System and method for projecting flexible spending account allocations

• US 8,204,768 B1
• Filed: 03/30/2007
• Issued: 06/19/2012
• Est. Priority Date: 03/30/2007
• Status: Active Grant

• Current Assignee: Intuit, Inc.
• Original Assignee: Intuit, Inc.
• Inventors: Grinberg, Milton
• Primary Examiner(s): Wong, Eric T
• Application Number:
  US11/694,290
• Time in Patent Office: 1,908 Days
• Field of Search: 705/35, 705/4
• US Class Current: 705/4
• CPC Class Codes: G06Q 40/00 Finance; Insurance; Tax strategies; Processing of corporate or income taxes
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A system and method for projecting a flexible spending account (FSA) allocation for a consumer may be dependent on historical healthcare-related claim information, including health insurance claim information and FSA reimbursement claim information. The method may be implemented as a web-based service or as a stand-alone software application. An FSA allocation application may identify, in historical claim information, recurring expenses predicted to be incurred in a given future time period, and may estimate an initial allocation for the time period based on these recurring expenses. The FSA allocation application may produce a recommended allocation by adjusting the initial allocation dependent on expected changes in the consumer'"'"'s health insurance plan, the consumer'"'"'s dependents, the health of one or more family members, tax regulations, or costs of medical services. An FSA allocation application may be configured to exchange information with a comprehensive healthcare management application, which may maintain the historical claim information.

Claims

1. A computer-implemented method, comprising:

receiving, at a consumer computing system, historical healthcare-related claim information comprising one or more prior healthcare-related expenses relating to previously filed healthcare claims and historical healthcare expense information relating to prior healthcare-related expenses that have not been claimed for either insurance or flexible spending account reimbursement;

predicting, using the consumer computing system, that at least one of the one or more prior healthcare-related expenses is likely to be incurred in a given future time period, the predicting comprising consideration of how long a given recurring expense or associated condition has existed, whether a single-treatment expense in the historical healthcare related claim information relates to a treatment that typically involves a series of treatments, and whether multiple claims within the historical healthcare-related claim information are associated with duplicate information, the duplicate information including diagnosis code, treatment or procedure code, or prescription name;

estimating an initial flexible spending account allocation dependent on said determining and also on identifying whether the number of claims and expenses associated with one or more particular conditions have increased over a given time period and thus are likely to increase further; and

producing a recommended flexible spending account allocation for a healthcare consumer corresponding to the given future time period dependent on said initial flexible spending account allocation and on projected benefits of one or more health insurance plans for the given future time period.

2. The method of claim 1, wherein the historical healthcare-related claim information comprises healthcare-related claim information for the healthcare consumer for a current health insurance plan year.

3. The method of claim 1, wherein the historical healthcare-related claim information comprises healthcare-related claim information for the healthcare consumer for two or more previous health insurance plan years.

4. The method of claim 1, wherein the historical healthcare-related claim information comprises health insurance claim information and flexible spending account reimbursement claim information.

5. The method of claim 1, wherein the historical healthcare-related claim information comprises healthcare-related claim information received from a healthcare management application.

6. The method of claim 1, wherein said determining comprises determining a duration of a medical condition or course of treatment.

7. The method of claim 1, wherein said determining comprises receiving confirmation from the healthcare consumer that the at least one of the one or more prior expenses is expected to be incurred in the given future time period.

8. The method of claim 1, wherein said estimating comprises calculating an amount at least as large as a sum of the at least one of the one or more prior expenses predicted to be incurred in the given future time period.

9. The method of claim 1, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on any differences between said projected benefits and benefits of a prior year health insurance plan.

10. The method of claim 1, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on other historical healthcare-related expense information received on behalf of the healthcare consumer.

11. The method of claim 1, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on projected healthcare-related expense information received on behalf of the healthcare consumer.

12. The method of claim 1, further comprising receiving information indicating a change in one or more dependents of the healthcare consumer, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on said received information.

