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System and method for processing flexible spending account transactions

  • US 7,174,302 B2
  • Filed: 06/11/2001
  • Issued: 02/06/2007
  • Est. Priority Date: 06/11/2001
  • Status: Active Grant
First Claim
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1. A method for processing a request to authorize payment against an account for reimbursing patient responsible balances (PRBs), comprising the steps of:

  • receiving from at least one payor data indicative of transactions involving adjudicated claims and associated PRBs;

    storing in a payor transaction database said data received from the at least one payor;

    receiving from a goods or service provider a request to authorize payment of a PRB against said account, wherein said account is associated with a customer in connection with a sales transaction between said customer and the goods or service provider; and

    initiating a substantiation process for the payment to the goods or service provider for the sales transaction prior to the authorization of the payment for the sales transaction, the substantiation process comprising;

    querying the payor transaction database;

    in the event that the payor transaction database contains transaction information of at least one transaction that matches said sales transaction, matching the transaction information to the sales transaction, then communicating to the goods or service provider authorization for payment of the PRB against the account, and settling the authorized payment of the PRB against the account; and

    in the event that the payor transaction database does not contain transaction information that matches said sales transaction, communicating to the goods or service provider a denial of payment of the payment of the PRB against the account.

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