Attachment integrated claims systems and operating methods therefor

• US 10,121,201 B2
• Filed: 03/10/2008
• Issued: 11/06/2018
• Est. Priority Date: 03/28/1996
• Status: Expired due to Fees

• Current Assignee: Integrated Claims Systems LLC
• Original Assignee: Integrated Claims Systems LLC
• Inventors: DiRienzo, Andrew L.
• Primary Examiner(s): Khattar, Rajesh
• Application Number:
  US12/045,233
• Publication Number:
  US 20080155456A1
• Time in Patent Office: 3,893 Days
• Field of Search: 713189, 713192, 713193, 705 4
• CPC Class Codes: G06F 3/0481 based on specific properties of the displayed interaction object or a metaphor-based environment, e.g. interaction with desktop elements like windows or icons, or assisted by a cursor's changing behaviour or appearance
• CPC Class Codes: G06F 3/0482 Interaction with lists of selectable items, e.g. menus
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 10/02 Reservations, e.g. for tickets, services or events
• CPC Class Codes: G06Q 10/025 Coordination of plural reservations, e.g. plural trip segments, transportation combined with accommodation
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/06 Buying, selling or leasing transactions
• CPC Class Codes: G06Q 40/00 Finance; Insurance; Tax strategies; Processing of corporate or income taxes
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G06Q 40/12 Accounting
• CPC Class Codes: G06Q 99/00 Subject matter not provided for in other groups of this subclass
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

Systems and methods for processing textual messages which are integrated with one or more digital attachments is described. These systems and methods are useful in the electronic filing and processing of, for example, image data, and of textual data associated with the image data. One particular application of these systems and methods would be for the electronic filing and processing of dental x-rays with patient claim forms.

Claims

1. A method implemented by a computer system for entering data into a computer system providing a dynamic form, the method comprising:

receiving at a first computer of the computer system, from a remote computer of the computer system, a file comprising first digital data in a plurality of identifiable data fields, said first digital data comprising;

insurance transaction data as content data of one or more identifiable data fields of the plurality of identifiable data fields; and

cross-referencing data as content data of at least one identifiable data field of the plurality of identifiable data fields;

wherein the cross-referencing data is configured to enable access to at least one attachment corresponding to the insurance transaction data;

wherein the received plurality of identifiable data fields is a first subset of a set of identifiable data fields for use by the computer system;

wherein each identifiable data field of the set of identifiable data fields consists of data that can be acted upon by software stored in non-transitory computer-usable media of the first computer;

wherein each identifiable data field of the set of identifiable data fields consists of a respective content data portion for storing respective content data and a respective label data portion storing respective label data;

wherein the respective label data for each identifiable data field of the set of identifiable data fields has been encoded and stored in non-transitory computer-usable media of the first computer;

wherein the respective label data for each identifiable data field of the set of identifiable data fields identifies its respective identifiable data field;

wherein the respective label data for each identifiable data field of the set of identifiable data fields further identifies the respective content data portion of its respective identifiable data field; and

wherein the respective label data for each identifiable data field of the set of identifiable data fields further identifies a type of content data to be stored in the respective content data portion of its respective identifiable data field;

wherein the insurance transaction data is unique to a particular patient-provider encounter of a particular patient;

accessing the first digital data from the identifiable data fields of the plurality of identifiable data fields to obtain the insurance transaction data and to obtain the respective cross-referencing data by using the respective label data of each identifiable data field of the plurality of identifiable data fields to identify the specific type of content data of each of those identifiable data fields;

accessing the at least one attachment at a second computer of the computer system by using the cross-referencing data; and

processing an insurance transaction using the received insurance transaction data and the at least one attachment;

wherein processing the insurance transaction comprises;

displaying, on the first computer, a dynamic form in a graphic user interface (GUI), the dynamic form comprising a plurality of GUI data entry boxes;

wherein each GUI data entry box of the plurality of GUI data entry boxes is related to a respective one of the identifiable data fields of the set of identifiable data fields;

wherein the respective identifiable data fields related to the plurality of GUI data entry boxes is a second subset of the set of identifiable data fields;

wherein that second subset of the set of identifiable data fields constitute a second file, the second file comprising a second insurance transaction form; and

wherein the GUI is configured to assist a user of the first computer in completing the identifiable data fields of the second insurance transaction form;

entering data, by the first computer, into the respective content portion of at least one of the identifiable data fields in the second insurance transaction form using solely;

the respective label data of at least one of the identifiable data fields of the plurality of identifiable data fields containing the received insurance transaction data;

the respective content data from that at least one of the identifiable data fields of the plurality of identifiable data fields; and

the respective label data of the identifiable data field in the second insurance transaction form into which that content data is being entered;

dynamically adjusting the GUI data entry boxes of the dynamic form displayed in the GUI as data is entered into the at least one identifiable data field of the second insurance transaction form in response to the particular content data that is entered into that at least one identifiable data field of the second insurance transaction form;

wherein the software of the first computer is responding to the respective label data and the respective content data of the particular identifiable data field into which that data is being entered;

wherein the particular identifiable data field into which that data is being entered is a delimited data string; and

wherein dynamically adjusting the GUI data entry boxes of the dynamic form displayed in the GUI includes at least one of;

 

write protecting, or removing from the GUI display, at least one of the GUI data entry boxes of the plurality of GUI data entry boxes to inhibit data entry by a user of the first computer;

 

notifying a user of the first computer of an error;

or

 

notifying a user of the first computer that data entry into the GUI data entry boxes of the plurality of GUI data entry boxes is incomplete;

wherein the second computer and the remote computer each contain respective software, stored in respective non-transitory computer-usable media, that are each coordinated with the software of the first computer such that each knows and can use the respective label data of each identifiable data field of the set of identifiable data fields; and

wherein, for each identifiable data field of the set of identifiable data fields, the respective label data of that identifiable data field comprises a digital sequence of computer-readable codes for text.

