Medical billing system and method
First Claim
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1. A method for processing a claim for treatment of a patient by a healthcare provider for submission to an indemnitor, the method comprising:
- creating an electronic claim containing patient information, the claim being for an amount of money;
processing the claim by a third party facilitator via a database of verification codes to identify errors in the patient information prior to initial submission of the claim to the indemnitor;
providing an advance payment by the third party facilitator to the healthcare provider;
submitting the claim to the indemnitor for payment of the amount of money; and
, receiving the payment of the amount of money by the third party from the indemnitor.
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Abstract
A method and system for processing medical claims resulting from the treatment of a patient by a healthcare provider, including processing the claim by a third party database to identify errors in the claim prior to submission to an indemnitor, is disclosed.
43 Citations
31 Claims
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1. A method for processing a claim for treatment of a patient by a healthcare provider for submission to an indemnitor, the method comprising:
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creating an electronic claim containing patient information, the claim being for an amount of money;
processing the claim by a third party facilitator via a database of verification codes to identify errors in the patient information prior to initial submission of the claim to the indemnitor;
providing an advance payment by the third party facilitator to the healthcare provider;
submitting the claim to the indemnitor for payment of the amount of money; and
,receiving the payment of the amount of money by the third party from the indemnitor. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 25, 26, 27, 28, 29, 30)
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24. A billing system for submitting medical claims created by a healthcare provider for pre-payment approval comprising:
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an electronic medical claim containing patient information;
a means for processing the claim by a third party via a database of verification codes and to identify errors in the claim prior to initial submission of the claim for payment by an indemnitor; and
,a means for advancing payment of the claim to the healthcare provider prior to payment by the indemnitor.
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31. A method for processing a claim for treatment of a patient by a healthcare provider for submission to an indemnitor, the method comprising:
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providing a software having a matrix for creating a claim for an amount of money;
creating an electronic claim containing patient information, using the software;
processing the claim through a first tier filtering process using a third party application service provider having a software database containing verification codes to identify errors in the patient information prior to submission of the claim to the indemnitor;
processing the claim through a second tier filtering process using a clearinghouse for further verification and identification of errors in the claim;
providing an advance payment by the third party to the healthcare provider;
submitting the claim through a third tier filtering process to the indemnitor for approval and subsequent payment of the amount of money; and
,receiving the payment of the amount of money by the third party from the indemnitor; and
,following up by the third party with indemnitor concerning any nonpayment on the claim.
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Specification