METHOD AND APPARATUS FOR AUTOMATIC HEALTHPLAN DATA RETRIEVAL AND RECONCILIATION USING A PROCESSING DEVICE

• US 20110320225A1
• Filed: 06/17/2011
• Published: 12/29/2011
• Est. Priority Date: 06/18/2010
• Status: Abandoned Application

• Current Assignee: Strategic Health Services
• Original Assignee: Strategic Health Services
• Inventors: Hulsey, Timothy D., Hulsey, Andrew T.
• Application Number:
  US13/162,721
• Publication Number:
  US 20110320225A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A method and apparatus for automatic healthplan data retrieval and reconciliation using a processing device is disclosed. The method may include retrieving accounting data, human resources data and health insurance data, comparing the accounting data, the human resources data and the health insurance data, identifying discrepancies between the accounting data, the human resources data and the health insurance data, and outputting the identified discrepancies to a user. The accounting data, human resources data and health insurance data pertain to individual employees'"'"' healthplans, and the identified discrepancies are related to enrollment, coverage and payment of healthplans.

Claims

1. A method for automatic healthplan data retrieval and reconciliation using a processing device, comprising:

retrieving accounting data, human resources data and health insurance data, wherein the accounting data, human resources data and health insurance data pertain to individual employees'"'"' healthplans;

comparing the accounting data, the human resources data and the health insurance data;

identifying discrepancies between the accounting data, the human resources data and the health insurance data, wherein the identified discrepancies are related to enrollment, coverage and payment of healthplans; and

outputting the identified discrepancies to a user.

2. The method of claim 1, wherein the human resources data includes at least one of employee identification information, employment status, healthplan enrollment status, healthplan identification, healthplan type, and dependent information.

3. The method of claim 1, wherein the accounting data includes at least one of employee identification information, employment status, an amount of payroll deductions for employees'"'"' healthplans, type of healthplan for which payroll deductions are made, and an amount of an employer'"'"'s contribution to the employee'"'"'s healthplan.

4. The method of claim 1, wherein the health insurance data includes at least one of employee identification information, employment status, an amount charged for employees'"'"' healthplans, type of healthplan for the amount charged, and an amount of an employer'"'"'s contribution to the employee'"'"'s healthplan.

5. The method of claim 1, wherein the identified discrepancies are output in a report for the user.

6. The method of claim 1, wherein at least one of company management, a third party administrator, a health insurance carrier, an accounting department, and a human resources department have at least some access to at least one of the accounting data, the human resources data, the health insurance data, and the identified discrepancies.

7. The method of claim 1, wherein the processing device is one of a server, a computer, and a handheld computer.

8. The method of claim 1, further comprising:

receiving proposed changes to at least one of accounting data, human resources data and health insurance data;

forecasting healthplan-related expenses based on the proposed changes to at least one of accounting data, human resources data and health insurance data, the healthplan-related expenses being at least one of a cost of increased/decreased subscribers on an employer'"'"'s healthplan, healthplan rate changes impact, healthplan demographics, effectiveness of healthplan changes, and cost of wellness programs; and

outputting the forecasted healthplan-related expenses to the user.

9. An apparatus that automatically retrieves and reconciles healthplan data, comprising:

a communication interface; and

a healthplan reconciliation unit that retrieves accounting data, human resources data and health insurance data through the communication interface, compares the accounting data, the human resources data and the health insurance data, identifies discrepancies between the accounting data, the human resources data and the health insurance data, outputs the identified discrepancies to a user,

wherein the accounting data, human resources data and health insurance data pertain to individual employees'"'"' healthplans and the identified discrepancies are related to enrollment, coverage and payment of healthplans.

10. The apparatus of claim 9, wherein the human resources data includes at least one of employee identification information, employment status, healthplan enrollment status, healthplan identification, healthplan type, and dependent information.

11. The apparatus of claim 9, wherein the accounting data includes at least one of employee identification information, employment status, an amount of payroll deductions for employees'"'"' healthplans, type of healthplan for which payroll deductions are made, and an amount of an employer'"'"'s contribution to the employee'"'"'s healthplan.

12. The apparatus of claim 9, wherein the health insurance data includes at least one of employee identification information, employment status, an amount charged for employees'"'"' healthplans, type of healthplan for the amount charged, and an amount of an employer'"'"'s contribution to the employee'"'"'s healthplan.

13. The apparatus of claim 9, wherein the healthplan reconciliation unit outputs the identified discrepancies in a report for the user.

14. The apparatus of claim 9, wherein at least one of company management, a third party administrator, a health insurance carrier, an accounting department, and a human resources department have at least some access to at least one of the accounting data, the human resources data, the health insurance data, and the identified discrepancies.

15. The apparatus of claim 9, wherein the apparatus is one of a server, a computer, a handheld computer, and a processing device.

16. The apparatus of claim 9, wherein the healthplan reconciliation unit receives proposed changes to at least one of accounting data, human resources data and health insurance data, forecasts healthplan-related expenses based on the proposed changes to at least one of accounting data, human resources data and health insurance data, the healthplan-related expenses being at least one of a cost of increased/decreased subscribers on an employer'"'"'s healthplan, healthplan rate changes impact, healthplan demographics, effectiveness of healthplan changes, and cost of wellness programs, and outputs the forecasted healthplan-related expenses to the user.

17. A non-transient computer-readable medium storing instructions for controlling a processing device for automatic healthplan data retrieval and reconciliation using a processing device, the instructions comprising:

retrieving accounting data, human resources data and health insurance data, wherein the accounting data, human resources data and health insurance data pertain to individual employees'"'"' healthplans;

comparing the accounting data, the human resources data and the health insurance data;

identifying discrepancies between the accounting data, the human resources data and the health insurance data, wherein the identified discrepancies are related to enrollment, coverage and payment of healthplans; and

outputting the identified discrepancies to a user.

18. The non-transient computer-readable medium of claim 17, wherein the human resources data includes at least one of employee identification information, employment status, healthplan enrollment status, healthplan identification, healthplan type, and dependent information.

19. The non-transient computer-readable medium of claim 17, wherein the accounting data includes at least one of employee identification information, employment status, an amount of payroll deductions for employees'"'"' healthplans, type of healthplan for which payroll deductions are made, and an amount of an employer'"'"'s contribution to the employee'"'"'s healthplan.

20. The non-transient computer-readable medium of claim 17, wherein the health insurance data includes at least one of employee identification information, employment status, an amount charged for employees'"'"' healthplans, type of healthplan for the amount charged, and an amount of an employer'"'"'s contribution to the employee'"'"'s healthplan.

21. The non-transient computer-readable medium of claim 17, wherein the identified discrepancies are output in a report for the user.

22. The non-transient computer-readable medium of claim 17, wherein at least one of company management, a third party administrator, a health insurance carrier, an accounting department, and a human resources department have at least some access to at least one of the accounting data, the human resources data, the health insurance data, and the identified discrepancies.

23. The non-transient computer-readable medium of claim 17, wherein the processing device is one of a server, a computer, and a handheld computer.

24. The non-transient computer-readable medium of claim 17, further comprising:

receiving proposed changes to at least one of accounting data, human resources data and health insurance data;

forecasting healthplan-related expenses based on the proposed changes to at least one of accounting data, human resources data and health insurance data, the healthplan-related expenses being at least one of a cost of increased/decreased subscribers on an employer'"'"'s healthplan, healthplan rate changes impact, healthplan demographics, effectiveness of healthplan changes, and cost of wellness programs; and

outputting the forecasted healthplan-related expenses to the user.