Health care eligibility verification and settlement systems and methods

• US 9,898,581 B2
• Filed: 04/21/2014
• Issued: 02/20/2018
• Est. Priority Date: 06/11/2002
• Status: Active Grant

• Current Assignee: First Data Corporation (Fiserv Incorporated)
• Original Assignee: First Data Corporation (Fiserv Incorporated)
• Inventors: Lutzen, Renee Elahi, Nauman, George, Weis, David G., Kennedy, Beverly, Bartlett, Robyn
• Primary Examiner(s): Chng, Joy
• Application Number:
  US14/257,784
• Publication Number:
  US 20140316798A1
• Time in Patent Office: 1,401 Days
• Field of Search: 705 2- 3
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G07G 1/0018 Constructional details, e.g. of drawer, printing means, input means
• CPC Class Codes: G07G 1/12 electronically operated digital data processing aspects G06Q20/00
• CPC Class Codes: G16H 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/00 ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics

Abstract

Devices, systems, and methods for processing healthcare and financial transactions are provided. A point-of-care terminal for processing a healthcare transaction by a healthcare provider includes a reader configured to read information from a healthcare eligibility and settlement presentation instrument associated with a patient, and a processor configured to process a healthcare transaction based on the information, wherein the healthcare transaction includes at least one of a healthcare eligibility verification transaction and a healthcare settlement transaction.

Claims

1. A point-of-care device, comprising:

a display;

a presentation instrument reader that reads a healthcare subscriber identifier and a financial account identifier from a presentation instrument;

one or more processors; and

a memory communicatively coupled with and readable by the one or more processors and having stored therein processor-readable instructions which, when executed by the one or more processors, cause the one or more processors to;

present, via the display, a menu allowing selection from multiple types of transactions, the multiple types of transactions comprising;

a financial transaction and a healthcare eligibility transaction;

present, via the display, a first option associated with the financial transaction and a second option associated with the healthcare eligibility transaction, wherein the first option and second option are presented simultaneously;

receive a first selection of the healthcare eligibility transaction from the multiple types of transactions presented as part of the menu;

receive the healthcare subscriber identifier associated with a patient via the presentation instrument reader;

transmit a first message comprising the healthcare subscriber identifier via a settlement network to a host system initiating the healthcare eligibility transaction;

receive, in response to the first message, via the settlement network from the host system, an accepted eligibility receipt that indicates a co-pay amount corresponding to a healthcare service;

receive a second selection of the financial transaction from the multiple types of transactions presented as part of the menu;

receive the financial account identifier via the presentation instrument reader;

transmit a second message comprising the financial account identifier via the settlement network to the host system initiating a financial transaction; and

a printer that prints a healthcare eligibility receipt and a financial transaction receipt.

2. The point-of-care device of claim 1, the point-of-care device further comprising:

a magnetic-stripe reader configured to read a magnetic stripe present on a transaction instrument, wherein the magnetic-stripe reader is the presentation instrument reader and the processor-readable instructions that, when executed, cause the one or more processors to receive the healthcare subscriber identifier associated with the patient via the presentation instrument reader comprise processor-readable instructions which, when executed, cause the one or more processors to;

receive, via the magnetic-stripe reader, the identifier associated with the patient from the magnetic stripe of the transaction instrument.

3. The point-of-care device of claim 2, wherein:

the magnetic-stripe reader is configured to obtain the healthcare subscriber identifier associated with the patient from a third track of the magnetic stripe of the transaction instrument; and

the first track and second track of the magnetic stripe of the transaction instrument are associated with financial transaction information that comprises the financial account identifier.

4. The point-of-care device of claim 1, wherein the processor-readable instructions that, when executed, cause the one or more processors to transmit the message to the host system initiating the healthcare eligibility transaction comprise processor-readable instructions which, when executed, cause the one or more processors to:

transmit the message to the host system via a credit card processing network, wherein the credit card processing network is the settlement network.

5. The point-of-care device of claim 1, wherein the processor-readable instructions, when executed, further cause the one or more processors to:

assign a first message type to the message initiating the healthcare eligibility transaction; and

assign a second message type to the financial transaction, wherein the first message type and the second message type are different and are used by a remote computer system to determine a type of transaction being conducted.

6. The point-of-care device of claim 1, wherein the accepted eligibility receipt further indicates a primary care physician of the patient.

