOD entry represents a parameter whose value indicates a claim component system or any other system that uses the database schema to update the conversational question. The C_QUESTION_NBR entry represents a parameter whose value indicates an identifier that identifies the question. In one implementation, the C_QUESTION_NBR entry stores a parameter value that is an integer.
In addition to a question detail database schema 202, the conversational question master database schema 118 may also be divided into the question text database schema 204. In one implementation, the question text database schema 204 contains entries that represent all of the question text of the conversational questions stored in the conversational question database 116. The question text database schema 204 contains several entries that support the internationalization of conversational questions such that each conversational question stored in the conversational question database 116 may be represented in more than one language. For example, the question text database schema 204 may store English question text, French question text, and German question text to represent a single conversational question. However, each conversational question may be represented by more or fewer languages.
Table 3 below shows one implementation of the question text database schema 204. Alternative arrangements of the question text database schema 204 are also possible. For example, the question text database schema 204 may include more or less entries than shown in Table 3. The question text database schema 204 may also have entries similar or identical to the entries found in the question detail database schema 202. For purposes of brevity, where the question text database schema 204 has entries similar to the question detail database schema 202, a discussion of those entries has been omitted.
In one implementation, each of the entries of the question text database schema 204 corresponds to a parameter of the conversational question that describes the question text of the conversational question.
The N_CONV_QUESTION TEXT_ID entry represents a question text identifier parameter whose value is a unique identifier for the question text corresponding to the conversational question or other message. The unique identifier may be a number, a series of alphanumeric characters, or any other type of identifier. The parameter value for the N_CONV_QUESTION TEXT_ID entry may be generated by the insurance claim processing computer system, by the conversational question generation system 102, or any other system.
The N_SEQUENCE_NUM entry represents a sequence number parameter whose value is a sequence number when the question text of the conversational question is greater than a predetermined question text character limit. In one implementation, the question text character limit is 4000 characters. In this implementation, when the number of characters in the question text of the conversational question is less than 4000 characters, the N_SEQUENCE_NUM parameter value is 0. However, when the number of characters in the question text of the conversational question is less than 4000 characters, the N_SEQUENCE_NUM parameter value starts at the number 1, and as additional rows of question text are added, the N_SEQUENCE_NUM parameter value is incremented by 1 and the incremented parameter value is associated with the added question text.
The C_LANGUAGE entry represents a language parameter whose value indicates the language culture of the question text. The C_LANGUAGE entry helps the use of multiple languages for the conversational question. The conversational question may have multiple C_LANGUAGE entries. In one implementation, the C_LANGUAGE entry indicates a number and the number is associated with a language. For example, the number “0409” may be associated with “English” and the number “040C” may be associated with French. In this example, the conversational question that is associated with multiple C_LANGUAGE entries is displayable in multiple languages. The language of the question text may be selected based on input provided by a user or the language of the question text may be selected by the conversational question generation system 102 or the insurance claim processing computer system.
The C_UPPERCASE_IND entry represents an uppercase parameter whose value is an uppercase indicator row for searches or the mixed case row for display, which is used for question text searches by the conversational question generation system 102 or the insurance claim processing computer system. The C_UPPERCASE_IND indicates a row containing a question in upper case.
The N_APPLICATION_ID entry represents a question text application parameter whose value is a unique identifier for the application to which the question text is assigned. For example, the N_APPLICATION_ID entry may indicate that the question text is assigned to a first notice of loss application of the insurance claim processing center. As another example, the N_APPLICATION_ID entry may indicate that the question text is assigned to underwriting.
The T_MSG_QUESTION TEXT entry represents a question text message parameter whose value is the question text of the conversational question or other message for display. The conversational question may have one or more associated T_MSG_QUESTION TEXT entries based on the number of languages associated with the conversational question. For example, a conversational question written in English, French, and German has three separate T_MSG_QUESTION TEXT entries: a T_MSG_QUESTION TEXT entry that stores English text; a T_MSG_QUESTION TEXT entry that stores French text; and, a T_MSG_QUESTION TEXT entry that stores German text.
The M_CONV_QUESTION TEXT_NM represents a question text name parameter whose value is an identifying name of the question text associated with the conversational question. The question text name parameter value may be used by the conversational question generation system 102, by the insurance claim processing computer system, or any other system, for searching and selecting the question text associated with the conversational question.
