Claim submission system and method

• US 20040122717A1
• Filed: 12/24/2002
• Published: 06/24/2004
• Est. Priority Date: 10/21/2002
• Status: Abandoned Application

• Current Assignee: TELUS Health Solutions Inc.
• Original Assignee: TELUS Health Solutions Inc.
• Inventors: Hancock, James
• Application Number:
  US10/326,972
• Publication Number:
  US 20040122717A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 30/04 Billing or invoicing
• CPC Class Codes: G06Q 40/02 Banking, e.g. interest calculation or account maintenance credit or loans G06Q40/03
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records

Abstract

A system and method to provide requested insurance data for populating data fields of an electronic claim form. The system comprises: a database including insurance related patient data and provider data; an interface for accessing the database, the interface capable of displaying the electronic claim form on a display; a unique identifier data field associated with the claim form, the unique identifier field for directing retrieval of the patient data and the provider data from the database, a set of unique identifiers employable by the unique identifier data field for associating an office location of each specified one of the providers with a respective one of the patients; and a data retrieval protocol for displaying the insurance data according to a selected one of the unique identifiers entered in the identifier data field; wherein the same unique identifier is associated with both the provider and the patient of the provider. The database also includes a patient database, a patient sub-database, a provider database, and a provider sub-database.

Claims

1. A system to provide requested insurance data for populating data fields of an electronic claim form, the system comprising:

a) a database including insurance related patient data and provider data;

b) an interface for accessing the database, the interface capable of displaying the electronic claim form on a display;

c) a unique identifier data field associated with the claim form, the unique identifier field for directing retrieval of the patient data and the provider data from the database, a set of unique identifiers employable by the unique identifier data field for associating an office location of each specified one of the providers with a respective one of the patients; and

d) a data retrieval protocol for displaying the insurance data according to a selected one of the unique identifiers entered in the identifier data field;

wherein the same unique identifier is associated with both the provider and the patient of the provider.

2. The system according to claim 1, wherein the database further comprises a patient database and a patient sub-database.

3. The system according to claim 1, wherein the database further comprises a provider database and a provider sub-database.

4. The system according to claim 3, wherein the provider data of the provider database includes multiple professional entries, each of the professional entries capable of being coupled to more than one of the unique identifiers.

5. The system according to claim 4, wherein the provider data of the provider sub-database includes multiple professional entries, each of the professional entries coupled to one of the unique identifiers.

6. The system according to claim 3, wherein the provider data of the provider database includes multiple provider entries, each of the provider entries capable of being coupled to more than one of the unique identifiers.

7. The system according to claim 2, wherein the patient data of the patient database includes multiple patient entries, each of the patient entries capable of being coupled to more than one of the unique identifiers.

8. The system according to claim 7, wherein the patient data of the patient sub-database includes multiple patient entries, each of the patient entries coupled to one of the unique identifiers.

9. The system according to claim 8, wherein the database further comprises a provider database and a provider sub-database.

10. The system according to claim 9, wherein the provider data of the provider database includes multiple professional entries, each of the professional entries capable of being coupled to more than one of the unique identifiers.

11. The system according to claim 10, wherein the provider data of the provider sub-database includes multiple professional entries, each of the professional entries being coupled to a common one of the unique identifiers.

12. The system according to claim 11, wherein the retrieval protocol retrieves provider data and associated patient data from the respective provider sub-database and the patient sub-database using the one common unique identifier.

13. The system according to claim 1 further comprising a filtering protocol used by the retrieval protocol.

14. The system according to claim 13, wherein the filtering protocol uses a common one of the unique identifiers to access both the patient data and provider data of the database.

15. The system according to claim 14, wherein the filtering protocol limits the amount of patient and provider data displayed by the interface, the filtering displaying relevant patient and provider information according to the common one of the unique identifiers.

16. The system according to claim 15, wherein the filtering protocol employs an object oriented pointer associated with the common one of the unique identifiers.

17. A computer program product to provide requested insurance data for populating data fields of an electronic claim form, the computer program product comprising:

a) a computer readable medium;

b) a database module stored on the computer readable medium for including insurance related patient data and provider data;

b) an interface module coupled to the database module, the interface module capable of displaying the electronic claim form on a display;

c) a unique identifier module associated with the claim form, the unique identifier module for directing retrieval of the patient data and the provider data from the database module, a set of unique identifiers employable by the identifier module for associating an office location of each specified one of the providers with a respective one of the patients; and

d) a data retrieval module for displaying the insurance data according to a selected one of the unique identifiers used by the identifier module;

wherein the same unique identifier is associated with both the provider and the patient of the provider.

18. The computer program product according to claim 17, wherein the database module further comprises a patient database and a patient sub-database.

19. The computer program product according to claim 17, wherein the database module further comprises a provider database and a provider sub-database.

20. The computer program product according to claim 19, wherein the provider data of the provider database includes multiple professional entries, each of the professional entries capable of having more than one of the unique identifiers.

21. The computer program product according to claim 20, wherein the provider data of the provider sub-database includes multiple professional entries, each of the professional entries having one of the unique identifiers.

22. The computer program product according to claim 19, wherein the provider data of the provider database includes multiple provider entries, each of the provider entries capable of having more than one of the unique identifiers.

23. The computer program product according to claim 18, wherein the patient data of the patient database includes multiple patient entries, each of the patient entries capable of having more than one of the unique identifiers.

24. The computer program product according to claim 23, wherein the patient data of the patient sub-database includes multiple patient entries, each of the patient entries having one of the unique identifiers.

25. The computer program product according to claim 24, wherein the database module further comprises a provider database and a provider sub-database.

26. The computer program product according to claim 25, wherein the provider data of the provider database includes multiple professional entries, each of the professional entries capable of having more than one of the unique identifiers.

27. The computer program product according to claim 26, wherein the provider data of the provider sub-database includes multiple professional entries, each of the professional entries having one of the unique identifiers.

28. The computer program product according to claim 27, wherein the retrieval module retrieves provider data and associated patient data from the provider sub-database and the patient sub-database using the one unique identifier.

29. The computer program product according to claim 17, wherein the retrieval module provides the insurance data to the interface module for automatically pre-populating the respective data fields.

30. A method to provide requested insurance data for populating data fields of an electronic claim form, the method comprising the steps of:

a) supplying a database including insurance related patient data and provider data;

b) associating a unique identifier data field with the claim form, the unique identifier field for directing retrieval of the patient data and the provider data from the database, the unique identifier data field using a set of unique identifiers for relating an office location of each specified one of the providers with a respective one of the patients;

c) entering a selected one of the unique identifiers in the identifier data field;

d) retrieving the insurance data from the database according to the selected one of the unique identifiers; and

e) displaying the retrieved data in the electronic claim form;

wherein the same unique identifier is associated with both the provider and the patient of the provider.