Insurance claim filing system and method
First Claim
1. A method for enabling a practice management system of a service provider to file an insurance claim electronically via a payer'"'"'s web site, said insurance claim being based on billing data stored on said practice management system, said method comprising the steps of:
- electronically locating billing data stored on a practice management system of a service provider;
electronically eliminating a portion of said billing data intended for payers that do not permit online filing of claims;
downloading from a payer'"'"'s web site to a web portal format instructions for formatting billing data for online filing of insurance claims at said payer'"'"'s web site, said portal operated by a third party who is not a prayer nor said service provider;
determining by said web portal an address at said payer'"'"'s webs site for filing insurance claims;
conveying from said web portal said format instructions and said address to said practice management system of said service provider;
said practice management system electronically accessing said payer'"'"'s web site;
said practice management system electronically navigating to said payer'"'"'s web site to said address where said insurance claims can be filed;
then electronically formatting said billing data in accordance with said format instructions to generate insurance claims; and
then uploading said insurance claims to said payer'"'"'s web site.
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Accused Products
Abstract
A method and system for enabling a service provider to file insurance claims electronically directly with the payer rather than through a clearinghouse. The system has two components interacting with an existing practice management system of a service provider and with online claim filing systems of insurance payers. The first is a software application installed on the service provider'"'"'s computer to seek out billing information and create files suitable for filing of formatted claims with the payer'"'"'s web sites. The second component is a web portal that interacts with both the first component and the payers'"'"' web sites to keep the former with formatting requirements and to facilitate filing of the claims electronically. The system uses a software “cookie” to convey instructions to the first component so that it can automatically connect to the appropriate page of each payer'"'"'s web site.
92 Citations
12 Claims
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1. A method for enabling a practice management system of a service provider to file an insurance claim electronically via a payer'"'"'s web site, said insurance claim being based on billing data stored on said practice management system, said method comprising the steps of:
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electronically locating billing data stored on a practice management system of a service provider; electronically eliminating a portion of said billing data intended for payers that do not permit online filing of claims; downloading from a payer'"'"'s web site to a web portal format instructions for formatting billing data for online filing of insurance claims at said payer'"'"'s web site, said portal operated by a third party who is not a prayer nor said service provider; determining by said web portal an address at said payer'"'"'s webs site for filing insurance claims; conveying from said web portal said format instructions and said address to said practice management system of said service provider; said practice management system electronically accessing said payer'"'"'s web site; said practice management system electronically navigating to said payer'"'"'s web site to said address where said insurance claims can be filed; then electronically formatting said billing data in accordance with said format instructions to generate insurance claims; and then uploading said insurance claims to said payer'"'"'s web site. - View Dependent Claims (2, 3, 4, 5)
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6. A system for filing an insurance claim at a web site operated by a payer, said web site permitting electronic filing by a service provider of billing data formatted as an insurance claim said system comprising:
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a web portal, operated by a third party who is not a payer nor said service provider, programmed to obtain from each web site of plural web sites that permit electronic filing of insurance claims, insurance claim formatting instructions and a web page location for filing said formatted billing data, wherein each web site is operated by a different payer; and a computer operated by a service provider having access to stored billing data and programmed to log on to said web portal to receive said format instructions and said web page location from the portal, said computer programmed to retrieve and format said billing data in accordance with said format instructions and to file said formatted data files as insurance claims at said web page location. - View Dependent Claims (7, 8, 9)
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10. A system for filing insurance claims at plural web sites, each web site operated by a different payer, said plural web sites permitting electronic filing of insurance claims based on billing data said system comprising:
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means for collecting billing data located on a practice management computer system of a service provider; a web portal for obtaining from each web site format instructions and a web page location for filing an insurance claim, said portal operated by a third party different from said payers and said service provider; means for download from said web portal to said practice management computer system said format instructions and said web page location; means for logging said practice management computer system onto said each web site in sequence and navigating to each web page location obtained by said web portal; means located on the practice management computer system for automatically formatting said billing data in accordance with said format instructions obtained by said web portal to create insurance claims; and means for uploading said insurance claims to said each web page location from said automatic formatting means. - View Dependent Claims (11, 12)
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Specification