The present invention enables the determination of what claim types can be
written based on a client data set(s). The reverse is also true where the
present invention provides the capability to determine what data sets are
required to write different claim categories and types. In an
illustrative embodiment, the determination of the scope of an audit in
accordance with the present invention includes the determination of the
claim types that can be written given a certain client data elements
and/or the determination of the data elements needed to write certain
claim types, both of which are based on the predefined relationships
between claim types and data elements. Possible claim types can also be
determined based on the client data set(s) and a permissible number of
missing client data fields.