The M_CONV_QUESTION TEXT_NM_UC entry represents an uppercase question text name parameter whose value is an uppercase parameter value of the parameter value stored in the M_CONV_QUESTION TEXT_NM entry. The insurance claim processing computer system may use the uppercase question text name parameter to facilitate name searches in the conversational question database 116.
The C_DISC_MSG_IND entry represents a discrepancy message indicator parameter that indicates whether the question text is used for a discrepancy rule or for the conversational question.
Furthermore, the conversational question master database schema 118 may also be sub-divided into the received answer database schema 206. In one implementation, the question text database schema 204 contains entries for answers supplied to the conversational questions. In one implementation, the received answer database schema 206 is configured to receive answers to the conversational questions that are not “modeled data” answers.
Table 4 below shows one implementation of the received answer database schema 206. Alternative arrangements of the received answer database schema 206 are also possible. For example, the received answer database schema 206 may include more or less entries than shown in Table 4. The received answer database schema 206 may also have entries similar or identical to the entries found in the question detail database schema 202 or the question text database schema 204. For purposes of brevity, where the received answer database schema 206 has entries similar to the schemas 202 and 204, a discussion of those entries has been omitted.
In one implementation, each of the entries of the received answer database schema 206 corresponds to a parameter of a received answer to the conversational question that describes the received answer of the conversational question. The parameter values for the received answer may be provided by any number of actors or systems. For example, the parameter values for the received answer may be provided by an insurance claim agent, provided by an insurance customer using a graphical user interface, or another system in communication with the conversational question generation system 102.
The N_ANSWER_ID entry represents a received answer identifier parameter whose value is a unique identifier for a received answer. The received answer identifier parameter value may be generated by the conversational question generation system 102, by the insurance claim processing computer system, or any other system.
The N_SEQUENCE_NUM entry represents a received answer sequence identifier parameter whose value is a sequence identification denoting the sequence of the rows associated with the received answer. For example, a received answer may have a number of alphanumeric characters that is greater than a predetermined limit of alphanumeric characters. When the alphanumeric characters of a received answer exceed the predetermined limit, the additional alphanumeric characters may be stored in additional rows associated with the received answer. Hence, the N_SEQUENCE_NUM entry determines the order of the rows.
The N_CONVERSATION_ID entry represents a conversational question identifier parameter whose value is foreign key to conversation table of the insurance claim processing computer system. Similarly, the N_CONV_RULE_ASN_ID entry represents a conversational rule identifier parameter whose value is a foreign key to a conversational rule table.
The N_NODE_ID entry represents a received answer node identifier parameter whose value is a generated unique node identifier. The answer node identifier parameter associates a received answer to a node in the insurance claim processing computer system that receives the answer. In one implementation, the N_NODE_ID entry indicates the web page of the question that was presented to the user. The N_NODE_ID entry helps the insurance claim processing computer system determine on which web page the answer for the question was collected.
The received answer database schema 206 also has entries for the different types of answers receivable by the insurance claim processing computer system or the conversational question generation system 102.
The T_STRING_ANSWER entry represents a text string parameter whose value is a text answer provided for the associated conversational question where the type of data is defined as a string. An example of a text string parameter value is “Toyota Corolla.”
The D_DATE_ANSWER entry represents a date parameter whose value is a date format where the type of data for the conversational question was defined as a date. An example of a date parameter value is “01/01/2008”.
The N_INTEGER_ANSWER entry represents an integer parameter whose value is a positive or negative “whole” number where the type of data of the conversational question was defined as an integer. An example of an integer parameter value is “1234.”
The N_DOUBLE_ANSWER entry represents a double parameter whose value is a number in which the decimal point can be in any position and where the type of data of the conversational question was defined as a double. An example of a double parameter value is “1.234.”
The A_CURRENCY_ANSWER entry represents a decimal parameter whose value is a number expressed in base-10 notation, regardless of whether there are any digits to the right of the decimal point. However, the decimal parameter value may also be expressed in other notation formats, such as base-2 or base-16 notation. An example of a currency parameter value is “$3.44.”
The C_CODE_ANSWER entry represents a code/decode parameter whose value is a code/decode value answer where the data type of the conversational question was defined as a code. In general, a code/decode value is an alphanumeric representation of another valid value. For example a code/decode value of “8A” may represent “United States of America.” Code/decode values assist in internationalizing valid values and efficiently store data in the database by taking up less space.
The C_BOOLEAN entry represents a Boolean parameter whose value is a true or false value where the data type of the conversational question was defined as a Boolean. An example of a Boolean parameter value is “true.”
