Method, system, apparatus and computer readable medium for preparing insurance claims for retail activities

• US 20060212345A1
• Filed: 03/16/2005
• Published: 09/21/2006
• Est. Priority Date: 03/16/2005
• Status: Abandoned Application

• Current Assignee: Resolution Health, Inc. (Elevance Health, Inc.)
• Original Assignee: Resolution Health, Inc. (Elevance Health, Inc.)
• Inventors: Benowitz, Gerald, Keehan, Robert, Steinberg, Earl P., Soza, Harry
• Application Number:
  US11/080,406
• Publication Number:
  US 20060212345A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/0224 based on user history
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof

Abstract

The present invention is directed to a method, apparatus and computer readable medium for reducing health care costs by creating an incentive for patients to choose the most economical, yet fully effective health care option.

Claims

1. A method for preparing insurance claims for retail activities, comprising:

receiving patient information for a patient,

evaluating said patient information to determine at least one first expenditure to be replaced by at least one reduced-cost expenditure, and

providing a coupon to said patient to discount said reduced-cost expenditure.

2. The method of claim 1, wherein said expenditure is a prescription drug and said reduced-cost expenditure is an over-the-counter drug.

3. The method of claim 1, wherein said reduced-cost expenditure is a preferred brand drug.

4. The method of claim 1, wherein said expenditure is medical equipment.

5. The method of claim 1, wherein said step of evaluating further comprises:

comparing one or more expenditures, including said at least one expenditure, against a predetermined list of items,

wherein said at least one first expenditure is included in said list of items.

6. The method of claim 1, wherein said step of evaluating further comprises:

comparing one or more health care characteristics of said patient against a predetermined list of items.

7. The method of claim 6, wherein said step of evaluating further comprises:

comparing one or more health care characteristics of said patient against a predetermined list of items.

8. The method of claim 1, wherein said reduced-cost expenditure provides substantially the same benefit as said first expenditure.

9. The method of claim 1, wherein at least part of said method is implemented on a computer.

10. The method of claim 1, wherein said coupon is an electronic coupon.

11. The method of claim 1, further comprising:

collecting said coupon after use.

12. The method of claim 1, further comprising:

evaluating said patient'"'"'s use of said coupon.

13. The method of claim 1, further comprising:

preparing a summary of usage of said coupon by said patient and cost savings related to usage of said coupon.

14. The method of claim 1, further comprising:

tracking the use of said coupon, and

preparing a report of said use of said coupon.

15. The method of claim 14, wherein said report of said use of said coupon is compatible with an insurance claim system.

16. The method of claim 14, wherein said tracking step comprises:

including a tracking code on said coupon, and

receiving confirmation that said coupon with said tracking code was redeemed after said patient redeems said coupon.

17. The method of claim 12 further comprising:

depositing funds into a health savings account for said patient as a result of the use of said coupon.

18. A method for reducing health care costs, comprising:

receiving a first coupon, which is provided in response to a personal health care history and designed to reduce health care costs,

using said coupon to reduce said health care costs.

19. The method of claim 18, wherein said first coupon is an electronic coupon.

20. The method of claim 18, wherein said first coupon provides a discount on the purchase of over-the-counter medication.

21. The method of claim 20, wherein said discount is the full price of the said over-the-counter medication.

22. The method of claim 18, wherein said first coupon provides a discount on the purchase of a preferred brand drug.

23. The method of claim 18, wherein said first coupon provides a discount on the purchase of medical equipment.

24. The method of claim 18, wherein said first coupon is provided by an insurer.

25. The method of claim 24, wherein said insurer is responsible to pay at least a portion of said health care costs.

26. The method of claim 18, wherein said first coupon is provided by a third party on behalf of an insurer.

27. The method of claim 18, wherein said first coupon contains a tracking code.

28. The method of claim 27, wherein said tracking code can be used to create a report when said first coupon is redeemed.

29. The method of claim 28, wherein said report is compatible with an insurance claim system.

30. The method of claim 27, wherein said tracking code is used to decide whether said patient will receive a second coupon.

