SYSTEMS AND METHODS FOR ALLOCATING PAYMENTS ACROSS MULTIPLE HEALTHCARE ACCOUNTS

• US 20150051915A1
• Filed: 08/14/2013
• Published: 02/19/2015
• Est. Priority Date: 08/14/2013
• Status: Abandoned Application

• Current Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Original Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Inventors: Moore, Matthew E.
• Application Number:
  US13/966,799
• Publication Number:
  US 20150051915A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 20/102 Bill distribution or payments
• CPC Class Codes: G06Q 20/22 Payment schemes or models
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records

Abstract

Systems and methods are provided for facilitating account payment posting transactions. A computer-implemented method may include receiving, from a computer associated with a healthcare provider, a healthcare payment transaction for a patient, wherein the healthcare payment transaction comprises an identifier for a guarantor of the patient and a total payment amount. The method may also include determining, based at least in part on the guarantor identifier, one or more open medical accounts for the guarantor, the one or more open medical accounts having respective outstanding balances. Furthermore, the method may include comparing the total payment amount with the respective outstanding balances and generating, based at least in part on the comparison, an account payment posting transaction. The account payment posting transaction may indicate respective amounts, of the total payment amount, to be allocated to the one or more open medical accounts. Additionally, the method may include transmitting the account payment posting transaction to the computer associated with the healthcare provider

Claims

1. A computer-implemented method, comprising:

receiving, by a service provider computer associated with a service provider from a healthcare provider computer associated with a healthcare provider, a healthcare payment transaction for a patient, wherein the healthcare payment transaction comprises an identifier for a guarantor of the patient and a total payment amount;

determining, by the service provider computer based at least in part on the guarantor identifier, one or more open medical accounts for the guarantor, each of the one or more open medical accounts having a respective outstanding balance;

comparing, by the service provider computer, the total payment amount with the respective outstanding balances for the open medical accounts;

generating, by the service provider computer based at least in part on the comparison, an account payment posting transaction comprising an indication of respective amounts of the total payment amount to be allocated to each of the one or more open medical accounts; and

transmitting, by the service provider computer, the account payment posting transaction to the healthcare provider computer.

2. The computer-implemented method of claim 1, wherein the healthcare payment transaction is a guarantor payment posting transaction.

3. The computer-implemented method of claim 1, wherein the healthcare provider computer comprises at least one of a healthcare provider computer or a remittance processor computer.

4. The computer-implemented method of claim 1, wherein comparing the total payment amount with the respective outstanding balances comprises:

determining, by the service provider computer, whether to apply a set of payment allocation rules to the respective outstanding balances of the one or more open medical accounts; and

allocating, upon negative determination to apply the set of payment allocation rules, the total payment amount to the respective outstanding balances.

5. The computer-implemented method of claim 4, further comprising:

allocating, by the service provider computer and based upon a positive determination to apply the set of payment allocation rules, the respective amounts of the payment, of the total payment amounts, to the respective outstanding balances according to the set of payment allocation rules.

6. The computer-implemented method of claim 1, further comprising:

determining, by the service provider computer, a healthcare provider identifier of the healthcare provider computer;

identifying, by the service provider computer based at least in part on the healthcare provider identifier, a user profile of the healthcare provider; and

determining whether a payment allocation rule exists for the healthcare provider.

7. The computer-implemented method of claim 4, wherein the set of payment allocation rules comprises at least one of a rule for overpayments, a rule for underpayments, a rule for an excess of open medical accounts, or a rule for a shortage of open medical accounts.

8. A system comprising:

at least one processor; and

at least one memory storing computer-executable instructions, that when accessed by the at least one processor, causes the at least one processor to;

receive, from a healthcare provider computer associated with a healthcare provider, a healthcare payment transaction for a patient, wherein the healthcare payment transaction comprises an identifier for a guarantor of the patient and a total payment amount;

determine, based at least in part on the guarantor identifier, one or more open medical accounts for the guarantor, each of the one or more open medical accounts having a respective outstanding balance;

compare the total payment amount with the respective outstanding balances for the open medical accounts;

generate, based at least in part on the comparison, an account payment posting transaction comprising an indication of respective amounts of the total payment amount to be allocated to each of the one or more open medical accounts; and

transmit the account payment posting transaction to the healthcare provider computer associated with the healthcare provider.

9. The system of claim 8, wherein the healthcare payment transaction is a guarantor payment posting transaction.

10. The system of claim 8, wherein the healthcare provider computer comprises at least one of a healthcare provider computer or a remittance processor computer.

11. The system of claim 8, wherein the computer-executable instructions to compare the total payment amount with the respective outstanding balances comprises computer-executable instructions to:

determine whether to apply a set of payment allocation rules to the respective outstanding balances of the one or more open medical accounts; and

allocate, upon negative determination to apply the set of payment allocation rules, the total payment amount to the respective outstanding balances

12. The system of claim 11, wherein the instructions further cause the at least one processor to:

allocate, upon a positive determination to apply the set of payment allocation rules, the respective amounts of the payment, of the total payment amounts, to the respective outstanding balances according to the set of payment allocation rules.

13. The system of claim 11, wherein the set of payment allocation rules is accessed from a database in communication with the service provider computer.

14. The system of claim 11, wherein the set of payment allocation rules comprises at least one of a rule for overpayments, a rule for underpayments, a rule for an excess of open medical accounts, or a rule for a shortage of open medical accounts.

15. A non-transitory computer-readable medium comprising computer-executable instructions, that when executed by at least one processor, causes the at least one processor to:

receive, from a healthcare provider computer associated with a healthcare provider, a healthcare payment transaction for a patient, wherein the healthcare payment transaction comprises an identifier for a guarantor of the patient and a total payment amount;

determine, based at least in part on the guarantor identifier, one or more open medical accounts for the guarantor, each of the one or more open medical accounts having a respective outstanding balance;

compare the total payment amount with the respective outstanding balances for the open medical accounts;

generate, based at least in part on the comparison, an account payment posting transaction comprising an indication of respective amounts of the total payment amount to be allocated to each of the one or more open medical accounts; and

transmit the account payment posting transaction to the computer associated with the healthcare provider.

16. The non-transitory computer-readable medium of claim 15, wherein the healthcare payment transaction is a guarantor payment posting transaction.

17. The non-transitory computer-readable medium of claim 15, wherein the healthcare provider computer comprises at least one of a healthcare provider computer or a remittance processor computer.

18. The non-transitory computer-readable medium of claim 15, wherein the computer-executable instructions to compare the total payment amount with the respective outstanding balances comprises computer-executable instructions to:

determine whether to apply a set of payment allocation rules to the respective outstanding balances of the one or more open medical accounts; and

allocate, upon negative determination to apply the set of payment allocation rules, the total payment amount to the respective outstanding balances

19. The non-transitory computer-readable medium of claim 18, wherein the instructions further cause the at least one processor to:

allocate, upon a positive determination to apply the set of payment allocation rules, the respective amounts of the payment, of the total payment amounts, to the respective outstanding balances according to the set of payment allocation rules.

20. The non-transitory computer-readable medium of claim 18, wherein the set of payment allocation rules comprises at least one of a rule for overpayments, a rule for underpayments, a rule for an excess of open medical accounts, or a rule for a shortage of open medical accounts.