The executable instruction sets 114 of
The question detail parameter module 208 is configured to receive a question detail parameter value that corresponds to a question detail parameter. The question detail parameter module 208 may use a graphical user interface or other communication interface to receive the question detail parameter value. For example, the question detail parameter module 208 may receive the question detail parameter value from one of the client computers 122-126 through network 120. As another example, the question detail parameter module 208 may receive the question detail parameter value from one of the components 104-110 of the conversational question generation system 102, such as from the I/O devices 110. In addition, the question detail parameter value may be provided by any number of actors or systems. For example, the question detail parameter value may be provided by an insurance claim agent, provided by an insurance customer using a graphical user interface, or provided by another system in communication with the conversational question generation system 102.
The question detail parameter module 208 is also in communication with the conversational question generation module 216. The question detail parameter module 208 may transmit one or more question detail parameter values to the conversational generation module 216 for dynamically generating the conversational question.
In addition, the question detail parameter module 208 is configured to display parameter values for a previously generated conversational question or edit the parameter values for a previously generated conversational question. The question detail parameter module 208 may communicate with the conversational question database 116 to retrieve parameter values, such as question detail parameter values, associated with the conversational question.
In one implementation, the question detail parameter module 208 implements multiple graphical user interfaces for viewing, editing, and storing parameter values associated with the conversational question. For example, the question detail parameter module 208 may use a graphical user interface for viewing the question detail parameter values associated with the conversational question.
As shown in
Although the viewing mode graphical user interface 300 may display many different types of controls, in one example, the viewing mode graphical user interface 300 may be configured to display an add conversational question control 302, a create-like conversational question control 304, an expire conversational question control 306, and an add-to-container conversational question control 308. The add conversational question control 302 is configured to instruct the question detail parameter module 208 to start the process of creating a new conversational question. The create-like conversational question control 304 is configured to instruct the question detail parameter module 208 to start the process of creating a new conversational question having parameter values similar to an existing conversational question
In generating a conversational question from a pre-existing conversational question, the create-like conversational question control 304 is configured to instruct the question detail parameter module 208 to use pre-existing parameter values from the pre-existing conversational question. The question detail module 208 may communicate with other modules, such as the question text module 210, to populate the parameter values of the new conversational question. Moreover, when the create-like conversational question control 304 is activated, the question detail module 208 may populate more than one type of parameter values, such as question detail parameter values, question text parameter values, and answer detail parameter values. Examples of parameters that are used in creating a new conversational question using the create-like conversational question control 304 include the question text message parameter, the external integration usage parameter, the display type parameter, the question text parameters, and the answer detail parameters.
In expiring the conversational question, the expire conversational question control 306 is configured to instruct the question detail parameter module 208 that the conversational question is not to be displayed in the insurance claim processing computer system. Although the conversational question parameter values may be deleted from the conversational question database 116, the conversational question generation system 102 may be configured to retain the parameter values of the conversational question in the conversational database 116 when the conversational question is expired. For example, retaining the parameter values of an expired conversational question may provide historical submission information for accounting and tracking purposes. In addition, the conversational generation system 102, the insurance claim processing computer system, or any other system, may search for and display expired conversational questions. In one implementation, when the conversational question is expired (e.g., deleted), the conversational question is no longer available to the insurance claim processing computer system and the conversational question may be deleted when an effective date parameter value is not associated with the conversational question.
In addition, the conversational question generation system 102 may have validation rules regarding expiring the conversational question. For example, the question detail parameter module 208 may be configured to establish the expiration parameter value as a calendar date when the conversational question expiration control 306 was activated. The question detail parameter module 208 may also implement a validation rule that prevents the expiration of conversational questions that are not assigned an activation parameter value.
In addition to the conversational question controls 302-308, the viewing mode graphical user interface 300 displays question detail parameter values associated with the conversational question according to the question detail database schema 202. Table 5 below shows the association between the entries of the question detail database schema 202 and the question detail parameters shown in
As previously discussed, the question detail parameter module 208 supports creating and editing question detail parameters for the conversational question.
In one implementation, the question detail parameter module 208 tracks the modifications to the conversational question. For example, when the conversational question is edited, the question detail parameter module 208 may generate a new copy of the edited conversational question. Thereafter, when the conversational question is modified the copy of that conversational question is versioned. After each modification to the conversational question, the old copy of the conversational question without the edits is expired, and the new copy of the conversational question with the modifications is activated, for example, starting the next day. However, the question detail parameter module 208 may not monitor each modification to the conversational question. For example, the conversational detail parameter module 208 may monitor types of modifications to the conversational question or may be configured to monitor modifications to preselected parameters of the conversational question. Other types of monitoring modifications to the conversational question are also possible.
