System and method for accessing critical care medical management information
First Claim
1. A method for storing, accessing, and tracking medical care management information for a health care case comprising the steps of:
- entering, for said case, case information for a critical care patient into an electronic referral form;
sending the referral form to a reinsurance carrier via a network;
storing the case information in a patient status record in a database;
sending a copy of the referral form, via a network, to a medical care management vendor and to case management personnel;
entering, in the database, updated case information comprising changes in said medical status; and
sending information including updated case information to the client and to the case management personnel.
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Accused Products
Abstract
A system for providing automated decision support mapping for making referrals to the correct type of medical case manager for critical care patients experiencing catastrophic medical conditions. In one aspect, the system provides a method for integrating medical care management functions for a health care case by receiving a referral form containing referral information and case information related to medical status of a critical care patient; storing the referral information in a referral record in a database; storing the case information in a patient status record in the database; and entering, into the database, updated case information comprising changes in a patient'"'"'s medical status
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Citations
30 Claims
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1. A method for storing, accessing, and tracking medical care management information for a health care case comprising the steps of:
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entering, for said case, case information for a critical care patient into an electronic referral form;
sending the referral form to a reinsurance carrier via a network;
storing the case information in a patient status record in a database;
sending a copy of the referral form, via a network, to a medical care management vendor and to case management personnel;
entering, in the database, updated case information comprising changes in said medical status; and
sending information including updated case information to the client and to the case management personnel. - View Dependent Claims (2, 3)
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4. A method for storing, accessing, and tracking medical care management information for a health care patient affiliated with a client for whom a carrier provides reinsurance, the method comprising the steps of:
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presenting an electronic referral form on a carrier web site;
creating a referral by receiving, via the Internet, referral information for the patient entered into the electronic referral form;
storing the referral information in a client referral record in a database managed by the carrier;
sending the referral information to a managed care vendor via the Internet;
wherein, if the vendor accepts the referral, an acceptance message is sent, via the Internet, to the client; and
updating patient status information stored in the database, via the Internet, to indicate changes in status of the patient;
wherein a query facility for querying the database for said referral information and said patient status information is provided by the server, via the Internet, to the client, the carrier, and the vendor. - View Dependent Claims (5, 6, 7, 8, 9)
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10. A system for accessing, tracking and storing medical care management information for a health care patient affiliated with a client for whom a carrier provides reinsurance, the system comprising:
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a carrier site including a server coupled to a network, to a carrier web site and to a carrier database;
at least one managed care vendor coupled to the network; and
at least one client site coupled to the network;
wherein said database contains referral information for the patient and information concerning the medical status of the patient;
wherein a client creates a referral by sending referral information for the patient, from the client site to the carrier web site, via the network;
wherein the referral information is stored in the carrier database; and
wherein the managed care vendor receives, via the Internet, said referral information that was stored in the carrier database. - View Dependent Claims (11, 12, 13)
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14. A method for creating and managing a referral for a health care patient affiliated with a client for whom a carrier provides reinsurance, the method comprising the steps of:
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accessing a carrier web site to view an electronic referral form;
selecting a new referral page on the web site;
creating a referral by entering referral information for said patient into the electronic referral form;
sending the referral information to a carrier server;
storing the referral information in a referral record in a database managed by the carrier;
selecting a managed care vendor using the referral information;
updating said referral record to indicate that the referral was made to the selected vendor;
sending the referral information to the vendor via a network;
sending a verification of the referral to the client via a network; and
sending the referral information to case management personnel. - View Dependent Claims (15, 16, 17)
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18. A method for storing, accessing, and tracking medical care management information a health care patient affiliated with a client for whom a carrier provides reinsurance, the method comprising the steps of:
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creating a referral by receiving, via the Internet, referral information for the patient into an electronic referral form;
storing the referral information in a client referral record in a database managed by the carrier; and
determining whether the client is set up as a direct client that does not require acceptance of the referral by the carrier;
wherein, if the client is not a direct client, the carrier reviews the referral information to determine whether to accept the referral, and sends the referral information to a managed care vendor via the Internet if the carrier accepts the referral; and
wherein, if the client is a direct client, the referral information is sent to the vendor via the Internet, and the carrier reviews the referral information to determine whether to accept the referral; and
if the vendor accepts the referral, an acceptance message is sent, via the Internet, to the client. - View Dependent Claims (19, 20)
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21. A method for integrating medical care management functions for a health care case comprising:
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receiving, via a network, from a client of a reinsurance carrier, referral information and case information for a critical care patient;
storing the referral information in a referral record in a database managed by the carrier;
storing the case information in a patient status record in the database;
entering into the database, via the network, updated case information comprising a change in said medical status; and
sending the referral information via the network to a managed care vendor. - View Dependent Claims (22, 23, 24, 25, 26)
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27. A system for integrating medical care management functions for a health care case comprising:
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means for receiving, via a network, a referral form containing referral information and case information for a critical care patient;
means for storing the referral information in a referral record in a database;
means for storing the case information in a patient status record in the database;
means for entering, into the database via the network, updated case information comprising changes in said medical status; and
means for automatically selecting a managed care vendor using the referral information. - View Dependent Claims (28, 29, 30)
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Specification