Billing modifier module for integrated emergency medical transportation database system
First Claim
1. An integrated emergency medical transportation database system having a billing modifier module, the system comprising:
- a medical emergency database configured to store at least clinical encounter information and transport information, wherein the transport information is associated with the clinical encounter information by at least including a location of a patient medical emergency; and
a billing modifier module configured to access the clinical encounter location stored in the medical emergency database and configured to compare the clinical encounter location to a list of geographic areas, and further configured so that the result of the comparison is used to determine at least one billing modifier to be applied to the medical charges associated with the medical emergency.
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Accused Products
Abstract
An integrated medical database system for the emergency medical transportation business. The system includes a dispatch and demographic module, a clinical module, an administration module and a billing module. Each module may communicate data with one or more of the other modules to form a system incorporating data sharing, thus achieving an end-to-end automation of emergency medical care accounting. Internal consistency checks are performed by the system to ensure that proper treatments are performed according to a chosen diagnosis. The system includes a billing modifier module operating on data from the dispatch and demographic module. In one embodiment, the billing modifier module applies Geographic Practice Cost Index (GPCI) and Metropolitan Statistical Area (MSA) billing modifiers based on modifiable computerized rules so as to provide a more accurate charge to the payer. The results of the billing modifier module are forwarded to the billing module.
67 Citations
33 Claims
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1. An integrated emergency medical transportation database system having a billing modifier module, the system comprising:
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a medical emergency database configured to store at least clinical encounter information and transport information, wherein the transport information is associated with the clinical encounter information by at least including a location of a patient medical emergency; and a billing modifier module configured to access the clinical encounter location stored in the medical emergency database and configured to compare the clinical encounter location to a list of geographic areas, and further configured so that the result of the comparison is used to determine at least one billing modifier to be applied to the medical charges associated with the medical emergency. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 13, 19, 20, 21, 22, 23, 24, 25, 26)
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11. A method of billing modification for an integrated emergency medical transportation database system, the method comprising:
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collecting at least clinical encounter information and transport information into a medical emergency database, wherein the transport information is associated with the clinical encounter information by at least including a location of a patient medical emergency; accessing the clinical encounter location stored in the medical emergency database; comparing the clinical encounter location to a list of geographic areas; determining a billing modifier based on the comparison; and applying the billing modifier to the medical charges associated with the medical emergency. - View Dependent Claims (12, 14, 15, 16, 17, 18, 27, 28, 29, 30, 31, 32)
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33. An integrated emergency medical transportation database system having a billing modifier module, the system comprising:
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a medical emergency database configured to store at least clinical encounter information and transport information, wherein the transport information is associated with the clinical encounter information by at least including a location of a patient medical emergency; and a billing modifier module configured to access the clinical encounter location stored in the medical emergency database and configured to compare the clinical encounter location to a list of geographic areas, and further configured so that the result of the comparison is used to determine at least one enhancement factor to be applied to the medical charges associated with the medical emergency.
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Specification