By tracking the modifications to the conversational question, systems currently using the conversational question continue to use the unedited conversational question, but any subsequent uses of the conversational question are of the edited conversational question. Although the edited conversational question may be configured for immediate activation, the question detail parameter module 208 may use a delay in the edited conversational question. For example, in one implementation, when a user desires to have an edited conversational question activated at some future date, the user may use the create-like conversational control 304 and set the activation date of the clone of the conversational question to the desired date, and then set the old conversational question to expire before the cloned conversational question goes into effect.
The question detail parameter module 208 also supports the user access levels discussed above. For example, the question detail parameter module 208 may permit an advanced user to edit or provide parameter values for all properties that define the conversational question. More particularly, an advanced user may have access privileges to edit or provide a parameter value for the answer-only parameter, the external integration usage parameter, the external integration name parameter, and the code accessible parameter. As another example, a basic user may have access privileges to a smaller subset of parameters. More particularly, the question detail parameter module 208 may limit a basic user to prevent a basic user from editing a providing a parameter value for the answer-only parameter, the external integration usage parameter, the external integration name parameter, and the code accessible parameter. However, other types of configurations of access levels are also possible. For example, a basic user may have more or less access to edit or provide parameters values for more or less parameters. The question detail parameter module 208 may also not distinguish between an advanced user and a basic user. Hence, a basic user may be an advanced user.
In general, a user may use the edit mode graphical user interface 400 to provide parameter values for the question detail parameters of the conversational question. In one implementation, the edit mode graphical user interface 400 includes various user interface elements, such as text boxes, drop-down boxes, radio buttons, check boxes, or other user interface elements for accepting user input. Providing question detail parameter values may include providing the conversational question name, assigning the conversational question to an application, defining the data type of the conversational question, and indicating the page display of the conversational question. Providing question detail parameter values may also include providing an activation and expiration date, and indicating whether the question serves as input or output to an integration touch point. In general, an integration touch point is a call to a rules engine that is configured to determine claim complexity or rules service that indicates potential fraud. Where the conversational question is part of an integration service, the name of the integration service may be provided. Lastly, an application change may be required where the conversational question changes the application code.
A user may provide any type of name for the conversational question. In one implementation, the conversational question name conforms TO XML 1.0 standards for naming XML nodes, as defined by the W3C in the Extensible Markup Language 1.0, Third Edition. The conversational question generation system 102 may be configured to permit the user to change the name of the conversational question. However, in one implementation, the conversational question generation system 102 does not permit the user to change the conversational question name. For example, the conversational generation system 102 may not allow duplicate conversational question names.
The conversational question generation system 102 may be in communication with an external integration rules engine (not shown). An example of an integration rules engine is an industry service that indicates if there is potential fraud. In one implementation, an integration rules engine evaluates answers to conversational questions. For example, the answer to the conversational question may be used as input for the integration rules engine. Examples of answers used in an integration rules engine include a string value that holds an XML document or a code/decode value that represents the output from the rules engine. In another implementation, the integration rules engine provides evaluation and an answer to the conversational question. The conversational question generation system 102 may use one or more parameters, such as the integration search name parameter and the external integration usage parameter to communicate with the external integration rules engine. The conversational question generation system 102 may use fewer or more parameters to communicate with the external integration rules engine.
In one implementation, the question detail parameter module 208 is configured with default conditions for the expiration and activation parameter values accepted by the question detail parameter module 208. For example, the question detail parameter module 208 may be configured with a condition that establishes that a valid expiration parameter value is a parameter value that is greater than a previously accepted activation parameter value. As another example, the question detail parameter module 208 may be configured with a condition that establishes that a valid activation parameter value is a parameter value greater than a following or present calendar date. As yet a further example, the question detail parameter module 208 may be configured with a condition that establishes that when the conversational question becomes active, the activation parameter value for the activated conversational question may not be modified or deleted.
In another implementation, the question detail parameter module 208 is configured with default parameter values for the expiration parameter value and the activation parameter value of conversational questions. As examples, the default value for the expiration parameter value may be Dec. 31, 2999 and the default value for the activation parameter may be the calendar date following the present calendar date.
