Systems and methods for verifying and editing electronically transmitted claim content
US8190453B2 · kind B2 · utility
Assignee
Inventors
Key dates
| Filing date | May 16, 2003 |
| Grant date | May 29, 2012 |
| Priority date | — |
| Expiry date | Jan 24, 2025 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG16Z99/00
- WIPO fieldIT methods for management
- WIPO sectorElectrical engineering
Abstract
Systems and methods verify the content of an electronically transmitted claim, such as a healthcare claim by intercepting the claim, reviewing the claim's contents, and comparing the claim to pre-established claim criteria established by a payer or both a healthcare service provider and payer. If the claim contains the appropriate content the claim is forwarded to its intended recipient, typically a payer such as an insurance company or government healthcare payer; otherwise the claim may be returned to the sender, e.g., a pharmacy, with an indication that it does not contain the correct content. Additionally, the claim may be edited by the system and forwarded in correct form to its intended recipient.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.