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Abstract:
United Health Care (UHC) is a diversified managed care company, serving virtually every segment of the health-care market. Founded in 1974, UHC has become an industry front runner by offering a broad portfolio of products and services to help clients, both providers and purchasers of health care, successfully manage their health-care costs. UHC’s highly integrated range of products and services includes a network of owned and managed health plans as well as specialty companies that individually address key and fast-growing cost areas of health care. UHC’s unique business mix provides an ideal research and development environment for developing, testing, and refining health-care-management products and service. Recognizing the power of knowledge-based systems, UHC’s senior management hired JP Little to investigate and apply expert systems and other advanced computing technologies to the health-care industry. Success was top priority for the selection of an initial application. There were many possibilities, but the domain of claim adjudication was selected as the best choice.