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System and method for reconciling an insurance payment with an insurance claim

  • US 20060010016A1
  • Filed: 08/04/2005
  • Published: 01/12/2006
  • Est. Priority Date: 05/01/2003
  • Status: Abandoned Application
First Claim
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1. A method for reconciling an insurance payment to an entity, such as a pharmacy, with an insurance claim made by the entity, comprising:

  • providing a claim value belonging to a set of claim values;

    providing a claim identification value associated with the claim value and belonging to a set of claim identification values;

    providing a payment value belonging to a set of payment values;

    providing a payment identification value associated with the payment value and belonging to a set of payment identification values; and

    where the payment identification value and the claim identification value correspond to each other, matching the payment value with the claim value. where the payment value and the claim value are matched, comparing the payment value and the claim value to identify at least one of an acceptably deviant payment, an underpayment, and an overpayment, and accurate payment.

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