Account Management with Estimate Benefits

• US 20130246090A1
• Filed: 03/15/2013
• Published: 09/19/2013
• Est. Priority Date: 03/15/2012
• Status: Abandoned Application

• Current Assignee: Experian Health, Inc. (Experian plc)
• Original Assignee: Passport Health Communications (Experian plc)
• Inventors: Hoffman, Paul Joseph, Mansfield, Lance Clifford
• Application Number:
  US13/832,185
• Publication Number:
  US 20130246090A1
• 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

Abstract

Estimate of benefits (EOB) data and healthcare billing data are provided in a single user interface. By providing a display of billing information and EOB information on a same screen, a patient may be enabled to better understand his payment responsibility compared to an amount owed to a healthcare provider. When a patient logs into a healthcare billing account, healthcare billing data may be provided, as well as input fields for entering EOB data. When EOB data is received, the billing data received from the healthcare provider billing system and the EOB data may be displayed in the single user interface. If a total of entered EOB amounts does not equal a total amount owed to the healthcare provider, a notification may be provided.

Claims

1. A method for providing estimate of benefits data with healthcare billing data in a single user interface, the method comprising:

receiving healthcare billing data associated with a patient account with a healthcare provider;

receiving estimate of benefits data associated with a healthcare encounter with the healthcare provider;

storing the received healthcare billing data and received estimate of benefits data; and

providing a display of the received healthcare billing data and received estimate of benefits data in a single user interface.

2. The method of claim 1, further comprising:

determining if an amount owed to the healthcare provider associated with the healthcare encounter equals a total estimate of benefits amount; and

if the amount owed to the healthcare provider associated with the healthcare encounter does not equal the total estimate of benefits amount, providing a notification.

3. The method of claim 1, wherein receiving healthcare billing data associated with a patient account with a healthcare provider comprises receiving healthcare billing data from a healthcare provider billing system.

4. The method of claim 1, wherein receiving estimate of benefits data associated with a healthcare encounter with the healthcare provider comprises receiving one or more of:

an amount not covered by a payer;

an amount applied to a deductible amount;

a co-pay amount;

or

a co-insurance amount.

5. The method of claim 4, wherein receiving estimate of benefits data associated with a healthcare encounter with the healthcare provider comprises receiving the estimate of benefits data via the single user interface.

6. The method of claim 1, further comprising providing one or more input fields in the single user interface for allowing a patient to enter estimate of benefits data associated with the healthcare encounter with the healthcare provider.

7. The method of claim 1, further comprising providing one or more input fields in the single user interface for allowing the healthcare provider to enter estimate of benefits data associated with the healthcare encounter with the healthcare provider.

8. The method of claim 1, further comprising providing one or more input fields in the single user interface for allowing an intermediary system to enter estimate of benefits data associated with a healthcare encounter with the healthcare provider.

9. The method of claim 1, further comprising:

receiving modified estimate of benefits data associated with the healthcare encounter with the healthcare provider;

storing the received modified estimate of benefits data;

providing a display of the received healthcare billing data and received modified estimate of benefits data in the single user interface.

determining if the amount owed to the healthcare provider associated with the healthcare encounter equals the total modified estimate of benefits amount; and

if the amount owed to the healthcare provider associated with the healthcare encounter does not equal the total modified estimate of benefits amount, providing a notification.

10. A system for providing an exception-based integrated patient access workflow, the system comprising:

a memory storage; and

a processing unit coupled to the memory storage, wherein the processing unit is operable to;

receive healthcare billing data associated with a patient account with a healthcare provider;

receive estimate of benefits data associated with a healthcare encounter with the healthcare provider;

store the received healthcare billing data and received estimate of benefits data; and

provide a display of the received healthcare billing data and received estimate of benefits data in a single user interface.

11. The system of claim 10, wherein the processing unit is further operable to:

determine if an amount owed to the healthcare provider associated with the healthcare encounter equals a total estimate of benefits amount; and

if the amount owed to the healthcare provider associated with the healthcare encounter does not equal the total estimate of benefits amount, provide a notification.

12. The system of claim 10, wherein the healthcare billing data associated with a patient account with a healthcare provider is received from a healthcare provider billing system.

13. The system of claim 10, wherein the estimate of benefits data associated with a healthcare encounter with the healthcare provider comprises one or more of:

an amount not covered by a payer;

an amount applied to a deductible amount;

a co-pay amount;

or

a co-insurance amount.

14. The system of claim 13, wherein the processing unit is further operable to receive the estimate of benefits data via the single user interface.

15. The system of claim 10, wherein the processing unit is further operable to provide one or more input fields in the single user interface for allowing a patient to enter estimate of benefits data associated with the healthcare encounter with the healthcare provider.

16. The system of claim 10, wherein the processing unit is further operable to provide one or more input fields in the single user interface for allowing the healthcare provider to enter estimate of benefits data associated with the healthcare encounter with the healthcare provider.

17. The system of claim 10, wherein the processing unit is further operable to provide one or more input fields in the single user interface for allowing an intermediary system to enter estimate of benefits data associated with the healthcare encounter with the healthcare provider.

18. A computer readable medium containing computer executable instructions which when executed by a computer perform a method of providing estimate of benefits data with healthcare billing data in a single user interface, the method comprising:

receiving healthcare billing data associated with a patient account with a healthcare provider, the healthcare billing data provided by a healthcare provider billing system;

receiving estimate of benefits data associated with a healthcare encounter with the healthcare provider, the estimate of benefits data received via one or more input fields in a user interface and including one or more of;

an amount not covered by a payer;

an amount applied to a deductible amount;

a co-pay amount;

or

a co-insurance amount;

storing the received healthcare billing data and received estimate of benefits data;

providing a display of the received healthcare billing data and received estimate of benefits data in the user interface;

determining if an amount owed to the healthcare provider associated with the healthcare encounter equals a total estimate of benefits amount; and

if the amount owed to the healthcare provider associated with the healthcare encounter does not equal the total estimate of benefits amount, providing a notification.

19. The computer readable medium of claim 18, further comprising providing one or more input fields in the single user interface for allowing input of estimate of benefits data associated with the healthcare encounter with the healthcare provider, the input provided by one of:

a patient;

the healthcare provider;

or

an intermediary system.

20. The computer readable medium of claim 18, further comprising:

receiving modified estimate of benefits data associated with the healthcare encounter with the healthcare provider;

storing the received modified estimate of benefits data;

providing a display of the received healthcare billing data and received modified estimate of benefits data in the single user interface. determining if the amount owed to the healthcare provider associated with the healthcare encounter equals the total modified estimate of benefits amount; and

if the amount owed to the healthcare provider associated with the healthcare encounter does not equal the total modified estimate of benefits amount, providing a notification.