Software system for aiding medical practitioners and their patients

• US 8,321,244 B2
• Filed: 03/31/2010
• Issued: 11/27/2012
• Est. Priority Date: 04/01/2009
• Status: Active Grant

• Current Assignee: New Era Enterprises, Inc.
• Original Assignee: Quality Health Ideas, LLC
• Inventors: Gaziano, Philip F.
• Primary Examiner(s): Pauls, John
• Application Number:
  US12/751,159
• Publication Number:
  US 20100280848A1
• Time in Patent Office: 972 Days
• Field of Search: 705/2, 705/3
• US Class Current: 705/3
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Applicant has disclosed a software system, preferably run over the Internet on an SQL server, used to prompt care providers to check certain medical conditions based upon: a patient'"'"'s history from, e.g., prior office visits to a physician'"'"'s office; and preferably, if appropriate, the patient'"'"'s history from other sources. Using the system results in more thorough care and enhanced billing. Applicant'"'"'s software provides a digital (or printed) version of a familiar billing format—the so-called Superbill. Medical conditions of a patient are highlighted to ensure the medical service provider performs the following services during a patient visit: investigates medical conditions of the patient, as prompted by highlights in the Superbill; and exhaustively addresses all the conditions worthy of investigation based on stored patient information. Afterwards, additional data obtained from the visit are entered into the computer system for later use. Since the system is set up on a standard billing format—i.e., the Superbill, the system helps to ensure that the service provider'"'"'s bills and the paperwork submitted to insurance carriers are accurate and complete.

Claims

1. A computerized method for aiding medical service providers and their patients comprising the following steps:

a. inputting medical service provider data for a patient into a computer system;

b. inputting patient data into the computer system, wherein the patient data includes medical conditions of the patient which have been identified;

c. securely storing the patient data, on the computer system, for later manipulation and for compliance with privacy laws;

d. subsequently providing a medical service provider, during an encounter with the patient, with a digital version of a superbill listing medical categories, wherein;

i. a plurality of the medical categories listed in the superbill have been digitally highlighted to display the medical conditions of the patient which have been identified previously; and

ii. a remainder of the medical categories listed in the superbill have not been digitally highlighted;

e. utilizing the highlighted medical categories in the superbill during the encounter by prompting the medical service provider;

i. to investigate and address the medical conditions of the patient, during the encounter with the patient, by reviewing the highlighted medical categories in the superbill; and

ii. to indicate on the superbill all medical conditions of the patient investigated and addressed during the encounter to provide billing information to an insurance carrier;

f. inputting additional patient data, obtained during the encounter, into the computer system for use in subsequent encounters with the patient and for providing complete billing information; and

g. wherein the superbill is a standard billing format, used by medical service providers and health insurance carriers, for bills submitted by service providers to the insurance carriers.

2. The method of claim 1 wherein the computer system is accessed via the Internet.

3. The method of claim 1 further comprising:

a. producing, via the computer system, reports indicating the need for referrals for certain patients, and

b. identifying, via the computer system, patients needing health care resources.

4. A computerized method for aiding medical service providers and their patients comprising the following steps:

a. inputting medical service provider data for a patient into a computer system;

b. inputting patient data into the computer system, wherein the patient data includes medical conditions of the patient which have been identified;

c. securely storing the patient data, on the computer system, for later manipulation and for compliance with privacy laws;

d. subsequently providing a medical service provider, during an encounter with the patient, with a digital version of a superbill having listed medical categories, wherein;

i. a plurality of medical categories listed in the superbill have been digitally highlighted to display the medical conditions of the patient which have been identified previously; and

ii. a remainder of the medical categories listed in the superbill have not been digitally highlighted;

e. highlighting additional medical conditions in the superbill which are known typically to coexist with the previously identified medical conditions, whereby the additional highlighting serves to direct the medical service provider'"'"'s attention to the additional medical conditions;

f. utilizing the highlighted medical categories in the superbill during the encounter to prompt the medical service provider;

i. to investigate and address the medical conditions of the patient, during the encounter with the patient, by reviewing the highlighted medical categories in the superbill; and

ii. to indicate on the superbill all medical conditions of the patient investigated and addressed during the encounter to provide billing information to an insurance carrier;

g. inputting additional patient data, obtained during the encounter, into the computer system for use in subsequent encounters with the patient and for providing complete billing information; and

h. wherein the superbill is a standard billing format, used by medical service providers and insurance carriers, for invoices submitted by medical service providers to the insurance carriers.

5. A computerized method for aiding medical service providers and their patients comprising the following steps:

a. inputting medical service provider data for a patient into a computer system;

b. inputting patient data into the computer system, wherein the patient data includes at least one medical condition of the patient identified previously;

c. securely storing the patient data, on the computer system, for later manipulation and for compliance with privacy laws;

d. subsequently providing a medical service provider, during an encounter with the patient, with a digital version of a superbill having listed categories, wherein;

i. at least one medical category listed in the superbill has been digitally highlighted to display the at least one medical condition of the patient previously identified; and

ii. a remainder of the medical categories listed in the superbill have not been digitally highlighted;

e. utilizing the at least one highlighted medical category in the superbill during the encounter to ensure prompt the medical service provider;

i. to investigate and address the at least one medical condition of the patient, during the encounter with the patient, by reviewing the at least one highlighted medical category in the superbill; and

ii. to indicate on the superbill each medical condition of the patient investigated and addressed during the encounter to provide billing information to an insurance carrier;

f. inputting additional patient data, obtained during the encounter, into the computer system for use in subsequent encounters with the patient and for providing complete billing information; and

wherein the superbill is a standard billing format, used by medical service providers and insurance carriers, for invoices submitted by medical service providers to the insurance carriers.

6. The method of claim 5 farther comprising:

a. highlighting additional medical conditions known typically to coexist with the at least one previously identified medical condition, whereby the additional highlighting serves to prompt the medical service to review the additional medical conditions.