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Medical benefits payment system

a payment system and medical benefit technology, applied in the field of medical benefit payment system, can solve the problems of creating inefficiencies for all payers

Active Publication Date: 2013-01-01
STONEEAGLE SERVICES
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

The present invention is a way to make payment to health care providers on behalf of a payer, like an insurance company or government organization. The invention involves using a stored-value card account to make a payment, which includes a card number, a verification code, and an expiration date. The payment is sent electronically to the health care provider, along with an explanation of benefits. The stored-value card can only be charged for the amount of the benefit, and the charge is reconciled to confirm the provider has been paid. The patent text discusses how to make a secure payment using an electronic stored-value card system.

Problems solved by technology

TheThis creates inefficiencies tofor all Payers that must coordinate payment for medical services.

Method used

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Examples

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Embodiment Construction

[0019]Turning to FIG. 1 (prior art), insured patient 20 consumes services from health care provider 30. Health care provider 30 submits a benefit claim to administrator 40 in order to receive payment. Administrator 40 may be a third party administrator, insurance company government entity, non-profit organization or the like. For the purposes of this specification, administrator 40 is considered any entity that adjudicates claims, compares them to the benefit plan and makes the decision to make payment for the services. Administrator 40 evaluates the claim made by health care provider 30 to determine whether all or a portion of the benefit claim is payable under the terms of the relevant policy issued by payer or plan sponsor (herein “payer”). 50. Payer 50 funds funding account 70 in anticipation of benefit claims. If administrator 40 finds that a benefit claim is payable, it draws the money from funding account 70. Administrator 40 then generates an explanation of benefits and a ch...

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Abstract

A method of facilitating payment of health care benefits to on behalf of a payer comprising the step of electronically transmitting a stored-value card account payment of the authorized benefit amount concurrently with an explanation of benefits.

Description

[0001]This reissue application has been filed for the reissue of U.S. patent application Ser. No. 11 / 566,930, filed Dec. 5, 2006 now U.S. Pat. No. 7,792,686 entitled “Medical Benefits Payment System” naming Robert M. Allen as inventor, the disclosure of which is incorporated by reference. FIELD OF INVENTION[0002]This invention relates to facilitating payments for medical benefits, and more specifically to streamline the payment of health care providers by administrators and insurance carriers that handle claims adjudication and payment to these providers.BACKGROUND OF THE INVENTION[0003]Third party administrators, insurance companies, and large self-funded corporations (herein “Payers”) adjudicate claims, compare them to the benefit plan and make the decision to write checks in payment for the claims. Currently, Payers are required to print checks and explanation of benefit (EOB) forms for delivery to the health care providers. The EOB lists the amount the health care provider bille...

Claims

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Application Information

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Patent Type & Authority Patents(United States)
IPC IPC(8): G06Q10/00G06Q40/08
CPCG06Q40/08G06Q10/10
Inventor ALLEN, ROBERT
Owner STONEEAGLE SERVICES
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