MACHINE STRUCTURED PLAN DESCRIPTION

• US 20200134736A1
• Filed: 12/30/2019
• Published: 04/30/2020
• Est. Priority Date: 08/21/2018
• Status: Active Grant

• Current Assignee: Collective Health, Inc.
• Original Assignee: Collective Health, Inc.
• Inventors: Khalak, Asif, Martinez-Ortuno, Sergio, Chiv, Henning, Gard, Michelle Alicia, Wise, Emma Louise
• Granted Patent: US 11,393,039 B2
• Time in Patent Office: Days
• CPC Class Codes: G06Q 10/1057 Benefits or employee welfare, e.g. insurance, holiday or retirement packages
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A plan authoring tool can receive user input describing parameters of benefits of a benefit plan. The plan authoring tool can convert the user input into a machine structured plan description (MSPD) that defines the benefit plan. The MSPD can be used by a plan documentation generator to generate one or more plan documents that explain the benefits and/or indicate how to manually adjudicate claims submitted in association with the benefit plan. The MSPD can also be used to automatically adjudicate claims. Plan analysis tools can be used to evaluate an MSPD to validate a new or edited benefit plan and/or provide user feedback on the benefit plan so that users, if desired, can revise the MSPD via the plan authoring tool.

Claims

1. A computer-implemented method comprising:

receiving user input at a plan authoring tool, the user input describing one or more parameters of one or more benefits of a benefit plan;

translating, by the plan authoring tool, the user input into a machine structured plan description (MSPD) that represents the one or more benefits as plan objects of the MSPD;

loading the MSPD and a template into a plan documentation generator, the template corresponding to a document type and a document format; and

generating, by the plan documentation generator, a plan document associated with the benefit plan by converting information in one or more of the plan objects into natural language according to the template.