System and Method for Initiation of Payment of a Member Cost Portion of Insurance Claim Expenses

• US 20070299699A1
• Filed: 01/05/2007
• Published: 12/27/2007
• Est. Priority Date: 01/05/2006
• Status: Abandoned Application

• Current Assignee: Dave Kisch, Thomas Policelli
• Original Assignee: Dave Kisch, Thomas Policelli
• Inventors: Policelli, Thomas, Kisch, Dave
• Application Number:
  US11/620,526
• Publication Number:
  US 20070299699A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 20/102 Bill distribution or payments
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A method and system for providing initiation of payment of a member'"'"'s cost portion of insurance claims to a provider includes an insurance company adjudicating claims received from a provider, and directing a financial institution having an association with the member to pay for the member'"'"'s cost portion of the insurance claims on the member'"'"'s behalf. The system for initiating payment of member'"'"'s cost portion of claims to providers includes a processor communicatively coupled to a database and an optional financial institution database and processing component communicatively coupled to the processor.

Claims

1. A method for initiating payment to a provider for a member portion of one or more claims, comprising:

storing member data including an association between a member and a financial institution;

receiving one or more insurance claims from a provider for one or more services rendered to the member;

adjudicating the one or more claims to calculate a member'"'"'s cost portion for the one or more services; and

generating payment instructions based upon the member data, wherein the payment instructions notify the financial institution associated with the member to pay the member'"'"'s cost portion to the provider.

2. The method of claim 1, wherein receiving the one or more insurance claims comprises receiving one or more medical insurance claims.

3. The method of claim 1, further comprising entering into an agreement with the financial institution that the financial institution will pay to the provider the member portion of the claim upon receiving the generated payment instructions.

4. The method of claim 3, further comprising receiving an indication from the financial institution that the member'"'"'s cost portion is paid to the provider.

5. The method of claim 4, further comprising receiving an indication from the financial institution that the member repaid the financial institution.

6. The method of claim 1, further comprising entering into an agreement with the provider that a transaction fee is to be charged to the provider for payments of the member'"'"'s cost portion made to the provider by the financial institution.

7. The method of claim 6, further comprising the financial institution paying the member'"'"'s cost portion to the provider less the transaction fee.

8. The method of claim 7, further comprising the financial institution billing the member for the member portion of the claim responsibility.

9. The method of claim 1, further comprising entering into an agreement with the member that the member will receive a discount for repayment to the financial institution of the paid member'"'"'s cost portion.

10. The method of claim 9, further comprising the financial institution billing the member for the member'"'"'s cost portion less the discount.

11. The method of claim 1, further comprising receiving an indication from the financial institution that the member'"'"'s cost portion is paid to the provider.

12. The method of claim 11, further comprising receiving an indication from the financial institution that the member repaid the financial institution.

13. The method of claim 11, further comprising receiving an indication from the financial institution that the member has not repaid the financial institution for a predetermined period of time.

14. The method of claim 13, further comprising generating a message to implement a payroll deduction process on the member'"'"'s payroll for repayment.

15. The method of claim 1, wherein the association between the member and the financial institution comprises data related to a line of credit extended to the member by the financial institution.

16. A system for initiating payment to a service provider, comprising:

a database for storing member data including an association between a member and a financial institution; and

a processor coupled to the database for receiving one or more insurance claims from a provider for one or more services rendered to the member, adjudicating the one or more claims to calculate a member'"'"'s cost portion for the one or more services, and generating payment instructions based upon the member data, wherein the payment instructions notify the financial institution associated with the member to pay the member'"'"'s cost portion to the provider.

17. The system of claim 16, further comprising a financial institution database and processing component configured for receiving the payment instructions from the processor and for paying the member'"'"'s cost portion to the provider

18. The system of claim 16, wherein the database is accessible by a provider to confirm the member association with the financial institution.

19. The system of claim 16, further comprising an electronic card system, wherein the database is accessible by the electronic card system, the electronic card system associated with integrated insurance cards configured to hold member data.

20. The system of claim 16, wherein the one or more insurance claims comprises one or more medical insurance claims.