System, method, and computer program product for processing a claim
First Claim
1. A method for processing a claim, comprising:
- receiving from an intake site information about a claim brought by a claimant;
creating a record for the claim in a database that includes the information about the claim received from the intake site;
presenting information from the record to a reviewer for determining whether to approve the claim;
receiving information relating to an action taken by the/each reviewer regarding the claim;
updating the record in the database to include the information relating to the action; and
providing at least one of the intake site and the reviewer with status information about a current status of the claim, the status information being updated at least until the claim has been approved by the reviewer.
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Accused Products
Abstract
A system, method, and computer program product for processing a claim are described. The system may include at least one intake site, a plurality of reviewers, one or more service providers, a bill payer and a claim process engine that may all be coupled to a network. In accordance with one embodiment, information about a claim brought by a claimant may be received from an intake site. A record for the claim may be created in a database that includes the information about the claim received from the intake site. Information from the record may be presented to one or more of the reviewers for determining whether to approve the claim. Information relating to an action taken by each reviewer regarding the claim may be received and the record in the database may be updated to include the information relating to the action. The intake site and/or the reviewer(s) may be provided with status information about a current status of the claim. The status information may be updated at least until the claim has been approved by the reviewer(s).
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Citations
20 Claims
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1. A method for processing a claim, comprising:
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receiving from an intake site information about a claim brought by a claimant;
creating a record for the claim in a database that includes the information about the claim received from the intake site;
presenting information from the record to a reviewer for determining whether to approve the claim;
receiving information relating to an action taken by the/each reviewer regarding the claim;
updating the record in the database to include the information relating to the action; and
providing at least one of the intake site and the reviewer with status information about a current status of the claim, the status information being updated at least until the claim has been approved by the reviewer. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
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19. A computer program product for processing a claim, comprising:
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computer code for receiving from an intake site information about a claim brought by a claimant;
computer code for creating a record for the claim in a database that includes the information about the claim received from the intake site;
computer code for presenting information from the record to a reviewer for determining whether to approve the claim;
computer code for receiving information relating to an action taken by the reviewer regarding the claim;
computer code for updating the record in the database to include the information relating to the action; and
computer code for providing at least one of the intake site and the reviewer with status information about a current status of the claim, the status information being updated at least until the claim has been approved by the reviewer.
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20. A system for processing a claim, comprising:
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a network;
an intake site, a plurality of reviewers, a service provider and a bill payer coupled to the network;
a claim process engine coupled to the network and having;
logic for receiving from the intake site information about a claim brought by a claimant;
logic for creating a record for the claim in a database;
logic presenting information from the record to at least one of the reviewers for determining whether to approve the claim;
logic for presenting information to the service provider for presenting information about claim for assisting the service provider in assessing the claim and recommending one or more services for resolving the claim;
logic for presenting bill payment information to the bill payer;
logic for receiving information relating to actions taken by intake site, the reviewers, the service provider and the bill payer regarding the claim;
logic for affording a hold queue wherein actions sending the claim to the hold queue requires a subsequent action to be taken after a predetermined amount of time;
logic for updating the record in the database to include the information relating to the action; and
logic for providing at least one of the intake site, one or more of the reviewers and the bill payer with status information about a current status of the claim.
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Specification