The question detail parameter module 208 may also be configured with additional predetermined conditions regarding other parameters and their associated parameter values. For example, the question detail parameter module 208 may be configured with a condition that establishes that when the storage type parameter value for the conversational question is “modeled data,” then the code accessible parameter value indicates that the conversational question is accessed by code within a business process of an application. As another example, the question detail parameter module 208 may be configured with a condition that establishes that when the conversational question is used as part of multiple messages in the insurance claim processing computer system, the question may not be deleted or expired until the conversational question is disassociated from all of the messages.
Although various implementations above illustrate examples of possible conditions for the question detail parameter module 208, the question detail parameter module 208 may not be configured with any conditions. In alternative implementations, the question detail parameter module 208 is configured with additional conditions or with fewer conditions. Similarly, the question detail parameter module 208 may be configured with default parameter values for other question detail parameters.
Some of the parameter values received by the question detail parameter module 208 may affect the question text module 210. For example, the question detail parameter module 208 may be configured with a condition relating to the answer-only parameter. In general, the question detail parameter module 208 is configured to receive a question text parameter value that corresponds to the question text entry of the question text database schema 202. However, the answer-only parameter may determine whether the question text module 210 should expect to receive a question text parameter value. For example, when the answer-only parameter indicates that the conversational question is an answer-only conversational question, the question text module 210 may not receive a question text parameter value. Alternatively, where the answer-only parameter indicates that the conversational question is not an answer only conversational question, the question text module 210 may receive a question text parameter value.
In addition, some of the parameter values received by the question detail parameter module 208 may affect the answer detail parameter module 212. For example, the answer data type parameter (Table 5) may affect the answer detail parameter module 212. More particularly, in one implementation, the answer data type parameter may determine the answer detail parameters receivable by the answer detail parameter module 212. As discuss below with reference to
In one implementation, the conversational question is associated with different language parameter values and different question text message parameters. For example, a conversational question may have three language parameter values that indicate that the conversational question is displayable in the English language, the German language and the French language. Similarly, and in this example, the conversational question may be associated with three question text message parameter values, where each question text message parameter value indicates the English language version of the conversational question, the German language version of the conversational question, and the French language version of the conversational question.
Hence, the conversational generation system 102 is configured to dynamically generate international conversational questions using the question text module 210. In one implementation, dynamically generating an international conversational question may include inserting rows for each language of the conversational question into the conversational question database 116. For example, there may be a zero-to-many relationship between the question detail database schema 202 and the question text database schema 204.
As previously discussed, in addition to question detail parameters and question text parameters, the conversational question also may be associated with answer detail parameters. In general, answer detail parameters describe the answer data type parameter assigned to the conversational question. More particularly, the answer detail parameter values determine how the conversational question displays and the behaviors the conversational question exhibits when the insurance claim processing computer system uses the conversational question. There are many different types of answer detail parameters, and the conversational question may be associated with all or some of these answer detail parameters.
Furthermore, the answer detail parameters may be represented in different formats by the conversational question generation system 102 and the insurance claim processing computer system. In one implementation, the conversational question generation system 102 uses an answer detail conversational parameter format and the insurance claim processing computer system uses an answer detail system parameter format. In this implementation, the answer detail parameter module 212 includes an answer detail mapping module 214 that maps the answer detail conversational parameter format to the answer detail system parameter format. The answer detail mapping module 214 is further explained below.
Table 7 shows one implementation of the answer detail parameters used in the conversational question generation system 102. Alternative implementations of the answer detail parameters may include more or less answer detail parameters. Alternative implementations of the answer detail parameters may also include different types of answer detail parameters.
The answer detail parameter module 212 is configured to receive a parameter value for some or all of the answer detail parameters described above in Table 7. In response to receiving a parameter value for the answer detail parameters, the answer detail parameter module 212 may display one or more answer detail graphical user interfaces. With reference to
As previously discussed, answer detail parameters may be associated with an answer data type. The association between the answer data type and the answer detail parameters may determine which answer detail parameters are configurable for an answer data type. Tables 8 and 9 show one example of associations between answer detail parameters and their answer data type. In addition, an answer detail parameter may be displayed based on which answer data type the answer detail parameter is associated. Table 8 shows which answer detail parameters are associated with the answer data types of short answer, date, number, numeric, currency, code value, or value.
Table 9 shows which answer detail parameters are associated with the answer data types of long answer, multi code value, time, new window, hyperlink, or label.
In addition, the answer detail parameter module 212 may be configured to receive or edit answer detail parameter values based on the previously discussed detected access level. Accordingly, in one implementation, the answer detail parameters that are received are dependent both on the answer data type parameter value received and the detected access level. Table 10 shows the answer detail parameters associated with a corresponding access level. In alternative implementations of the answer detail parameter module 212, the answer detail parameters may not be associated with an access level. Other implementations are also possible.