13. The method of claim 1, further comprising receiving information indicating a change in health for the healthcare consumer or one or more dependents of the healthcare consumer, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on said received information.

14. The method of claim 1, further comprising detecting in said historical healthcare-related claim information one or more of:

an average of two or more similar expenses, a trend in expenses associated with a given condition, a rate of change in a group of related expenses, and a rate of change in a recurring expense, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on results of said detecting.

15. The method of claim 1, wherein said accessing, said determining, said estimating, and said producing are performed by a software application configured to produce a recommended flexible spending account allocation for an upcoming FSA plan period.

16. A computing system, comprising:

one or more processors;

memory coupled to the one or more processors, wherein the memory is configured to store;

historical healthcare-related claim information comprising one or more prior healthcare-related expenses relating to previously filed healthcare claims and historical healthcare expense information relating to prior healthcare-related expenses that have not been claimed for either insurance or flexible spending account reimbursement; and

program instructions executable by the one or more processors to implement a flexible spending account allocation application configured to;

access the historical healthcare-related claim information and the historical healthcare expense information;

predict that at least one of the one or more prior healthcare-related expenses is likely to be incurred in a given future time period, the predicting comprising consideration of how long a given recurring expense or associated condition has existed, whether a single-treatment expense in the historical healthcare related claim information relates to a treatment that typically involves a series of treatments, and whether multiple claims within the historical healthcare-related claim information are associated with duplicate information, the duplicate information including diagnosis code, treatment or procedure code, or prescription name;

estimate an initial flexible spending account allocation dependent on said determining and also on identifying whether the number of claims and expenses associated with one or more particular conditions have increased over a given time period and thus are likely to increase further; and

produce a recommended flexible spending account allocation for a healthcare consumer corresponding to the given future time period dependent on said initial flexible spending account allocation and on projected benefits of one or more health insurance plans.

17. The system of claim 16, wherein the historical healthcare-related claim information comprises healthcare-related claim information for the healthcare consumer for one or more health insurance plan years.

18. The system of claim 16, wherein the historical healthcare-related claim information comprises one or more of:

health insurance claim information and flexible spending account reimbursement claim information.

19. The system of claim 16, wherein the historical healthcare-related claim information comprises healthcare-related claim information received from a healthcare management application.

20. The system of claim 16, wherein said determining comprises determining a duration of a medical condition or course of treatment.

21. The system of claim 16, wherein to determine if any of the one or more prior expenses are predicted to be incurred in the given future time period, said flexible spending account allocation application is further configured to prompt the healthcare consumer to provide an indication of whether or not any of the one or more prior expenses are expected to be incurred in the given future time period.

22. The system of claim 16, wherein said estimating comprises calculating an amount at least as large as a sum of the at least one of the one or more prior expenses predicted to be incurred in the given future time period.

23. The system of claim 16, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on one or more of:

any differences between said projected benefits and any prior year health insurance plan benefits, other historical healthcare-related expense information received on behalf of the healthcare consumer, and projected healthcare-related expense information received on behalf of the healthcare consumer.

24. The system of claim 16, wherein said flexible spending account allocation application is further configured to receive information indicating a change in one or more dependents of the healthcare consumer or a change in health for the healthcare consumer or one or more dependents of the healthcare consumer, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on said received information.

25. The system of claim 16, wherein said flexible spending account allocation application is further configured to detect in said historical healthcare-related claim information one or more of:

an average of two or more similar expenses, a trend in expenses associated with a given condition, a rate of change in a group of related expenses, and a rate of change in a recurring expense, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on results of said detecting.

26. The system of claim 16, wherein said flexible spending account allocation application is further configured to prompt the healthcare consumer to provide information indicating any expected changes in health insurance plan benefits, any expected changes in one or more dependents of the healthcare consumer, or any expected changes in health for the healthcare consumer or one or more dependents of the healthcare consumer, wherein said producing comprises adjusting said initial flexible spending account allocation dependent on the information provided in response to said prompt.

