HEALTH PLAN SUBROGATION SYSTEM

• US 20110022408A1
• Filed: 07/23/2010
• Published: 01/27/2011
• Est. Priority Date: 07/23/2009
• Status: Abandoned Application

• Current Assignee: Healthcare Strategies, Inc.
• Original Assignee: Healthcare Strategies, Inc.
• Inventors: Albert, Janice K., Pramik, John
• Application Number:
  US12/842,427
• Publication Number:
  US 20110022408A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records

Abstract

A software system for providing assistance to third party healthcare payors and others in recouping funds to which they have a subrogation right. The system generally comprises a web enabled computer server and a dynamic information gathering module for instructing a processor to search a health insurance claims database for all claims of record meeting a specified criteria and display, and a search window for allowing a user to enter a selected black box drug and date range for searching said health insurance claims database. The software application can identify individuals who took a particular drug and had an adverse outcome, and can identify specific diagnoses which can be imputed back to drugs or chemical exposure (such as mesothelioma caused by exposure to asbestos, and liver toxicity caused by acetominophen (including combination drugs containing acetaminophen). The software system assists health insurers in collecting funds subject to a subrogation claim.

Claims

1. A software system for providing assistance to third party healthcare payors and others in recouping funds to which they have a subrogation right, comprising:

a health insurance claims database;

a web enabled computer server;

a dynamic information gathering module hosted on said web enabled computer server and accessible to a plurality of remote computer terminals, said dynamic information gathering module comprising a plurality of software instructions stored on a computer-readable medium for instructing a processor to search said health insurance claims database for all claims record all records meeting a specified criteria and display, and a search window for allowing a user to enter a selected black box drug and date range for searching said health insurance claims database.