Estimating benefit plan costs

• US 20070239492A1
• Filed: 04/10/2006
• Published: 10/11/2007
• Est. Priority Date: 04/10/2006
• Status: Abandoned Application

• Current Assignee: Accenture Global Services Limited (Accenture PLC)
• Original Assignee: Accenture Global Services Limited (Accenture PLC)
• Inventors: Cornelius, Richard, Hamilton, Neville, Nunn, Charles, McCaghy, Loren, Sweetland, Christopher
• Application Number:
  US11/401,735
• Publication Number:
  US 20070239492A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A method may aggregate historical transactions for a consumer, each transaction being associated with services or products provided to the consumer. Thereafter, one or more benefit plans available to the consumer are identified. These benefit plans (e.g., healthcare insurance plans) provide payment for predetermined services or products provided to the consumer. Costs that would be incurred by the consumer if the consumer used each of the identified one or more benefit plans for payment of the transactions are then determined. Based on this determination, data indicating costs associated with at least one benefit plan are transmitted. Related apparatuses, computer program products, and computer systems are also described.

Claims

1. A computer-implemented method comprising:

aggregating historical transactions for a consumer, each transaction being associated with services or products provided to the consumer;

automatically identifying one or more benefit plans available to the consumer, the benefit plans providing payment for predetermined services or products provided to the consumer;

automatically determining, for each identified benefit plan, a cost that would be incurred by the consumer if the consumer used the benefit plan for payment of the transactions; and

transmitting data indicating costs associated with at least one benefit plan.

2. A method as in claim 1, further comprising:

automatically identifying one or more benefit plan spending accounts available to the consumer to draw upon for payment of predetermined services or products provided to the consumer; and

automatically determining costs that would be incurred by the consumer if the consumer had drawn from the identified one or more benefit plans savings accounts for payment of the transactions.

3. A method as in claim 1, wherein the transmitted data comprises costs associated with the one or more benefit plan requiring the least out-of-pocket costs to the consumer.

4. A method as in claim 1, wherein the transmitted data comprises an estimation of a portion of the transaction not covered by the benefit plan.

5. A method as in claim 1, wherein the transmitted data comprises an estimation of a portion of the transaction covered by a benefit plan spending account.

6. A method as in claim 1, wherein determining costs that would be incurred by the consumer further comprises:

associating each aggregated historical transaction with a benefit category, each benefit category having an associated benefit level; and

estimating, for each benefit category, a payment amount that will not be covered by the benefit plan.

7. A method as in claim 1, further comprising:

receiving, in response to the transmitted data, a request selecting one or more of the benefit plans.

8. A method as in claim 7, further comprising:

transmitting, in response to the received request, identification data associated with the consumer to one or more network nodes associated with the selected one or more benefit plans.

9. A method as in claim 1, further comprising associating a credit rating with the consumer;

and excluding identified benefit plans requiring a consumer credit rating higher than the associated credit rating.

10. A method as in claim 1, further comprising:

retrieving the historical transactions of the consumer from a data repository.

11. A method as in claim 1, further comprising:

presenting the consumer with a series of interrogatories in a graphical user interface to collect the historical transactions.

12. An apparatus comprising:

an aggregation unit to aggregate historical transactions for a consumer, each transaction being associated with services or products provided to the consumer;

a determination unit to identify one or more benefit plans available to the consumer, the benefit plans providing payment for predetermined services or products provided to the consumer, and to determine, for each identified benefit plan, a cost that would be incurred by the consumer if the consumer used the benefit plan for payment of the transactions; and

a transmission unit to transmit data indicating costs associated with at least one benefit plan.

13. A computer program product, embodied on computer readable-material, said computer program product including executable instructions causing a computer system to conduct one or more of operations comprising:

aggregate historical transactions for a consumer, each transaction being associated with services or products provided to the consumer;

identify one or more benefit plans available to the consumer, the benefit plans providing payment for predetermined services or products provided to the consumer;

determine, for each identified benefit plan, a cost that would be incurred by the consumer if the consumer used the benefit plan for payment of the transactions; and

transmit data indicating costs associated with at least one benefit plan.

