System and Method for Obtaining, Maintaining and Maximizing Healthcare Benefits
First Claim
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1. A system for identifying and maintaining patient health care benefits, comprising:
- a relational database, the database having access to health care benefits program data, the program data includes criteria for participation in the program;
a memory storage device configured for storage of health care related data; and
a processor for controlling the system, wherein the processor applies the health care criteria to the health care related data and generates eligibility statistics, wherein the processor generates a user notification based upon occurrence of a change event.
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Abstract
A system and method for obtaining, maintaining, and maximizing health care coverage benefits for individuals and families is provided. Patient data is applied to health care coverage program criteria and a patient specific coverage report is generated. Notification alerts are generated and provide a users change event notifications. Proximity alerts are generated and provided within the coverage report, identifying potential loss and gain of coverage benefits and eligibility.
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Citations
21 Claims
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1. A system for identifying and maintaining patient health care benefits, comprising:
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a relational database, the database having access to health care benefits program data, the program data includes criteria for participation in the program;
a memory storage device configured for storage of health care related data; and
a processor for controlling the system, wherein the processor applies the health care criteria to the health care related data and generates eligibility statistics, wherein the processor generates a user notification based upon occurrence of a change event. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 12)
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9. A method for obtaining and maintaining patient benefits comprising the following steps:
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receiving a patient transferal;
receiving patient data;
based upon the patient data, applying benefits coverage criteria to the patient data;
identifying benefits programs, wherein the benefits programs provide health care coverage benefits to the patient;
providing a benefits program application for identified benefits programs;
submitting benefits program applications;
receiving benefits program enrollment verification;
obtaining updated patient data;
dynamically providing a benefits program roadmap, the roadmap providing a benefits program timeline and program criteria necessary for maintaining benefits coverage; and
providing a change event status notification, the notification including an actual or potential change event that alters benefits coverage based upon the patient data and program criteria. - View Dependent Claims (10, 11, 15)
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13. A method for maintaining and maximizing health care coverage comprising the steps of:
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entering patient data into a memory storage device;
based upon the patient data, applying benefits coverage criteria to the patient data;
identifying additional benefits programs, wherein the benefits programs provide health care coverage benefits to the patient;
entering updated patient data into a memory storage device, wherein the updated patient data is dynamically applied to the criteria;
dynamically providing a benefits program roadmap, wherein the roadmap prompts the user to fulfill healthcare benefits criteria; and
providing a change event status notification, the notification including potential loss of benefits data and potential new benefits opportunities. - View Dependent Claims (14, 16, 17, 18)
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19. A method for providing a patient-specific benefits coverage report comprising the following steps:
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inputting patient-specific data into a memory storage device;
inputting benefits program criteria into a relational database;
applying the user-specific data to the program criteria;
generating a patient-specific benefits coverage report, the report comprising a benefits section, a benefits maintenance roadmap and benefits program proximity alert section, the benefits section providing currently available benefits and the roadmap providing user-specific program requirements, wherein the proximity alert section provides potential benefits program eligibility based upon patient-specific data and key program requirements.
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20. A health benefits coverage screening system comprising:
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a graphical user interface for accessing a relational database, the database configured to identify health care benefits coverage options for health care consumers; and
a multimedia health care benefits resource library having health care coverage tutorials. - View Dependent Claims (21)
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Specification