Provider claim editing and settlement system
US6341265B1 · kind B1 · utility
Assignee
Inventors
Key dates
| Filing date | Dec 3, 1998 |
| Grant date | Jan 22, 2002 |
| Priority date | — |
| Expiry date | Dec 3, 2018 |
Classification
- Technology area (CPC Y)Emerging Cross-Sectional Technologies
- CPC primaryY10S707/99948
- WIPO fieldMedical technology
- WIPO sectorInstruments
Abstract
Methods and systems for interactively creating and submitting insurance claims and determining whether the submitted claims are in condition for payment by an insurer. A medical technician operating a client computer establishes communication with a remote server. The remote server transmits a claim form to the client computer for display to the medical technician. Using the claim form, the technician enters patient identification information, which is transmitted to the server to determine whether the patient is a beneficiary of an approved insurance plan. If the patient is a beneficiary, the technician can prepare an insurance claim using the claim form displayed by the client computer. The technician enters a diagnosis code and a treatment code representing the diagnosis and treatment of the patient. The diagnosis and treatment codes are transmitted to the remote server, which processes the codes to determine whether the claim corresponds to health care services that are approved for payment. If the insurance claim is not in condition for payment, the medical technician is notified. The medical technician can then amend the insurance claim as necessary and resubmit the claim.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.