14. A computer-implemented method comprising:

obtaining historical medical data for a consumer;

automatically associating the obtained medical data with a health care requirements profile, the health care requirements profile identifying predicted healthcare requirements for the consumer based on one or more individuals having medical data analogous to the obtained medical data;

automatically identifying one or more benefit plans available to the consumer, the benefit plans providing payment for predetermined healthcare services or products provided to the consumer;

automatically determining, for each identified benefit plan, a cost that would be incurred by the consumer if the consumer used the benefit plan for payment of expenses associated with the predicted healthcare requirements; and

transmitting data indicating costs associated with at least one benefit plan.

15. A method as in claim 14, further comprising:

automatically identifying one or more benefit plan spending accounts available to the consumer to draw upon for payment of predetermined services or products provided to the consumer; and

automatically determining costs that would be incurred by the consumer if the consumer had drawn from the identified one or more benefit plans savings accounts for payment of expenses associated with the predicted healthcare requirements.

16. A method as in claim 14, wherein the transmitted data comprises costs associated with the one or more benefit plan requiring the least out-of-pocket costs to the consumer.

17. A method as in claim 14, wherein the transmitted data comprises an estimation of a portion of the transaction not covered by the benefit plan.

18. A method as in claim 14, wherein the transmitted data comprises an estimation of a portion of the transaction covered by a benefit plan spending account.

19. A method as in claim 14, wherein determining costs that would be incurred by the consumer further comprises:

associating each predicted healthcare requirement with a benefit category, each benefit category having an associated benefit level; and

estimating, for each benefit category, a payment amount that will not be covered by the benefit plan.

20. A method as in claim 14, further comprising:

receiving, in response to the transmitted data, a request selecting one or more of the benefit plans.

21. A method as in claim 20, further comprising:

transmitting, in response to the received request, identification data associated with the consumer to one or more network nodes associated with the selected one or more benefit plans.

22. A method as in claim 24, further comprising associating a credit rating with the consumer;

and excluding identified benefit plans requiring a consumer credit rating higher than the associated credit rating.

23. A method as in claim 14, wherein the obtaining comprises:

retrieving the medical data of the consumer from a data repository.

24. A method as in claim 14, wherein the obtaining comprises:

presenting the consumer with a series of interrogatories in a graphical user interface to collect the medical data.

25. An apparatus comprising:

an acquisition unit to obtain historical medical data for a consumer;

an association unit to associate the obtained medical data with a health care requirements profile, the health care requirements profile identifying predicted healthcare requirements for the consumer based on one or more individuals having medical data analogous to the consumer medical data;

a determination unit to identify one or more benefit plans available to the consumer, the benefit plans providing payment for predetermined healthcare services or products provided to the consumer, and to determine, for each identified benefit plan, a cost that would be incurred by the consumer if the consumer used the benefit plan for payment of expenses associated with the predicted healthcare requirements; and

a transmission unit to transmit data indicating costs associated with at least one benefit plan.

26. A computer program product, embodied on computer readable-material, said computer program product including executable instructions causing a computer system to conduct one or more of operations comprising:

obtain historical medical data for a consumer;

associate the obtained medical data with a health care requirements profile, the health care requirements profile identifying predicted healthcare requirements for the consumer based on one or more individuals having medical data analogous to the consumer medical data;

identify one or more benefit plans available to the consumer, the benefit plans providing payment for predetermined healthcare services or products provided to the consumer;

determine, for each identified benefit plan, a cost that would be incurred by the consumer if the consumer used the benefit plan for payment of expenses associated with the predicted healthcare requirements; and

transmit data indicating costs associated with at least one benefit plan.

27. A computer-implemented method comprising:

obtaining at least one of aggregated historical transactions or predicted transactions for a consumer, each transaction being associated with services or products provided to the consumer;

automatically identifying one or more payment sources available to the consumer, the payment sources providing payment for predetermined services or products provided to the consumer;

automatically determining, for each identified payment source, a cost that would be incurred by the consumer if the consumer used the payment source for payment of the transactions; and

transmitting data indicating costs associated with at least one payment source.