Electronic healthcare information management for on-demand healthcare

• US 20070276698A1
• Filed: 05/23/2007
• Published: 11/29/2007
• Est. Priority Date: 05/23/2006
• Status: Abandoned Application

• Current Assignee: VIIAD Systems, LLC
• Original Assignee: VIIAD Systems, LLC
• Inventors: Zubak, John, Mitgang, Harvey
• Application Number:
  US11/805,443
• Publication Number:
  US 20070276698A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD

Abstract

A system and method for generating healthcare identification and reconciliation information and are provided. In an illustrative implementation, a computer-implemented healthcare information and reconciliation platform (HIRP) maintains a HIR engine which is operable on various data including but not limited to patient data, network data, plan data, insurance carrier/payor data, and healthcare provider data. In an illustrative operation, the HIR engine can receive input data representative of a participating user'"'"'s benefit plan. The HIR engine can process the inputted data and correlate the inputted data against healthcare provider data, benefit plan data, healthcare network data and insurance carrier/payor data to generate and/or store an electronic healthcare card/document representative of the most up-to-date contractual obligations between the cooperating parties (e.g., healthcare provider, benefit plan administrator, healthcare network, insurance carrier, and the covered person/patient) and healthcare related information for use in an on-demand healthcare system.

Claims

1. A system for processing on-demand healthcare transactions comprising:

a data store comprising patient data, healthcare provider data, and insurance carrier data, healthcare network data, healthcare related data, and on demand benefit plan data;

a healthcare identification and reconciliation engine operable on the data store to generate in real-time one or more electronic healthcare cards/documents having healthcare identification and management information thereon that is representative of one or more items comprising current contractual obligations existing between cooperating parties of a healthcare system and healthcare related data; and

a means for presenting the electronic healthcare cards/documents;

a means for storing generated electronic healthcare cards/documents for use in reporting and monitoring; and

a means for deploying the generated electronic healthcare cards/documents in an on-demand healthcare system.

2. The system as recited in claim 1 further comprising a means for communicating data representative of deployed generated electronic healthcare cards/documents in an on-demand healthcare system to one or more cooperating parties comprising any of on-demand benefit plan operators, subscribers, and participating benefit service providers for use in reconciling payment and/or obligations of an on-demand healthcare transaction.

3. The system as recited in claim 2 wherein the means for communicating data comprises a communications network.

4. The system as recited in claim 1 wherein the healthcare identification and reconciliation engine comprises a computing environment.

5. The system as recited inc claim 1 wherein the means for deploying the generated electronic healthcare cards/documents comprises a computing application operable on a computing environment.

6. The system as recited in claim 1 wherein the on-demand benefit plan comprises data representative of one or more services that can be requested from a benefit service provider on a piece-meal basis.

7. The system as recited in claim 6 wherein the on-demand benefit plan is managed by an on-demand benefit plan administrator/operator.

8. The system as recited in claim 1 wherein the healthcare cards/documents are generated and applied when an on-demand benefit service is requested by a participating subscriber.

9. The system as recited in claim 1 wherein the healthcare cards/documents contain data representative of contractual obligations and requirements for use in transacting an on-demand healthcare transaction in accordance with the on-demand healthcare benefit plan.

10. The system as recited in claim 1 wherein the means for storing generated electronic healthcare cards/documents for use in reporting and monitoring comprises a computing application operable on a computing environment.

11. A computer-implemented interactive method for generating current healthcare identification and reconciliation information for use in an on-demand healthcare system, comprising:

providing a graphical user interface operable to receive and display healthcare information;

receiving data from the graphical user interface representative of a participating user'"'"'s current benefit plan information;

correlating the received data against one or more of healthcare provider data, healthcare network data, benefit plan data and insurance carrier/payor data to produce verified healthcare information for the participating user;

providing one or more on-demand healthcare services available to the participating user; and

generating an electronic healthcare card/document having verified healthcare information representative of one or more items comprising healthcare related data and current relationships between cooperating parties comprising any of healthcare providers, benefit plan administrators, healthcare networks, insurance carriers/payors, and participating users for use in transacting services in an on-demand healthcare system.

12. The method as recited in claim 11 further comprising receiving a request for one or more available on-demand healthcare services.

13. The method as recited in claim 12 further comprising providing an explanation of benefits for requested one or more available on-demand healthcare services.

14. The method as recited in claim 13 further comprising generating an electronic healthcare card/document for use in transacting the requested one or more on-demand healthcare services.

15. The method as recited in claim 13 further comprising tracking the application of the generated electronic healthcare card/document to the requested one or more on-demand healthcare services for use in reconciling the requested one or more on-demand healthcare services.

16. The method as recited in claim 14 further comprising communicating the generated electronic healthcare card/document to a participating on-demand healthcare benefit service provider.

17. The method as recited in claim 16 further comprising receiving confirmation from the participating on-demand healthcare benefit service provider for the requested one or more on-demand healthcare services

18. The method as recited in claim 12 further comprising receiving payment information from participating users representative of the manner in which participating users can pay for on-demand healthcare services.

19. The method as recited in claim 12 further comprising generating an explanation of benefits for an on-demand healthcare network.

20. The method as recited in claim 19 further comprising storing the generated explanation of benefits for the on-demand healthcare network for subsequent use.