Systems and Methods for Processing Claims in Real-Time
First Claim
1. A claim handling system for facilitating the real-time processing of claims, said claim handling system comprising:
- a secure claim transmission application (SCTA) being configured for executing the steps of;
receiving a plurality of claims from a practice management system, wherein each one of said plurality of claims identifies a payer to which the claim is directed;
generating a different encryption key for transmitting each one of said plurality of claims to a claim server;
receiving an encrypted claim response from said claim server for each one of said plurality of claims, wherein said encrypted claim response corresponds to a response generated by said payer to a corresponding claim transmitted to said payer by said claim server;
decrypting each one of said encrypted claim responses corresponding to each one of said plurality of claims; and
making available each of said decrypted claim responses to said practice management system, wherein each decrypted claim response is received by said SCTA in real-time or near real-time in response to the transmission to said claim server of said claim corresponding to said decrypted claim response.
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Accused Products
Abstract
Claim processing system providing an interface to permit pharmacy and medical management systems to use the Internet to transmit third-party insurance claims on a claim-by-claim basis in real-time or near-real-time to one or more claim servers that receive insurance claim requests over the Internet in an encrypted form. The one or more claim servers decrypt the claim requests and forward them to a health network application which facilitates the submission of the claims to insurance payers and the response of the insurance payers to the requests. Payer responses are received by the claim servers, encrypted and forwarded to the pharmacy and medical management systems in real-time or near real-time.
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Citations
20 Claims
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1. A claim handling system for facilitating the real-time processing of claims, said claim handling system comprising:
a secure claim transmission application (SCTA) being configured for executing the steps of; receiving a plurality of claims from a practice management system, wherein each one of said plurality of claims identifies a payer to which the claim is directed; generating a different encryption key for transmitting each one of said plurality of claims to a claim server; receiving an encrypted claim response from said claim server for each one of said plurality of claims, wherein said encrypted claim response corresponds to a response generated by said payer to a corresponding claim transmitted to said payer by said claim server; decrypting each one of said encrypted claim responses corresponding to each one of said plurality of claims; and making available each of said decrypted claim responses to said practice management system, wherein each decrypted claim response is received by said SCTA in real-time or near real-time in response to the transmission to said claim server of said claim corresponding to said decrypted claim response. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A method for facilitating the real-time processing of claims, comprising:
receiving a plurality of claims from a practice management system, wherein each one of said plurality of claims identifies a payer to which the claim is directed; generating a different encryption key for transmitting each one of said plurality of claims to a claim server; receiving an encrypted claim response from said claim server for each one of said plurality of claims, wherein said encrypted claim response corresponds to a response generated by said payer to a corresponding claim transmitted to said payer by said claim server; decrypting each one of said encrypted claim responses corresponding to each one of said plurality of claims; and making available each of said decrypted claim responses to said practice management system, wherein each decrypted claim response is received by said practice management system in real-time or near real-time in response to the transmission to said claim server of said claim corresponding to said decrypted claim response. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
Specification