Benefit plan intermediary

• US 20070239493A1
• Filed: 04/10/2006
• Published: 10/11/2007
• Est. Priority Date: 04/10/2006
• Status: Active Grant

• 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
• Granted Patent: US 7,739,129 B2
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 20/40 Authorisation, e.g. identification of payer or payee, verification of customer or shop credentials; Review and approval of payers, e.g. check credit lines or negative lists
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A method may receive data comprising a request to assure payment for a transaction with a consumer, the transaction being associated with a provision of a service or a sale of a product. Thereafter, it may be determined whether payment of at least a portion of the transaction will be covered by a benefit plan associated with the consumer, and additionally, whether the consumer is able to pay for at least a portion of the transaction not covered by the benefit plan. Data is then transmitted authorizing the transaction if a predetermined amount of the transaction will be covered by at least one of the benefit plan or the consumer. Related apparatuses, computer program products, and computer systems are also described.

Claims

1. A computer-implemented method comprising:

receiving data comprising a request to assure payment for a transaction with a consumer, the transaction being associated with a provision of a service or a sale of a product;

automatically determining whether payment of at least a portion of the transaction will be covered by a benefit plan associated with the consumer;

automatically determining whether the consumer is able to pay for at least a portion of the transaction not covered by the benefit plan; and

automatically transmitting data authorizing the transaction if a predetermined amount of the transaction will be covered by at least one of the benefit plan or the consumer.

2. A method as in claim 1, wherein the transmitted data identifies portions of the transaction not covered by the benefit plan.

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

generating, by a service provider, the request to assure payment.

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

verifying that the request identifies a category of transaction, a service provider, and the consumer.

5. A method as in claim 1, wherein the determining whether payment of at least a portion of the transaction will be covered by a benefit plan associated with the consumer comprises associating a standard benefit plan reimbursement rate with the transaction and comparing the payment with the standard benefit plan reimbursement rate.

6. A method as in claim 1, wherein the determining whether payment of at least a portion of the transaction will be covered by a benefit plan associated with the consumer comprises determining whether the consumer has claims against the benefit plan exceeding a predetermined payment threshold.

7. A method as in claim 1, further comprising determining whether the consumer has an associated spending account that may be drawn upon for payment of at least a portion of the transaction.

8. A method as in claim 7, wherein the transmitting data further comprises authorizing the transaction if a predetermined amount of the transaction will be covered by the spending account.

9. A method as in claim 1, wherein the determining whether the consumer is able to pay for at least a portion of the transaction not covered by the benefit plan comprises determining whether the consumer has sufficient credit to pay for any portions of the transaction not covered by the benefit plan.

10. A method as in claim 1, wherein the determining whether the consumer is able to cover at least a portion of the transaction not covered by the benefit plan comprises determining whether the consumer has available funds in a financial institution to pay for any portions of the transaction not covered by the benefit plan.

11. A method as in claim 1, wherein the determining whether the consumer is able to cover at least a portion of the transaction not covered by the benefit plan comprises performing a risk assessment to determine whether the consumer is likely to pay for any portions of the transaction not covered by the benefit plan.

12. A method as in claim 1, further comprising determining whether to guarantee payment of the transaction based on at least one of the benefit plan and the ability of the consumer to pay for at least a portion of the transaction.

13. A method as in claim 1, further comprising verifying that the transaction has occurred.

14. A method as in claim 13, further comprising transmitting data including a claim for the transaction to a network node associated with the benefit plan.

15. A method as in claim 1, further comprising transferring, from a bank account associated with the benefit plan to a bank account associated with a service provider, funds equal to the portion of the payment for the transaction covered by the benefit plan.

16. A method as in claim 1, further comprising debiting an account associated with the consumer sufficient to cover a portion of the payment for the transaction not covered by the benefit plan.

17. A method as in claim 1, wherein the determining whether payment of at least a portion of the transaction will be covered by a benefit plan associated with the consumer comprises identifying a plurality of benefit plans associated with at least one of the consumer and transaction and sequentially polling each of the benefit plans to determine if any portion of the transaction will be covered.

18. A method as in claim 17, further comprising ranking each of the plurality of benefit plans according to predetermined primacy criteria.

19. A computer-implemented method comprising:

receiving data comprising a request to pre-authorize payment for a transaction with a consumer, the transaction being associated with a provision of a service or a sale of a product;

automatically determining whether payment of at least a portion of the transaction will be covered by at least one benefit plan associated with the consumer;

automatically determining whether payment of at least a portion of the transaction will be covered by at least one benefit spending account associated with the consumer;

automatically determining whether the consumer is able to pay for at least a portion of the transaction not covered by both of the at least one benefit plan and the at least one benefit spending account; and

automatically transmitting data pre-authorizing the transaction if a predetermined amount of the transaction will be covered by at least one of the at lease one benefit plan, the at least one benefit spending account, or the consumer.

20. A computer-implemented method comprising:

receiving data comprising a request to approve a transaction with a consumer, the transaction requiring a payment and being associated with a provision of a service or a sale of a product;

associating at least one of the consumer and the transaction with one or more payment sources;

ranking each of the associated one or more payment sources into a ranking order based on predetermined coverage priorities for the transaction;

sequentially polling each of the associated one or more payment sources according to the ranking order until it is determined that a predetermined amount of payment will be covered by the polled one or more payment sources; and

transmitting data approving the transaction if a predetermined amount of the transaction will be covered by the polled one or more payment sources.

21. An apparatus comprising:

a receiver to receive a request to assure payment for a transaction with a consumer, the transaction being associated with a provision of a service or a sale of a product;

a determination unit to determine whether payment of at least a portion of the transaction will be covered by a benefit plan associated with the consumer, and to determine whether the consumer is able to pay for any portions of the transaction not covered by the benefit plan; and

an authorization unit to send data authorizing the transaction if a predetermined amount of the transaction will be covered by at least one of the benefit plan or the consumer.

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

receive data comprising a request to assure payment for a transaction with a consumer, the transaction being associated with a provision of a service or a sale of a product;

determine whether payment of at least a portion of the transaction will be covered by a benefit plan associated with the consumer;

determine whether the consumer is able to pay for at least a portion of the transaction not covered by the benefit plan; and

transmit data authorizing the transaction if a predetermined amount of the transaction will be covered by at least one of the benefit plan or the consumer.