System and method for facilitating the exchange of health care transactional information
First Claim
1. A health care transaction processing system for facilitating information exchange between a health care provider and a plurality of payors, said system comprising:
- a health care provider computer configured to generate transaction data of a first predefined format;
a transaction processing platform operatively connected to said health care provider computer, said transaction processing platform (i) converting said transaction data from said first predefined format into a first document formatted consistently with one of a plurality of common data type definitions (DTDs) corresponding to a set of standardized health care transactions, and (ii) translating said first document into a first transaction request document formatted consistently with a second predefined format; and
a first payor computer operatively connected to said transaction processing platform, said first payor computer being associated with a first of said payors and configured to provide a first transaction response document to said transaction processing platform on the basis of said first transaction request document.
2 Assignments
0 Petitions
Accused Products
Abstract
A health care transaction processing system for facilitating information exchange between a health care provider and a plurality of payors is described herein. The system comprises a health care provider computer configured to generate transaction data of a first predefined format. A transaction processing platform, operatively connected to the health care provider computer, serves to (i) convert the transaction data from the first predefined format into a first document formatted consistently with one of a plurality of common data type definitions (DTDs) corresponding to a set of standardized health care transactions, and (ii) translate the first document into a first transaction request document formatted consistently with a second predefined format. The system further includes a first payor computer operatively connected to the transaction processing platform. The first payor computer is associated with a first of the payors and is configured to provide a first transaction response document to the transaction processing platform on the basis of the first transaction request document.
86 Citations
16 Claims
-
1. A health care transaction processing system for facilitating information exchange between a health care provider and a plurality of payors, said system comprising:
-
a health care provider computer configured to generate transaction data of a first predefined format;
a transaction processing platform operatively connected to said health care provider computer, said transaction processing platform (i) converting said transaction data from said first predefined format into a first document formatted consistently with one of a plurality of common data type definitions (DTDs) corresponding to a set of standardized health care transactions, and (ii) translating said first document into a first transaction request document formatted consistently with a second predefined format; and
a first payor computer operatively connected to said transaction processing platform, said first payor computer being associated with a first of said payors and configured to provide a first transaction response document to said transaction processing platform on the basis of said first transaction request document. - View Dependent Claims (2, 3, 4, 5)
-
-
6. A method for facilitating information exchange between a health care provider and a plurality of payors, said method comprising:
-
generating, at a facility of said health care provider, transaction data of a first predefined format;
converting said transaction data from said first predefined format into a first document formatted consistently with one of a plurality of common data type definitions (DTDs) corresponding to a set of standardized health care transactions;
translating said first document into a first transaction request document formatted consistently with a second predefined format; and
generating, at a facility of a first of said payors, a first transaction response document on the basis of said first transaction request document. - View Dependent Claims (7, 8, 9, 10)
-
-
11. A health care transaction processing platform comprising:
-
a web server in communication with a health care provider computer; and
an application server operatively connected to said web server, said application server including;
a central processing unit, and a memory containing;
an XML processing module operative to convert transaction data received from said health care provider computer in a first predefined format into a first document formatted in accordance with one of a plurality of standardized health care transactions;
a personalization engine configured to translating said first document into a first transaction request document formatted consistently with a second predefined format; and
a core application program including an eligibility module. - View Dependent Claims (12, 13, 14, 15, 16)
-
Specification