Attachment integrated claims system and operating method therefor

• US 6,343,310 B1
• Filed: 12/26/2000
• Issued: 01/29/2002
• Est. Priority Date: 03/28/1996
• Status: Expired due to Term

• Current Assignee: Integrated Claims Systems LLC
• Original Assignee: Andrew L. Dirienzo
• Inventors: DiRienzo, Andrew L.
• Primary Examiner(s): Peeso, Thomas R.
• Application Number:
  US09/745,489
• Time in Patent Office: 399 Days
• Field of Search: 709/200, 709/201, 709/202
• US Class Current: 709/200
• CPC Class Codes: G06F 3/0481 based on specific properties of the displayed interaction object or a metaphor-based environment, e.g. interaction with desktop elements like windows or icons, or assisted by a cursor's changing behaviour or appearance
• CPC Class Codes: G06F 3/0482 Interaction with lists of selectable items, e.g. menus
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 10/02 Reservations, e.g. for tickets, services or events
• CPC Class Codes: G06Q 10/025 Coordination of plural reservations, e.g. plural trip segments, transportation combined with accommodation
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/06 Buying, selling or leasing transactions
• CPC Class Codes: G06Q 40/00 Finance; Insurance; Tax strategies; Processing of corporate or income taxes
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G06Q 40/12 Accounting
• CPC Class Codes: G06Q 99/00 Subject matter not provided for in other groups of this subclass
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 30/20 for handling medical images, e.g. DICOM, HL7 or PACS
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

An attachment integrated claims (AIC) system includes an e-mail form (with specific fields that must be filled out) that adjusts itself, in both information required and formatting, to meet the demands of the receiving party. It is particularly advantageous for Electronic Data Interchange (EDI) situations where a user must send similar (but not necessarily identical) messages to several organizations. This is particularly important where, once an e-mail is received by those organizations, the information in the message must be digitally integrated into differing legacy information systems. In other words, the AIC system permits transmission of a dynamic claim form and integrated attachment to an insurance carrier via a non-clearinghouse communications channel. An AIC system including several computers connected via a communications channel, an electronic file, and an operating method therefor are also described.

Claims

1. A graphical user interface (GUI) instantiated by computer software for generating a file from text data entered into selected ones of N fields in the GUI, wherein:

the selected ones of the N fields which accept text data are determined responsive to text entered into a first predetermined one of the N fields;

N is an integer greater than 2;

the first portion of the selected ones of the N fields are automatically filled in when the text is entered into the first predetermined one of the N fields; and

the selected ones of the N fields is further limited responsive to text entry into a second predetermined one of the N fields.

2. A graphical user interface (GUI) instantiated by computer software for generating a file from text data entered into selected ones of N fields in the GUI, wherein:

the selected ones of the N fields which accept text data are determined responsive to text entered into a first predetermined one of the N fields;

the format of the file is determined responsive to text entered in the first predetermined one of the N fields; and

N is an integer greater than 2.

3. The GUI as recited in claim 2, wherein the first portion of the selected ones of the N fields are automatically filled in when the text is entered into the first predetermined one of the N fields.

4. The GUI as recited in claim 2, wherein the selected ones of the N fields are further limited responsive to text entry into a second predetermined one of the N fields.

5. The GUI as recited in claim 4, wherein the first predetermined one of the N fields accepts a payer name or ID number, and wherein the second predetermined on of the N fields accepts a code corresponding to a medical service.

6. A graphical user interface (GUI) instantiated by computer software for generating a file transmittable to a selected one of M recipients from text data entered into selected ones of N fields in the GUI, wherein:

part of the information in the computer software is determined responsive to the requirements of the M recipients;

the selected ones of the N fields which accept text data are determined responsive to text entered into a first predetermined one of the N fields;

N is an integer greater than 2.

7. The GUI as recited in claim 6, wherein the computer software is updated as the respective file requirements of the M recipients change.

8. The GUI as recited in claim 6, wherein the text entered into the first predetermined one of the N fields is an identification code for the selected one of M recipients.

9. The GUI as recited in claim 6, wherein a first portion of the selected ones of the N fields are automatically filled in when the file is opened.

10. The GUI as recited in claim 6, wherein a second portion of the selected ones of the N fields are automatically filled in when the text is entered into the first predetermined one of the N fields.

11. The GUI as recited in claim 10, wherein the first predetermined one of the N fields accepts a payer name, and wherein the second predetermined on of the N fields accepts a code that identifies a medical service or medical diagnosis.

12. The GUI as recited in claim 6, wherein the selected ones of the N fields is further limited responsive to text entry into a second predetermined one of the N fields.

13. The GUI as recited in claim 12, wherein the computer software is automatically updated whenever the file is transmitted to the one of the M recipients corresponding to the payer name.

14. The GUI as recited in claim 6, wherein the computer software is automatically updated from a single source accessible by all of the M recipients.

15. The GUI as recited in claim 6, wherein the computer software resides on a server computer accessible via the Internet.

16. The GUI as recited in claim 15, wherein the file is archived on the computer used to access the server.

17. The GUI as recited in claim 15, wherein the file is transmitted from the server to the selected one of the M recipients.

18.The GUI as recited in claim 15, wherein the computer software is accessible by all of the M recipients and can be updated by any one of them.

