Medical billing method and system

• US 6,655,583 B2
• Filed: 05/08/2002
• Issued: 12/02/2003
• Est. Priority Date: 04/13/2001
• Status: Expired due to Fees

• Current Assignee: Advanced Medical Interventions Incorporated
• Original Assignee: Advanced Medical Interventions Incorporated
• Inventors: Walsh, Christopher S., Crowder, Robert Joseph Jr.
• Primary Examiner(s): Frech, Karl D.
• Assistant Examiner(s): Sanders, Allyson
• Application Number:
  US10/140,215
• Publication Number:
  US 20020148893A1
• Time in Patent Office: 573 Days
• Field of Search: 235/380, 235/375, 235/472.01, 235/383, 705/3, 705/2, 705/1, 705/41, 705/38
• US Class Current: 235/380
• CPC Class Codes: A61N 2005/1074 Details of the control system, e.g. user interfaces
• CPC Class Codes: A61N 5/1048 Monitoring, verifying, controlling systems and methods
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 20/105 involving programming of a portable memory device, e.g. IC cards, "electronic purses"
• CPC Class Codes: G06Q 30/04 Billing or invoicing
• CPC Class Codes: G06Q 40/03 Credit; Loans; Processing thereof
• 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 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof

Abstract

A billing method is provided for billing for medical treatments and other services. The method includes capturing a treatment event by electronically scanning, at the time of the treatment event, a machine readable patient identifier (e.g., a bar code) carried by a patient treatment chart. The chart has entered thereon a prescribed treatment schedule. Capture of treatment event is entered into a computerized billing system along with the corresponding patient identifier. The patient treatment chart is used to validate charges entered into the system. All treatment events that are entered into the billing system for a particular patient identifier are collected and an invoice is generated for all of the collected treatment events entered into the billing system for the specific patient identifier. A method is also provided for tracking the patient treatment chart as an alerting device in checking on charge capture.

Claims

1. A billing method for billing for medical treatments, said method comprising:

capturing a treatment event by electronically scanning, at a time of the treatment event, a machine readable patient identifier carried by a patient treatment chart having entered thereon a prescribed treatment;

entering the captured treatment event into a computerized billing system along with the corresponding patient identifier;

using the patient treatment chart to validate charges entered into the billing system;

collecting all treatment events that are entered into the billing system for a specific patient identifier; and

generating an invoice for all of the collected treatment events entered into the billing system for the specific patient identifier.

2. A method as claimed in claim 1 wherein said patient treatment chart contains a prescribed schedule of treatments for the patient.

3. A method as claimed in claim 2 further comprising providing an indication whether or not a specific treatment of the prescribed schedule of treatments has been carried out.

4. A method as claimed in claim 3 wherein a dialog box is presented to a user on a monitor located at a site at which the treatment event takes place, said dialog box presenting choices corresponding to (i) full treatment, (ii) partial treatment and (iii) no treatment and wherein the user checks an appropriate box to indicate to the billing system the treatment, if any, that was performed.

5. A method as claimed in claim 1 wherein the treatment event is entered into the treatment chart at the time the treatment takes place.

6. A method as claimed in claim 1 wherein the patient treatment chart is used to verify that appropriate documentation exists for all charges entered into the billing system.

7. A method as claimed in claim 1 wherein a milestone billing report is generated after a predetermined number of said treatment events is captured and wherein generation of an invoice by the billing system takes place responsive to the generation of the milestone report.

8. A method as claimed in claim 7 wherein the billing system designates every fifth treatment event as a milestone for triggering generation of said milestone billing report.

9. A method as claimed in claim 8 wherein the milestone billing report includes a patient name, milestone information and bill date for a given milestone, said bill date being the date of the first treatment event of the treatment events leading up to the milestone.

10. A method as claimed in claim 9 wherein, when a full course of treatment for the patient is completed and the number of leftover unbilled treatments is not divisible by five, the billing system, in billing for the leftover treatments when there are at least three treatments, treats the leftover treatments as a further milestone and assigns as a bill date for the milestone the date of the first of the leftover treatments.

11. A method as claimed in claim 8 wherein the billing system enables a user to log on to check whether said milestones are being properly reported.

12. A method as claimed in claim 11 wherein a check is made by the billing system when a milestone is generated to check for at least one of the following errors:

(i) items on the patient chart are not billed out and (ii) a prescribed treatment schedule is not entered into the chart.

13. A method as claimed in claim 1 wherein the billing system provides that, in generating the invoice, nothing can be billed for that is not entered into the patient treatment chart.

14. A method as claimed in claim 1, wherein a characteristic audio signal, previously assigned to the patient and unique to the patient, is generated when there is a match between the patient identifier carried by the treatment chart and a stored patient identifier.

