Method of product procurement and cash flow including a manufacturer, a transaction facilitator, and third party payor

• US 7,340,401 B1
• Filed: 06/18/2001
• Issued: 03/04/2008
• Est. Priority Date: 06/18/2001
• Status: Expired due to Fees

• Current Assignee: Jeffrey J. Mathy, Martin D. Koenig
• Original Assignee: Jeffrey J. Mathy, Martin D. Koenig
• Inventors: Mathy, Jeffrey J., Koenig, Martin D.
• Primary Examiner(s): Gilligan; C. Luke
• Assistant Examiner(s): KOPPIKAR, VIVEK D
• Application Number:
  US09/883,557
• Time in Patent Office: 2,451 Days
• Field of Search: 705 2- 4, 705/26
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/0613 Third-party assisted
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A method of order placement and product delivery between a healthcare facility and a third party payor, such as an insurance provider, in which a transaction facilitator submits the order for a prescribed medical device and generates a claim from the transaction facilitator to the insurance company. The healthcare facility initially contacts the insurance provider to obtain authorization for a prescribed medical device and medical procedure. Upon granting authorization, the insurance provider contacts the transaction facilitator to select the medical device. The transaction facilitator orders the medical device and arranges for delivery from manufacturer to the healthcare facility. Upon implantation, the transaction facilitator bills the insurance provider. At no time does the healthcare facility receive a bill from the manufacturer, thereby eliminating the bill for the medical device from the healthcare facility to the insurance provider.

Claims

1. A method of providing a device, the cost of which is covered by a third party payor, to a health care facility and obtaining payment for the device from the third party payor, the method comprising the steps of:

submitting a request for the device from the health care facility to the third party payor for authorization of payment;

relaying the request for the device from the third party payor to a transaction facilitator, the transaction facilitator being separate from the health care facility;

utilizing the transaction facilitator for contacting a manufacturer for the device to order the device requested by the health care facility without communication between the health care facility and the manufacturer, wherein the manufacturer delivers the device to the health care facility without billing the health care facility;

generating a cost claim for the device from the transaction facilitator to the third party payor;

receiving payment at the transaction facilitator for the claim from the third party payor; and

transferring funds from the transaction facilitator to the manufacturer for payment for the device.

2. The method of claim 1 wherein the transaction facilitator includes an on-line website, wherein the step of relaying the request for the device from the third party payor to the transaction facilitator includes the third party payor electronically contacting the website.

3. The method of claim 2 wherein the step of submitting a request for the device to the third party payor includes the step of the health care facility electronically connecting to the website of the transaction facilitator to submit the request for the device.

4. The method of claim 2 wherein the step of ordering the device includes generating an electronic message from the website of the transaction facilitator to the manufacturer indicating that an order has been placed for the device.

5. The method of claim 4 further comprising the step of the device manufacturer accessing the website of the transaction facilitator to receive the order placed by the third party payor.

19. The method of claim 1 wherein the transaction facilitator is separate from the third party payor and the healthcare facility.

6. A method of providing a prescribed medical device covered by insurance to a healthcare facility and obtaining payment for the medical device from an insurance provider, the method comprising the steps of:

submitting a request for the medical device from the healthcare facility to the insurance provider for authorization;

relaying the request for the medical device from the insurance provider to a transaction facilitator, the transaction facilitator being separate from the health care facility;

utilizing the transaction facilitator to electronically contact a manufacturer for the medical device to order the medical device requested by the health care facility without communication between the health care facility and the manufacturer, wherein the manufacturer delivers the medical device to the healthcare facility without billing the health care facility;

generating a claim for the medical device from the transaction facilitator to the insurance provider;

receiving payment at the transaction facilitator for the claim from the insurance provider; and

transferring funds from the transaction facilitator to the device manufacturer for payment for the medical device.

7. The method of claim 6 wherein the transaction facilitator includes an on-line website, wherein the step of relaying the request for the medical device from the insurance provider to the transaction facilitator includes the insurance provider electronically contacting the website.

8. The method of claim 7 wherein the step of submitting a request for the medical device to the insurance company includes the step of the healthcare facility electronically connecting to the website of the transaction facilitator to submit the request for the medical device.

9. The method of claim 7 wherein the step of ordering the medical device includes generating an electronic message from the website of the transaction facilitator to the device manufacturer indicating that an order has been placed for a medical device.

10. The method of claim 9 further comprising the step of the manufacturer accessing the website of the transaction facilitator to receive the order placed by the insurance provider.

20. The method of claim 6 wherein the transaction facilitator is separate from the insurance provider and the healthcare facility.

11. A method of providing a device for use with a patient, the cost of which is covered by a third party payor, to a healthcare facility, the method comprising the steps of:

electronically submitting a request for a proposed treatment and a preferred device from the healthcare facility to the third party payor;

providing electronic authorization from the third party payor to the healthcare facility for the proposed treatment;

upon authorization, relaying the request for the preferred device from the third party payor to a transaction facilitator;

utilizing the transaction facilitator to contact a manufacturer for the device to order the device, wherein the manufacturer delivers the device to the health care facility without billing the health care facility;

generating a claim for the device from the transaction facilitator to the third party payor without billing the healthcare facility;

receiving payment at the transaction facilitator for the claim from the third party payor; and

transferring funds from the transaction facilitator to the manufacturer for payment for the device.

12. The method of claim 11 wherein the step of authorizing the proposed treatment and the preferred device includes providing patient identification information and insurance coverage information to the third party payor prior to authorization.

13. The method of claim 11 wherein the request for the preferred device is made after the healthcare facility receives authorization for the proposed treatment.

14. The method of claim 11 wherein the step of authorizing the proposed treatment and the preferred device includes prompting the healthcare facility to respond to pre-determined treatment questions prior to receiving electronic authorization.

15. The method of claim 11 wherein the third party payor includes an on-line web site such that the requests for the proposed treatment and the preferred device are submitted to the third party payor web site.

16. The method of claim 15 wherein the transaction facilitator includes an on-line web site such that the third party payor electronically contacts the transaction facilitator web site.

17. The method of claim 11 wherein the step of requesting the preferred device includes selecting the preferred device from a list of devices.

18. The method of claim 11 wherein the request for the proposed treatment and the preferred device are both made prior to the electronic authorization from the third party payor.