2. A method implemented by a computer system, for entering data into a computer system providing a dynamic form, the method comprising:

displaying a dynamic form in a graphic user interface (GUI), the dynamic form comprising a plurality of GUI data entry boxes, on a first computer of the computer system, the first computer comprising software stored in non-transitory computer-usable media;

wherein each GUI data entry box of the plurality of GUI data entry boxes is a GUI field of the dynamic form, and wherein each GUI field of the dynamic form is a GUI data entry box of the plurality of GUI data entry boxes;

wherein each GUI data entry box of the plurality of GUI data entry boxes of the dynamic form is correlated to a specific identifiable data field of a set of identifiable data fields;

wherein each identifiable data field of the set of identifiable data fields consists of data that can be acted upon by the software of the first computer;

wherein each identifiable data field of the set of identifiable data fields consists of a respective content data portion for storing respective content data and a respective label data portion storing its respective label data;

wherein the respective label data for each identifiable data field of the set of identifiable data fields has been encoded and stored in non-transitory computer-usable media of the first computer;

wherein the respective label data for each identifiable data field of the set of identifiable data fields identifies that particular identifiable data field; and

wherein the respective label data for each identifiable data field of the set of identifiable data fields;

 

identifies the respective content data portion of that particular identifiable data field;

 

identifies a type of content to be stored to the respective content data portion of that particular identifiable data field;

 

identifies the type of content to be stored to the respective content data portion of that particular identifiable data field even when the respective content data portion of that particular identifiable data field is empty of content data; and

wherein when data is entered into a GUI data entry box of the plurality of GUI data entry boxes of the dynamic form, the data is entered so as to fill the respective content data portion of the respective identifiable data field correlated to that GUI data entry box as its respective content data, thereby generating a filled identifiable data field that is a delimited data string;

wherein the dynamic form is used to assist an operator in completing the identifiable data fields of an insurance transaction form;

receiving a first instance of insurance transaction data into a predetermined GUI data entry box of the plurality of GUI data entry boxes of the dynamic form, wherein the received first instance of the insurance transaction data has been entered by a user of the first computer;

dynamically adjusting the GUI data entry boxes of the dynamic form displayed in the GUI by using the data that has been received into the predetermined GUI data entry box, and that has been received into the predetermined GUI data entry box'"'"'s correlated identifiable data field, in a first logic process to dynamically adjust the GUI data entry boxes of the dynamic form displayed in the GUI;

wherein dynamically adjusting the GUI data entry boxes of the dynamic form displayed in the GUI in the first logic process comprises;

identifying at least one other identifiable data field of the set of identifiable data fields by its label data alone, and, for each at least one other identifiable data field of the set of identifiable data fields, identifying its respective correlated GUI data entry box of the plurality of GUI data entry boxes of the GUI;

for each at least one other identifiable data field of the set of identifiable data fields, inhibiting data entry into its respective correlated GUI data entry box of the plurality of GUI data entry boxes of the GUI, so that a user of the first computer can not enter data into any GUI data entry box of the plurality of GUI data entry boxes of the GUI inhibited from data entry; and

for each GUI data entry box of the plurality of GUI data entry boxes of the GUI inhibited from data entry, visually notifying the user that data entry into that GUI data entry box has been inhibited comprises graying out that GUI data entry box in the GUI or removing that GUI data entry box from the GUI;

receiving a second instance of insurance transaction data into a second CAA data entry box of the plurality of GUI data entry boxes of the dynamic form, wherein the received second instance of the insurance transaction data has been entered by a user of the first computer;

using the data that has been received into the second GUI data entry box, and that has been received into the second GUI data entry box'"'"'s correlated identifiable data field, in a second logic process to dynamically adjust the dynamic form displayed in the GUI;

wherein dynamically adjusting the dynamic form displayed in die GUI in the second logic process comprises visually notifying a user of the first computer of an error;

clicking a transmission icon in the GUI display to submit the insurance transaction data for transmission to a second computer of the computer system;

using the insurance transaction data received into the plurality of GUT data entry boxes, and into their correlated identifiable data fields, in a third logic process to dynamically adjust the dynamic form displayed in the GUI;

wherein dynamically adjusting the dynamic form displayed in the GUI in the third logic process includes visually notifying the operator, that the insurance transaction data can not be submitted to the second computer until all GUI data entry boxes of the plurality of GUI data entry boxes of the dynamic form that have not been inhibited from data entry have been completed;

generating a computer file comprising a subset of filled identifiable data fields of the set of identifiable data fields corresponding to GUI data entry boxes of the plurality of GUI data entry boxes of the dynamic form that have not been inhibited from data entry and that have received their respective content data;

wherein the content data portion of each of the filled identifiable data fields of the computer file consists of an instance of insurance transaction data;

wherein the software of the first computer and software stored in non-transitory computer-usable media of the second computer are coordinated such that each know, and can use, the label data of each identifiable data field of the set of identifiable data fields;

wherein the insurance transaction data is related to a particular patient-provider encounter of a particular patient; and

wherein the respective label data for each identifiable data field of the set of identifiable data fields comprises a digital sequence of computer-readable codes for text.