Billing modifier module for integrated emergency medical transportation database system
First Claim
1. A method of modifying charges for a bill using one or more transport associated geographic billing modifiers based on a location of an emergency encountered during emergency medical transportation, the method adapted to be performed on a processor, wherein the processor is connected to a memory to execute the following steps:
- obtaining, by the processor, the location of a medical emergency remote from a hospital emergency room;
checking, by the processor, a library comprising a plurality of geographic areas corresponding to one or more geographic billing modifiers against the location; and
if a match is found of the location being within one of the geographic areas, applying, by the processor, the library'"'"'s geographic billing modifiers to modify charges associated with the emergency medical transportation based on the location.
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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.
57 Citations
19 Claims
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1. A method of modifying charges for a bill using one or more transport associated geographic billing modifiers based on a location of an emergency encountered during emergency medical transportation, the method adapted to be performed on a processor, wherein the processor is connected to a memory to execute the following steps:
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obtaining, by the processor, the location of a medical emergency remote from a hospital emergency room; checking, by the processor, a library comprising a plurality of geographic areas corresponding to one or more geographic billing modifiers against the location; and if a match is found of the location being within one of the geographic areas, applying, by the processor, the library'"'"'s geographic billing modifiers to modify charges associated with the emergency medical transportation based on the location. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 18)
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9. An integrated medical database system with a geographic billing modifier module that modifies charges in a bill by applying one or more transport associated geographic billing modifiers based on a location of an emergency remote from a hospital emergency room to determine whether the emergency location qualifies for enhanced reimbursement, the system comprising:
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a processor; a non-transitory computer readable medium storing instructions to be executed when accessed by the processor, said instructions comprising; a transport information module configured to receive the location of a medical emergency; a geographic billing modifier module configured to store a plurality of pickup geographic areas and compare the location to the pickup geographic areas, wherein if a match exists for the location in the pickup geographic areas, the geographic billing modifier module modifies charges based on the location. - View Dependent Claims (10, 11, 12, 19)
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13. An emergency medical database system having a geographic billing modifier module for modifying charges in a bill based on a location of a patient'"'"'s medical emergency, the system comprising:
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a billing computer; a billing module executed by the billing computer; and a plurality of geographic billing modifiers stored in the billing computer, wherein the geographic billing modifiers are used to modify transport charges based on the location by applying a Geographic Practice Cost Index (GPCI) and a Metropolitan Statistical Area (MSA). - View Dependent Claims (14)
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15. A non-transitory computer usable medium having computer readable program code embodied therein for modifying charges incurred during medical transportation to a medical facility, the computer readable code comprising instructions for:
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obtaining a zip code of the location of a patient'"'"'s medical emergency, the location; remote from a hospital emergency room; checking a library comprising geographic areas corresponding to a Geographic Practice Cost Index (GPCI) geographic billing modifier or a Metropolitan Statistical Area (MSA) geographic billing modifier; and applying one or more of the geographic billing modifiers to modify charges on a bill based on the location. - View Dependent Claims (16, 17)
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Specification