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HEALTHCARE SYSTEM AND METHOD FOR REAL-TIME CLAIMS ADJUDICATION AND PAYMENT

  • US 20070005402A1
  • Filed: 06/30/2006
  • Published: 01/04/2007
  • Est. Priority Date: 07/01/2005
  • Status: Abandoned Application
First Claim
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1. A system for providing real-time payment processing for patient healthcare services to a provider of such services, where payment may be made by multiple payer sources, the system comprising:

  • a point of sale (POS) device for use by the provider in entering patient ID information and a healthcare treatment code for the patient healthcare services;

    a host for receiving the patient ID information and treatment code from the POS device for submission to a first payer source; and

    a network connecting the POS device and host to the first payer source, the first payer source providing explanation of benefits (EOB) information in response to receiving patient ID information and the healthcare treatment code, the EOB information including at least (a) information on a permitted charge corresponding to the treatment code and (b) information relating to any patient portion of such permitted charge that is not to be paid by the first payer;

    wherein the POS device electronically receives the EOB information and displays the same at the time of healthcare services by the provider, in order to permit the patient to authorize real-time payment of the patient portion from at least one of the other payer sources.

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