27. A nontransitory computer-readable storage medium, comprising program instructions computer-executable to implement a reimbursement account allocation application configured to:

receive historical healthcare-related claim information comprising one or more prior healthcare-related expenses relating to previously filed healthcare claims and historical healthcare expense information relating to prior healthcare-related expenses that have not been claimed for either insurance or flexible spending account reimbursement;

predict that at least one of the one or more prior healthcare-related expenses is likely to be incurred in a given future time period, the predicting comprising consideration of how long a given recurring expense or associated condition has existed, whether a single-treatment expense in the historical healthcare related claim information relates to a treatment that typically involves a series of treatments, and whether multiple claims within the historical healthcare-related claim information are associated with duplicate information, the duplicate information including diagnosis code, treatment or procedure code, or prescription name;

estimate an initial reimbursement account allocation dependent on said determining and also on identifying whether the number of claims and expenses associated with one or more particular conditions have increased over a given time period and thus are likely to increase further; and

produce a recommended reimbursement account allocation for a consumer corresponding to the given future time period dependent on said initial reimbursement account allocation and on projected benefits related to the reimbursement account.

28. The storage medium of claim 27, wherein the reimbursement account is a dependent care account (DCA).

29. The storage medium of claim 28, wherein said producing comprises adjusting the initial reimbursement account allocation dependent on one or more of:

a change in applicable regulations, a change in an employer-specified maximum allowable DCA allocation, a change in status for one or more dependents of the consumer, and an anticipated change in dependent care expenses for the given future time period.

30. The storage medium of claim 27, wherein the reimbursement account is a flexible spending account (FSA).

31. The storage medium of claim 30, wherein the historical claim information comprises healthcare-related claim information for the consumer for one or more health insurance plan years.

32. The storage medium of claim 30, wherein the historical claim information comprises one or more of:

health insurance claim information and flexible spending account reimbursement claim information.

33. The storage medium of claim 30, wherein the historical claim information comprises healthcare-related claim information received from a healthcare management application.

34. The storage medium of claim 30, wherein said determining comprises determining a duration of a medical condition or course of treatment.

35. The storage medium of claim 30, wherein to determine if the at least one of the one or more prior expenses are predicted to be incurred in the given future time period, said reimbursement account allocation application is further configured to prompt the consumer to provide an indication of whether or not any of the one or more prior expenses are expected to be incurred in the given future time period.

36. The storage medium of claim 30, wherein said estimating comprises calculating an amount at least as large as a sum of said the at least one of the one or more prior expenses predicted to be incurred in the given future time period.

37. The storage medium of claim 30, wherein said producing comprises adjusting said initial reimbursement account allocation dependent on one or more of:

any differences between projected benefits of one or more health insurance plans and any prior year health insurance plan benefits, other historical healthcare-related expense information received on behalf of the consumer, and projected healthcare-related expense information received on behalf of the consumer.

38. The storage medium of claim 30, wherein said reimbursement account allocation application is further configured to receive information indicating a change in one or more dependents of the consumer or a change in health for the consumer or one or more dependents of the consumer, wherein said producing comprises adjusting said initial reimbursement account allocation dependent on said received information.

39. The storage medium of claim 27, wherein said reimbursement account allocation application is further configured to detect in said historical claim information one or more of:

an average of two or more similar expenses, a trend in two or more related expenses, a rate of change in a group of related expenses, and a rate of change in a recurring expense, wherein said producing comprises adjusting said initial reimbursement account allocation dependent on results of said detecting.

40. The storage medium of claim 27, wherein said reimbursement account allocation application is further configured to prompt the consumer to provide information indicating any expected changes in benefits related to the reimbursement account, any expected changes in one or more dependents of the consumer, or any expected changes in expenses reimbursable from the reimbursement account, wherein said producing comprises adjusting said initial reimbursement account allocation dependent on the information provided in response to said prompt.