31. The method of claim 27, wherein said tracking code is used to decide whether a deposit will be made into a health savings account for said patient.

33. The method of claim 18, wherein said coupon is an electronic coupon.

34. The method of claim 18, wherein said alternate treatment is an over-the-counter drug.

35. The method of claim 18, wherein said alternate treatment is a preferred brand drug.

36. The method of claim 18, wherein said alternate treatment is medical equipment.

37. The method of claim 18, further comprising receiving information regarding the use of said coupon.

38. The method of claim 37, further comprising:

evaluating said information regarding the use of said coupon,

determining that said coupon was used,

preparing a second coupon for a discount on said alternative treatment, and

providing said coupon to said patient.

39. The method of claim 37, further comprising:

evaluating said information regarding the use of said coupon,

determining that said coupon was used,

depositing funds into a health savings account for said patient.

32. A method for preparing insurance claims for retail activities, comprising:

determining a recurring health care cost for a patient that could be beneficially replaced by an alternate treatment,

preparing a coupon for a discount on said alternate treatment,

providing said coupon to said patient.

40. The method of claim 32, wherein the step of providing further comprises:

providing an evaluation of health care costs for said patient to said patient.

41. The method of claim 32, wherein a third party is responsible to pay at least a portion of said recurring health care cost.

42. The method of claim 41, wherein said third party provides said coupon to said patient.

43. The method of claim 32, wherein at least a portion of said method is carried out in a computer.

44. The method of claim 32, wherein said coupon contains identification information.

45. The method of claim 44, wherein said identification information is a tracking code.

46. The method of claim 44, further comprising:

receiving a report of use of said coupon after said coupon is redeemed.

47. The method of claim 46, wherein said report is compatible with an insurance claim system.

48. The method of claim 32, wherein the coupon is processed by a redemption agent after use by said patient.

49. A method of increasing sales by preparing insurance claims for retail activities, comprising:

determining a first product that provides substantially the same benefits as a second product,

identifying a user of said second product,

preparing a coupon for a discount on said first product,

providing said coupon to said user,

receiving reimbursement from a third-party financer.

50. The method of claim 49, wherein said third-party financer is an insurer.

51. The method of claim 49, wherein said coupon is an electronic coupon.

52. The method of claim 49, wherein said first product is an over-the-counter medication.

53. The method of claim 49, wherein said first product is a preferred brand drug.

54. The method of claim 49, wherein said first product is medical equipment.

55. The method of claim 49, wherein said identifying step includes receiving health history information for said user from an insurer.

56. The method of claim 55, wherein said health history information is a summary, and does not include identifying information for said user.

57. The method of claim 49, wherein said coupon is processed by a redemption agent after use by said user.

58. The method of claim 49, wherein said coupon includes a tracking code.

59. The method of claim 58, wherein said tracking code can be used to prepare a report of the redemption of said coupon after said coupon is redeemed.

60. The method of claim 59, further comprising depositing funds into a health savings account for said patient as a result of the use of said coupon.

61. The method of claim 59, wherein said report is compatible with an insurance claim system.

62. A method of

receiving a coupon from a retailer, said coupon having been provided to an end user in response to said user'"'"'s health history,

reimbursing said retailer for the price of said coupon,

evaluating data on said coupon indicating an end user who used said coupon,

compiling said data, and

receiving a reimbursement for said coupon.

63. The method of claim 62, wherein said data on said coupon is an identification number.

64. The method of claim 62, wherein said reimbursement includes payment for said step of evaluating said data on said coupon.

65. the method of claim 62, wherein at least part of said method is carried out on a computer.

66. The method of claim 62, wherein said coupon is an electronic coupon.

67. The method of claim 66 wherein at least part of said method is carried out on a computer.

68. The method of claim 62, wherein said step of compiling said data comprises:

creating a report that is compatible with an insurance claim system.

69. The method of claim 62, wherein said reimbursement is from an insurance claim system.