SYSTEM AND METHOD FOR PROVIDING HEALTH CARE SERVICES USING SMART HEALTH CARDS
First Claim
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1. A method for providing health care services using smart health cards, comprising:
- reading a smart health card issued to a member to obtain member information;
retrieving an electronic form associated with a HIPAA compliant EDI transaction;
automatically populating, by a processor, the electronic form associated with the HIPAA compliant EDI transaction with member information obtained from the smart health card;
forwarding the populated electronic form associated with the HIPAA compliant EDI transaction; and
updating the member information on the smart health card based on diagnosis and treatment.
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Abstract
A system and method for providing health care services using smart health cards is provided. Smart health cards including at least member information are issued to members. When a member visits a provider, the smart health card is read to obtain the member information and the retrieved member information is used to generate HIPAA compliant EDI transactions.
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Citations
28 Claims
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1. A method for providing health care services using smart health cards, comprising:
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reading a smart health card issued to a member to obtain member information; retrieving an electronic form associated with a HIPAA compliant EDI transaction; automatically populating, by a processor, the electronic form associated with the HIPAA compliant EDI transaction with member information obtained from the smart health card; forwarding the populated electronic form associated with the HIPAA compliant EDI transaction; and updating the member information on the smart health card based on diagnosis and treatment. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
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9. A provider system for providing health care services using smart health cards, comprising:
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a smart health card reading module that reads a smart card issued to a member to obtain member information; an EDI transaction module that; retrieves an electronic form associated with a HIPAA compliant EDI transaction; populates the electronic form associated with the HIPAA compliant EDI transaction with member information obtained from the smart health card; forwards the populated electronic form associated with the HIPAA compliant EDI transaction; and a smart health card interaction module that updates member information on the smart health card based on diagnosis and treatment. - View Dependent Claims (10, 11, 12, 13, 14, 15, 16)
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17. A method for providing health care services using smart health cards, comprising:
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registering one or more payers on a contractual basis, the one or more payers having participating one or more providers and one or more members; registering one or more employers on a contractual basis, the one or more employers employing one or more members; receiving member information associated with the one or more members; issuing a smart health card to each of the one or more members, the smart health card including the member information; and forwarding at least one HIPAA compliant EDI transaction to the one or more payers, the HIPAA compliant EDI transaction associated with an electronic form that is populated with the member information obtained from the smart health card. - View Dependent Claims (18, 19, 20, 21, 22, 23, 24, 25)
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26. A system for providing health care services using smart cards, comprising:
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means for registering one or more payers on a contractual basis, the one or more payers having participating one or more providers and one or more members; means for registering one or more employers on a contractual basis, the one or more employers employing one or more members; means for receiving member information associated with the one or more members; means for issuing a smart health card to each of the one or more members, the smart health card including the member information; means for forwarding at least one HIPAA compliant EDI transaction to the one or more payers, the HIPAA compliant EDI transaction associated with an electronic form that is populated with the member information obtained from the smart health card.
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27. A method for providing health care services using smart cards, the method comprising:
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obtaining demographic and provider information associated with a member from a smart health card issued to the member; retrieving a first electronic form associated with a HIPAA compliant eligibility request and populating the first electronic form with the demographic information obtained from the smart health card; retrieving a second electronic form associated with a HIPAA compliant claim and populating the second electronic form with the demographic and the provider information obtained from the smart health card, the second electronic form being populated after examination of the member by a provider who the member visits for health care services; and forwarding, to a payer, the populated first and second electronic form associated with the HIPAA compliant eligibility request and the HIPAA compliant claim. - View Dependent Claims (28)
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Specification