The answer detail parameter module 212 may also use additional graphical user interfaces for receiving answer detail parameter values.
In general, an insurance claim processing computer system will have its own parameter representations for representing answer detail system parameters and data type system parameters. Accordingly, the conversational question generation system 102 may include an answer detail mapping module 214 that converts the conversational question parameter representations to system parameter representations of the insurance claim processing computer system. For example, after receiving the answer detail parameter values, the answer detail parameter module 212 may communicate with the answer detail mapping module 214 to associate the answer detail parameter values with their corresponding answer detail system parameter representations for use by the insurance claim processing computer system. Alternatively, or in addition, the answer detail parameter module 212 may also associate the answer data type parameter value with a data type system parameter representation.
In one implementation, answer detail mapping module 214 includes an answer detail parameter mapping schema where the answer detail system parameter representations are numerical and the answer detail conversational parameter representations are alphanumeric characters. Table 11 shows one example of an answer detail parameter mapping schema where the insurance claim processing computer system uses numerical answer detail system parameter representations.
In another implementation, the answer detail mapping module 214 includes a data type mapping schema. Table 12 shows one example of a data type mapping schema.
An example illustrates the operation of the answer detail parameter module 212 using the answer detail mapping module 214.
The answer detail parameter module 212 communicates the single string to the conversational question generation module 216. The conversational question generation module 216 may then save the communicated single string in the T_DATA_TYP_DETAIL entry of the question detail database schema 202. Using the example of
- 06=True&07=240&08=1&09=2&10=45&15=1§Y¤divInjuries&20=True&22=243&23=8A&27=False
as the T_DATA_TYP_DETAIL entry of the question detail database schema 202 for the conversational question shown in
The conversational question generation module 216 generates the conversational question from the question detail parameters, the question text parameters, and the answer detail parameters. In one implementation, the conversational question generation module 216 communicates the question detail parameter values to the conversational question database 116 based on the question detail database schema 202. In addition, the conversational question generation module 216 communicates the question text parameter values to the conversational question database 116 based on the question text database schema 204. As previously discussed, the conversational question generation module 216 also communicates the answer detail parameter values to the conversational question database 116.
The conversational question generation system 102 may also implement a conversational question summary graphical user interface.
The elements illustrated in the Figures interoperate as explained in detail above. In implementing the system described above, one or more technologies may be used. However, the technologies are merely exemplary and alternative technologies may be used as well. For example, the system may be implemented in one or more computer programming languages. Examples of computer programming languages include ASP, C, and PHP. The system may also use various computer programming frameworks including the .NET framework available from Microsoft Corporation located in Redmond, Wash. The system may also use various database technologies including Microsoft SQL Server, also available from the Microsoft Corporation. In addition, the system may use markup languages, such as XML for transmitting data structures and additional data type definitions, HTML, DHTML, or other markup languages.
All of the discussion, regardless of the particular implementation described, is exemplary in nature, rather than limiting. For example, although selected aspects, features, or components of the implementations are depicted as being stored in memories, all or part of systems and methods consistent with the innovations may be stored on, or read from other machine-readable media, for example, secondary storage devices such as hard disks, floppy disks, and CD-ROMs; or other forms of ROM or RAM either currently known or later developed.
Furthermore, although specific components of innovations were described, methods, systems, and articles of manufacture consistent with the innovation may include additional or different components. For example, a processor may be implemented as a microprocessor, microcontroller, application specific integrated circuit (ASIC), discrete logic, or a combination of other type of circuits or logic. Similarly, memories may be DRAM, SRAM, Flash or any other type of memory. Flags, data, databases, tables, entities, and other data structures may be separately stored and managed, may be incorporated into a single memory or database, may be distributed, or may be logically and physically organized in many different ways. Programs may be parts of a single program, separate programs, or distributed across several memories and processors. The schemas used herein may be any diagram, plan, scheme, organizational pattern, structure, framework, or combinations thereof. The schemas may further describe one or more databases to a database management system, including the aspects of a database, such as attributes, fields, domains, and parameters of the attributes or fields.
While various embodiments of the innovation have been described, it will be apparent to those of ordinary skill in the art that many more embodiments and implementations are possible within the scope of the innovation. Accordingly, the innovation is not to be restricted except in light of the attached claims and their equivalents.
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