METHOD AND SYSTEM FOR ESTIMATING THE FINANCIAL LIABILITY OF A PATIENT FOR A MEDICAL SERVICE
First Claim
1. A computer implemented method, comprising:
- accessing a first data set including established payments that medical service providers have agreed to be paid by healthcare coverage entities for providing medical services to individuals;
determining if the first data set includes a specific established payment that a medical service provider of a patient has agreed to be paid by a healthcare coverage entity of the patient for a medical service provided to the patient;
if the first data set includes the specific established payment, returning the specific established payment for the medical service as an expected payment associated with the medical service;
if the first data set does not include the specific established payment, accessing a second data set including historical payments made by healthcare coverage entities to medical service providers for medical services provided to a population of individuals;
estimating the expected payment associated with the medical service for the patient based on the historical payments;
estimating a cost expected to be borne by the patient for incurring the medical service based on the expected payment and based on a set of parameters associated with a healthcare coverage plan of the patient; and
presenting financial information that communicates the cost expected to be borne by the patient for incurring the medical service.
7 Assignments
0 Petitions
Accused Products
Abstract
A computer implemented method involving a medical service for a patient includes estimating an expected payment associated with the medical service for the patient based on a set of data including payments for similar medical services provided to a population of individuals. The method also includes estimating a cost expected to be borne by the patient for incurring the medical service based on the estimated expected payment and based on a set of parameters associated with a healthcare coverage plan of the patient. The method further includes presenting financial information that communicates the cost expected to be borne by the patient for incurring the medical service.
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Citations
36 Claims
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1. A computer implemented method, comprising:
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accessing a first data set including established payments that medical service providers have agreed to be paid by healthcare coverage entities for providing medical services to individuals;
determining if the first data set includes a specific established payment that a medical service provider of a patient has agreed to be paid by a healthcare coverage entity of the patient for a medical service provided to the patient;
if the first data set includes the specific established payment, returning the specific established payment for the medical service as an expected payment associated with the medical service;
if the first data set does not include the specific established payment, accessing a second data set including historical payments made by healthcare coverage entities to medical service providers for medical services provided to a population of individuals;
estimating the expected payment associated with the medical service for the patient based on the historical payments;
estimating a cost expected to be borne by the patient for incurring the medical service based on the expected payment and based on a set of parameters associated with a healthcare coverage plan of the patient; and
presenting financial information that communicates the cost expected to be borne by the patient for incurring the medical service. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9)
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10. A computer implemented method involving a medical service for a patient, comprising:
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estimating an expected payment associated with the medical service for the patient based on a set of data including payments for similar medical services provided to a population of individuals;
estimating a cost expected to be borne by the patient for incurring the medical service based on the estimated expected payment and based on a set of parameters associated with a healthcare coverage plan of the patient; and
presenting financial information that communicates the cost expected to be borne by the patient for incurring the medical service. - View Dependent Claims (11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. A system comprising:
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a computer system;
program code on a computer-readable medium, which when executed on the computer system performs functions including;
estimating an expected payment associated with a medical service for a patient based on a set of data including payments for similar medical services provided to a population of individuals;
estimating a cost expected to be borne by the patient for incurring the medical service based on the estimated expected payment and based on a set of parameters associated with a healthcare coverage plan of the patient; and
presenting financial information that communicates the cost expected to be borne by the patient for incurring the medical service. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36)
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Specification