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US Patent 8447627 Medical services claim management system and method

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Is a
Patent
Patent
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Patent attributes

Patent Jurisdiction
United States Patent and Trademark Office
United States Patent and Trademark Office
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Patent Number
84476270
Patent Inventor Names
Mark R. Cruise0
Date of Patent
May 21, 2013
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Patent Application Number
122538710
Date Filed
October 17, 2008
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Patent Citations Received
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US Patent 11990229 Healthcare provider claims denials prevention systems and methods
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US Patent 11669678 System with report analysis and methods for use therewith
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US Patent 11709868 Landmark point selection
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US Patent 11860941 Outcome analysis for graph generation
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US Patent 11868376 Systems and methods for visualization of data analysis
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Patent Primary Examiner
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Lena Najarian
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Patent abstract

Methods for managing requests by a medical services provider for payment from a payer are described. In one embodiment, claims are aggregated into a single file and submitted for payment electronically. If a file level rejection occurs, rejected claims are removed and the single file reformed and resubmitted. This is repeated as necessary until the file is accepted. In another embodiment, claims are assigned first unique identifiers and line items in claims are assigned second unique identifiers. The unique identifiers are used to track every transaction. In another embodiment, an explanation of benefits relating to a claim is received and processed. Copayments are reallocated to line items according to the explanation of benefits. Writeoffs and transfers to next payers are performed automatically according to adjudication codes in the explanation of benefits.

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