SYSTEM AND METHOD FOR MANAGING MEDICAL DATA AND FACILITATING REIMBURSEMENT FOR HEALTH CARE

• US 20110166875A1
• Filed: 01/05/2011
• Published: 07/07/2011
• Est. Priority Date: 01/05/2010
• Status: Abandoned Application

• Current Assignee: Abbott Diabetes Care Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: Abbott Diabetes Care Incorporated (Abbott Laboratories Incorporated)
• Inventors: Hayter, Gary A., Wei, Charles, Taub, Marc B.
• Application Number:
  US12/985,233
• Publication Number:
  US 20110166875A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management

Abstract

System and method receive medical data of a patient having a disease afflicted health condition for processing and analysis of that data. Software installed on a health care provider'"'"'s computer for processing the medical data includes a GUI reimbursement window that informs the HCP of reimbursement possibilities for analysis of the data and counseling of the patient. The reimbursement window also includes hyperlinks and may also include codes for insurance claims. Lists of reimbursement entities, pre-authorization instructions, coding instructions, and contacts may all be included and may be personalized for a particular patient. In one case, a complete bill is created and submitted to an insurance entity. In another, a patient data base is created so that the reimbursement window can inform the HCP of patient analysis frequency, which may affect reimbursement.

Claims

1. A method of managing medical data and facilitating reimbursement for data analysis, the method comprising:

selecting a program to process medical data;

automatically enabling a reimbursement display that includes information relating to reimbursement for analysis of medical data; and

selecting the reimbursement display of information and options for viewing.

2. The method of managing medical data and facilitating reimbursement of claim 1, wherein the step of enabling comprises enabling the display in a separate window.

3. The method of managing medical data and facilitating reimbursement of claim 2, wherein the window is interactive.

4. The method of managing medical data and facilitating reimbursement of claim 2, wherein the window provides specific instructions for obtaining reimbursement.

5. The method of managing medical data and facilitating reimbursement of claim 2, wherein the step of selecting the reimbursement display further comprises connecting the reimbursement window to an electronic reimbursement system by which an automated reimbursement process is initiated.

6. The method of managing medical data and facilitating reimbursement of claim 1, wherein the step of enabling comprises automatically enabling a display of reimbursement information and reimbursement options for analysis of processed medical data comprising at least one of:

linking to secondary websites related to reimbursement;

linking to websites containing reimbursement resources;

linking to websites containing a form usable for reimbursement;

linking to a request for obtaining reimbursement;

linking to a web page of a reimbursement entity;

creating a customizable superbill for reimbursement for analysis services;

creating a bill having relevant reimbursement codes;

checking reimbursement codes to confirm correct coding entries;

looking up reimbursement coding usage with a lookup tool;

automatically updating reimbursement codes;

displaying information directed to patient coverage pre-authorization requirement data;

displaying information directed to patient pre-authorization process instructions;

creating a patient coverage pre-authorization request;

displaying information related to evidence needed to justify reimbursement;

displaying information directed to workflow support so that a relevant function is provided in the right stages of serving the patient;

displaying alarms and notices relating to requirements for further information by a reimbursement entity; and

displaying information relating to audit trail records with respect to processing of information for the reimbursement entity.

7. The method of managing medical data and facilitating reimbursement of claim 1, wherein the step of automatically enabling a reimbursement display further comprises automatically enabling the display during operation of a medical data processing program.

8. The method of managing medical data and facilitating reimbursement of claim 1, further comprising uploading medical data, wherein the step of automatically enabling a reimbursement display further comprises automatically enabling the display as part of uploading medical data.

9. The method of managing medical data and facilitating reimbursement of claim 1, further comprising uploading medical data, and installing the reimbursement display from a source of the uploaded medical data.

10. The method of managing medical data and facilitating reimbursement of claim 1, further comprising uploading medical data from a physiological parameter monitor, and installing the reimbursement display from the physiological parameter monitor.

11. The method of managing medical data and facilitating reimbursement of claim 1, wherein the step of automatically enabling a reimbursement display comprises automatically enabling the reimbursement display upon receipt of patient analytics data.