7. A method for conducting a health care transaction, the method comprising:

presenting, by a point-of-care device, a menu allowing selection from multiple types of transactions, the multiple types of transactions comprising;

a financial transaction and a healthcare eligibility transaction, wherein presentation of the multiple types of transactions occurs simultaneously and the point-of-care device comprises a presentation instrument reader configured to read a healthcare subscriber identifier and a financial account identifier from a presentation instrument;

presenting, by a point-of-care device, a first option associated with the financial transaction and a second option associated with the healthcare eligibility transaction, wherein the first option and second option are presented simultaneously;

receiving, by the point-of-care device, a selection of the healthcare eligibility transaction from the multiple types of transactions;

receiving, by the point-of-care device via the presentation instrument reader, the healthcare subscriber identifier associated with a patient;

transmitting, by the point-of-care device, via a settlement network, a first message to a host system that comprises the healthcare subscriber identifier initiating the healthcare eligibility transaction;

receiving, by the point-of-care device, via the settlement network, in response to the first message, an accepted eligibility receipt that indicates a co-pay amount corresponding to a healthcare service;

receiving, by the point-of-care device, a second selection of the financial transaction from the multiple types of transactions;

receiving, by the point-of-care device, the financial account identifier via the presentation instrument reader;

transmitting, by the point-of-care device, a second message comprising the financial account identifier via the settlement network to the host system initiating a financial transaction; and

print with a printer a healthcare eligibility receipt and a financial transaction receipt.

8. The method for conducting the health care transaction of claim 7, wherein receiving the identifier associated with the patient via the presentation reader comprises:

receiving, via a magnetic-stripe reader of the point-of-care device, the healthcare subscriber identifier associated with the patient from a magnetic stripe of a transaction instrument, wherein the presentation reader comprises the magnetic-stripe reader.

9. The method for conducting the health care transaction of claim 8, wherein the healthcare subscriber identifier associated with the patient is received from a third track of the magnetic stripe of the transaction instrument, the first track and second track comprising financial account information which comprises the financial account identifier.

10. The method for conducting the health care transaction of claim 7, wherein transmitting the message to the host system initiating the healthcare eligibility transaction comprises:

transmitting the message to the host system via a credit card processing network, wherein the credit card processing network is the settlement network.

11. The method for conducting the health care transaction of claim 7, the method further comprising:

assigning, by the point-of-care device, a first message type to the message initiating the healthcare eligibility transaction; and

assign, by the point-of-care device, a second message type to the financial transaction, wherein the first message type and the second message type are different and are used by a remote computer system to determine a type of transaction being conducted.

12. The method for conducting the health care transaction of claim 7, wherein the accepted eligibility receipt further indicates a primary care physician of the patient.

13. A non-transitory processor-readable medium comprising processor-readable instructions configured to cause one or more processors of a point-of-care device that comprises a printer, and a presentation instrument reader configured to read a healthcare subscriber identifier and a financial account identifier from a presentation instrument to:

cause presentation of a menu allowing selection from multiple types of transactions, the multiple types of transactions comprising;

a financial transaction and a healthcare eligibility transaction;

cause presentation of a first option associated with the financial transaction and a second option associated with the healthcare eligibility transaction, wherein the first option and second option are presented simultaneously;

receive a selection of the healthcare eligibility transaction from the multiple types of transactions presented as part of the menu;

receive the healthcare subscriber identifier associated with a patient, the identifier being received via a presentation instrument reader device;

transmit a first message comprising the healthcare subscriber via a credit card processing network to a host system initiating the healthcare eligibility transaction;

receive, in response to the first message, via the credit card processing network, an accepted eligibility receipt that indicates a co-pay amount corresponding to a healthcare service;

receive a second selection of the financial transaction from the multiple types of transactions presented as part of the menu;

receive the financial account identifier via the presentation instrument reader;

transmit a second message comprising the financial account identifier via the settlement network to the host system initiating a financial transaction; and

print with the printer a healthcare eligibility receipt and a financial transaction receipt.

14. The non-transitory processor-readable medium of claim 13, wherein the processor-readable instructions are further configured to cause the one or more processors to:

receive, via a magnetic-stripe reader, the healthcare subscriber identifier associated with the patient from a magnetic stripe of a transaction instrument, wherein the presentation instrument reader device is a magnetic-stripe reader.

15. The non-transitory processor-readable medium of claim 14, wherein the processor-readable instructions configured to cause the one or more processors to receive the identifier comprise processor-readable instructions configured to cause the one or more processors to receive the identifier associated with the patient from a third track of the magnetic stripe of the transaction instrument;

wherein the first track and second track of the magnetic stripe of the transaction instrument are associated with financial transaction information.