18. The GUI as recited in claim 15, wherein:

the form is completed on the server;

the completed form is downloaded to the accessing computer; and

the completed form is transmitted to the chosen one of the M recipients from the accessing computer.

19. A graphical user interface (GUI) instantiated by computer software for generating a file transmittable to a selected one of M recipients from text data entered into selected ones of N fields in the GUI, wherein:

part of the information in the computer software is determined responsive to the requirements of the M recipients,

the selected ones of the N fields which accept text data are determined responsive to text entered into a first predetermined one of the N fields,

the format of the file is determined responsive to text entered in the first predetermined one of the N fields, and

N is an integer greater than 2.

20. The GUI as recited in claim 20, wherein the computer software is updated as the respective file requirements of the M recipients change.

21. The GUI as recited in claim 20, wherein the text entered into the first predetermined one of the N fields is an identification code for the selected one of M recipients.

22. The GUI as recited in claim 20, wherein a first portion of the selected ones of the N fields are automatically filled in when the file is opened.

23. The GUI as recited in claim 20, wherein a second portion of the selected ones of the N fields are automatically filled in when the text is entered into the first predetermined one of the N fields.

25. The GUI as recited in claim 20, wherein the selected ones of the N fields is further limited responsive to text entry into a second predetermined one of the N fields.

27. The GUI as recited in claim 20, wherein the computer software is automatically updated from a single source accessible by all of the M recipients.

28. The GUI as recited in claim 20, wherein the computer software resides on a server computer accessible via the Internet.

24. The GUI as recited in claim 24, wherein the first predetermined one of the N fields accepts a payer name, and wherein the second predetermined on of the N fields accepts a code that identifies a medical service or medical diagnosis.

26. The GUI as recited in claim 26, wherein the computer software is automatically updated whenever the file is transmitted to the one of the M recipients corresponding to the payer name.

29. The GUI as recited in claim 29, wherein the file is archived on the computer used to access the server.

30. The GUI as recited in claim 29, wherein the file is transmitted from the server to the selected one of the M recipients.

31. The GUI as recited in claim 29, wherein the computer software is accessible by all of the M recipients and can be updated by any one of them.

32. The GUI as recited in claim 29, wherein;

the form is completed on the server;

the completed form is downloaded to the accessing computer; and

the completed form is transmitted to the chosen one of the M recipients from the accessing computer.

33. A coherent computer system providing interoperability between a plurality of independent computers, comprising:

a plurality of first computers and associated first users, each of the first computers comprising a first storage medium storing computer readable instructions for permitting the respective first computer to;

generate a form including N fields;

receive textual data as field data in selected ones of the N fields;

assemble said field data into a first file; and

transmit the first file to a selected one of a plurality of second computers via a communications channel; and

a plurality of second computers and associated second users, each of the second computers comprising a second storage medium storing computer readable instructions for permitting the respective second computer to receive said first file via the communications channel, wherein;

the selected ones of the N fields which accept text data are determined responsive to text entered into a first predetermined one of the N fields,

the format of the file is determined responsive to text entered in the first predetermined one of the N fields,

the selected one of the respective second computers is selected responsive to the text entered into the first predetermined one of the N fields,

the computer readable instructions stored on the first computers are updated responsive to changes to one of content and format generated by the second users, and

N is an integer greater than 2.

34. The coherent computer system as recited in claim 34, wherein the selected ones of the N fields is further limited responsive to text entry into a second predetermined one of the N fields.

35. The coherent computer system as recited in claim 35, wherein the first predetermined one of the N fields accepts a payer name or ID number, and wherein the second predetermined on of the N fields accepts a code specifying a medical service.

36. A coherent computer system providing interoperability between a plurality of independent computers, comprising:

a plurality of first computers and associated first users, each of the first computers comprising a first storage medium storing computer readable instructions for permitting the respective first computer to access a server, and

a server computer accessible via a wide area network (WAN) storing computer readable instructions for permitting a first user (computer) to;

generate a form including N fields;

receive textual data as field data in selected ones of the N fields;

assemble said field data into a first file; and

transmit the first file to a selected one of a plurality of second computers via a communications channel; and

a plurality of second computers and associated second users, each of the second computers comprising a second storage medium storing computer readable instructions for permitting the respective second computer to receive said first file via the communications channel, wherein;

the selected ones of the N fields which accept text data are determined responsive to text entered into a first predetermined one of the N fields,

the format of the file is determined responsive to text entered in the first predetermined one of the N fields,

the selected one of the respective second computers is selected responsive to the text entered into the first predetermined one of the N fields,

the computer readable instructions stored on the first computers are updated responsive to changes to generated by the second users, and

N is an integer greater than 2.

37. The coherent computer system as recited in claim 37, wherein the selected ones of the N fields is further limited responsive to text entry into a second predetermined one of the N fields.

38. The coherent computer system as recited in claim 38, wherein the first predetermined one of the N fields accepts a payer name or ID number, and wherein the second predetermined on of the N fields accepts a code specifying a medical service.

39. A dynamic electronic form which permits each of a plurality of first users to independently determine the format of its respective version of the electronic form, and to freely change the format over time.

40. The dynamic electronic form as recited in claim 40, wherein the electronic form presented to each of a plurality of second users is constant, irrespective of changes to the format dictated by respective ones of the first users.

41. The dynamic electronic form as recited in claim 40, wherein the appearance of the electronic form presented to each of a plurality of second users is different.