12. The method of managing medical data and facilitating reimbursement of claim 1, wherein the step of automatically enabling a reimbursement display that includes information further comprises enabling a reimbursement display that includes at least one of:

additional reimbursement resources comprising billing codes;

additional reimbursement resources comprising diagnosis menus; and

additional reimbursement resources comprising potential treatment options.

13. A method of managing medical data and facilitating reimbursement for data analysis, the method comprising:

selecting a program to process medical data;

automatically enabling a reimbursement display in a separate interactive window of a GUI when processing medical data, the display including information relating to reimbursement for analysis of medical data and instructions for obtaining reimbursement;

uploading medical data from a physiological parameter monitor;

installing the reimbursement display from the physiological parameter monitor; and

selecting the reimbursement display of information and options for viewing.

14. The method of managing medical data and facilitating reimbursement of claim 13, wherein the step of selecting the reimbursement display further comprises connecting the reimbursement window to an electronic reimbursement system by which an automated reimbursement process is initiated.

15. The method of managing medical data and facilitating reimbursement of claim 13, wherein the step of enabling comprises automatically enabling a display of reimbursement information and reimbursement options for analysis of processed medical data comprising at least one of:

linking to secondary websites related to reimbursement;

linking to websites containing reimbursement resources;

linking to websites containing a form usable for reimbursement;

linking to a request for obtaining reimbursement;

linking to a web page of a reimbursement entity;

creating a customizable superbill for reimbursement for analysis services;

creating a bill having relevant reimbursement codes;

checking reimbursement codes to confirm correct coding entries;

looking up reimbursement coding usage with a lookup tool;

automatically updating reimbursement codes;

displaying information directed to patient coverage pre-authorization requirement data;

displaying information directed to patient pre-authorization process instructions;

creating a patient coverage pre-authorization request;

displaying information related to evidence needed to justify reimbursement;

displaying information directed to workflow support so that a relevant function is provided in the right stages of serving the patient;

displaying alarms and notices relating to requirements for further information by a reimbursement entity; and

displaying information relating to audit trail records with respect to processing of information for the reimbursement entity.

16. A medical data management system to facilitate reimbursement for analysis services on medical data, the analysis performed with a processor and a display, the system comprising:

a medical monitor configured to sense a physiological parameter relevant to a particular disease-afflicted health condition and to provide medical data representative of the sensed parameter; and

a physical medium containing a program configured to program a processor to;

automatically enable a reimbursement display that includes information relating to reimbursement for analysis of the received medical data; and

control a display to present the reimbursement display in a separate window.

17. The medical data management system to facilitate reimbursement for medical data analysis services of claim 16, wherein the program is further configured to program the processor to present in the reimbursement display at least one of:

a link to a secondary website related to reimbursement;

a link to a website containing reimbursement resources;

a link to a website containing a form usable for reimbursement;

a link to a request for obtaining reimbursement;

a link to a web page of a reimbursement entity;

information directed to patient coverage pre-authorization requirement data;

information directed to patient pre-authorization process instructions;

information related to evidence needed to justify reimbursement;

information directed to workflow support so that a relevant function is provided in the right stages of serving the patient;

alarms and notices relating to requirements for further information by a reimbursement entity;

information relating to audit trail records with respect to processing of information for the reimbursement entity;

and is further configured to program the processor to perform at least one of;

create a customizable superbill for reimbursement for analysis services;

create a bill having relevant reimbursement codes;

check reimbursement codes to confirm correct coding entries;

look up reimbursement coding usage with a lookup tool;

automatically update reimbursement codes; and

create a patient coverage pre-authorization request.

18. The medical data management system to facilitate reimbursement for medical data analysis services of claim 16, wherein the program is further configured to program the processor to connect the reimbursement window to an electronic reimbursement system by which an automated reimbursement process is initiated.

19. The medical data management system to facilitate reimbursement for medical data analysis services of claim 16, wherein the program is further configured to program the processor to upload medical data from the medical monitor and install the reimbursement display from the medical monitor.

20. The medical data management system to facilitate reimbursement for medical data analysis services of claim 16, wherein:

the medical monitor comprises a glucose sensor configured to sense a glucose level and to provide glucose level signals; and

the program is further configured to program the processor to receive the glucose level signals, analyze the received glucose level signals, enable the reimbursement display that includes information relating to reimbursement for the analysis, and present the reimbursement display on the display.