System and method for providing real-time bi-directional charge capture-centralized conversation between billing and provider entities

• US 10,395,005 B2
• Filed: 03/15/2013
• Issued: 08/27/2019
• Est. Priority Date: 03/15/2013
• Status: Active Grant

• Current Assignee: Mass Ip, LLC
• Original Assignee: Nuesoft Technologies Incorporated (Global Payments Incorporated)
• Inventors: Alibakhsh, Massoud, Famorzadeh, Shahram
• Primary Examiner(s): Gilligan, Christopher L
• Application Number:
  US13/841,072
• Publication Number:
  US 20140278471A1
• Time in Patent Office: 2,356 Days
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/00 ICT specially adapted for the handling or processing of patient-related medical or healthcare data for medical reports G16H15/00; for therapies or health-improving plans G16H20/00; for the handling or processing of medical images G16H30/00
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/00 ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics

Abstract

A system for providing real-time bi-directional charge capture-centralized conversation between Billing and Provider entities, comprising a first computer apparatus with a computer apparatus charge capture module installed and a second computer apparatus with a computer apparatus billing module installed that are used to transmit and/or receive real-time charge capture centralized conversation data. Real-time charge capture-centralized conversation data is comprised of real-time charge capture data, which can be combined to create real-time claim data.

The system further comprises first and second computer apparatus receipt and transmission via secured communication links. The real-time charge capture data, capture-centralized conversation data and claim data is presented in a social media conversation style format. The first and second computer apparatus make it possible for both a Billing and a Provider entity to initiate, transmit or modify any of the sets of real-time charge capture data or charge capture-centralized conversation data.

Claims

1. A method for providing a real-time bi-directional health care charge capture-centralized conversation securely between a Billing entity and a Provider entity regarding a real-time charge capture data and a real-time claim data within a secure network, said method comprising the steps of:

providing a first computer apparatus having a display and having a first secure point-to-point connection to a database server and a second computer apparatus having a display and having a second secure point-to-point access to said database server, said first and said second computer apparatuses having a charge capture module, said charge capture module having secure access to a real-time charge capture-centralized conversation data stored on said database server;

loading an interface thereon said first computer apparatus, said interface having a charge capture interface, a billing interface and a messaging interface, wherein said charge capture interface is capable of recording at least one of the group consisting of;

diagnoses, diagnosis notes, treatments, treatment notes and combinations thereof, and wherein said billing interface is capable of recording at least one of the group comprising consisting of standardized diagnostic codes and standardized treatment codes, and wherein said messaging interface is capable of displaying a threaded conversation of messages between the Billing entity and the Provider entity;

displaying said interface on said display of said first computer apparatus;

loading said charge capture module via said network thereon said first computer apparatus;

performing at least one action in said charge capture module on said first computer apparatus from a group of actions including;

entering a message associated with said real-time charge capture data, entering a message associated with said real-time claim data, editing said real-time claim data, and combinations thereof said messages comprising a request for supplemental information, a request for clarification, a request for correction, responses to said requests, or combinations thereof;

packaging data resulting from said at least one action into a data package;

transmitting said data package from said first computer apparatus to said database server via said first secure point-to-point connection; and

gathering said data package into a threaded conversation as an updated version of said real-time charge capture-centralized conversation data;

wherein the Billing entity utilizes said second secure point-to-point connection to cooperatively assemble a healthcare claim for reimbursement based upon data in said real-time charge capture-centralized conversation data thereby communicating in a secure.

2. The method of claim 1, further comprises the step of:

loading an interface from said database server thereon said second computer apparatus, said interface having a charge capture interface, a billing interface and a messaging interface;

displaying said interface on said display of said second computer apparatus;

loading said charge capture module via said network thereon said second computer apparatus;

performing at least one action in said charge capture module on said second computer apparatus from a group of actions including;

entering a message associated with said real-time charge capture data, entering a message associated with said real-time claim data, editing said real-time charge capture data, and combinations thereof as said real-time charge capture-centralized conversation data;

transmitting said real-time charge capture-centralized conversation data from said second computer apparatus to said database server;

storing said real-time charge capture-centralized conversation data from said second computer apparatus on said non-transitory computer readable medium connected to said database server.

3. The method of claim 2, further comprises the step of:

transmitting said updated real-time charge capture-centralized conversation data to said second computer apparatus from said database via said second secure point-to-point connection.

4. The method of claim 3, further comprises the step of:

receiving said updated real-time charge capture-centralized conversation data from said first computer apparatus on said database server and further performing said plurality of actions in said charge capture module on said second computer apparatus in order to further update said updated real-time charge capture-centralized conversation data by utilizing said second secure point-to-point connection.

5. The method of claim 1, wherein said group of actions performed in said charge capture module on said first computer apparatus further includes attaching an attachment to said real-time charge capture-centralized conversation data.

6. The method of claim 5, wherein said attachment to said real-time charge capture-centralized conversation data is a picture.

7. The method of claim 5, wherein said attachment to said real-time charge capture-centralized conversation data is a form.

8. The method of claim 5, wherein said attachment to said real-time charge capture-centralized conversation data is a chart.

9. The method of claim 5, wherein said attachment to said real-time charge capture-centralized conversation data is video.

10. The method of claim 5, further comprising the step of:

sorting said real-time charge capture data and said real-time claim data.

11. The method of claim 5, further comprising the step of:

sorting said real-time charge capture data and said real-time claim data by said Provider entity.

12. The method of claim 5, further comprising the step of:

sorting said real-time charge capture-centralized conversation data.

13. The method of claim 5, further comprising the step of:

marking said charge capture data finalized.

14. The method of claim 13, further comprising the step of:

submitting said charge capture data for payment.