30. A method as claimed in claim 1 further comprising electronically scanning a corresponding machine readable patient identifier associated with an element employed in connection with the treatment event.

31. A method as claimed in claim 30 wherein the patient treatment chart carries said machine readable patient identifier and is scanned prior to scanning of said element, and wherein scanning of said element is delayed a predetermined period after scanning of said patient treatment chart.

32. A method as claimed in claim 30 wherein the patient treatment chart carries said machine readable patient identifier, and at least said patient treatment chart must be scanned prior to scanning of said element.

33. A method as claimed in claim 32 wherein a patient photograph also carries said patient identifier and said patient photograph must also be scanned prior to scanning said element.

34. A method as claimed in claim 1 further comprising producing a checklist for potentially billable standard numeric codes identifying physician services, based on matching thereto of a further standard code assigned in accordance with a treating physician'"'"'s diagnosis, and using the checklist for placing documented but unfiled results in the record.

35. A method as claimed in claim 1 wherein the patient treatment chart includes a proposed treatment plan for the patient, and the method further comprises scanning of the patient treatment chart to provide an indication of potentially billable items associated with the proposed treatment plan.

36. A method as claimed in claim 1 wherein the captured event and corresponding patient identifier are entered into a workstation monitor of the computerized billing system and the method further comprises presenting sidebar boxes on the workstation monitor which list potentially billable items.

37. A method as claimed in claim 1 wherein the centralized computerized billing system receives billing information from at least one event capture system of each of a plurality of different billing sources.

38. A method as claimed in claim 37 wherein, on a given day, the centralized system receives, by modem, updated billing information from each said event capture system and downloads, in a compressed and encrypted form, the updated billing information, and wherein, on the following day, the computerized billing system automatically determines whether a predetermined number of treatment events has been reached for any of the patient identifiers and, if so, determines, for each, whether a corresponding weekly treatment charge has been correctly entered into the billing system on a correct bill date based on the updated billing information and previously stored billing information.

15. A billing method for billing for medical treatments administered to a patient, said method comprising:

capturing an independent treatment event by electronically scanning, at a time of the independent treatment event, a machine readable patient identifier for identifying the patient;

entering, at the time of the treatment event, data with respect to the treatment event, and other billable items, into a patient treatment chart associated with a specific patient identifier;

monitoring the treatment events captured for each specific patient identifier and, when the number of treatment events for a specific patient identifier reaches a predetermined number, selecting the patient treatment chart associated with the specific patient identifier; and

when the treatment chart is selected, generating an invoice identified by the patient identifier based on the patient treatment chart.

16. A method as claimed in claim 15 wherein said machine readable identifier is carried by the patient treatment chart and said patient treatment chart has entered thereon a prescribed schedule of treatment events.

17. A method as claimed in claim 15 further comprising electronically scanning a corresponding machine readable patient identifier associated with an element employed in connection with the treatment event.

18. A method as claimed in claim 17 wherein said element comprises a port film.

19. A method as claimed in claim 17 wherein said element comprises a diode.

20. A method as claimed in claim 15 further comprising providing an indication whether or not a specific treatment of the prescribed schedule of treatments has been carried out.

21. A method as claimed in claim 20 wherein a dialog box is presented to a user on a monitor located at the site at which the treatment event takes place, said dialog box presenting choices corresponding to (i) full treatment, (ii) partial treatment and (iii) no treatment and wherein the user checks the appropriate box to indicate to the billing system the treatment, if any, that was performed.

22. A method as claimed in claim 15 wherein said predetermined number is five and a milestone billing report is generated each time the number of treatment events reaches a milestone of a fifth successive treatment in a series of treatments of a patient.

23. A method as claimed in claim 22 wherein the milestone billing report includes a patient name, milestone information and bill date for a given milestone, said bill date being designated as the date of the first treatment event of the treatment events leading up to the milestone.

24. A method as claimed in claim 22 wherein, when a full course of treatment for the patient is completed and the number of leftover unbilled treatments is not divisible by five, the billing system, in billing for the leftover treatments, treats the leftover treatments as a further milestone should there be at least three treatments and assigns as the bill date the date of the first of the leftover treatments.

25. A method as claimed in claim 24 wherein the billing system enables a user to log on to check whether said milestones are being properly reported.

26. A method as claimed in claim 22 wherein said treatment events are captured at a plurality of different treatment sites and a computerized billing system at a central billing office is used to determine the number of milestones reached for each treatment site during a preselected billing period and automatically checking if the corresponding charge for said period is recorded on the billing system on the correct bill date for each milestone reached.

27. A method as claimed in claim 15, wherein a characteristic audio signal, previously assigned to the patient and unique to the patient, is generated when there is a match between the patient identifier being scanned and a stored patient identifier.

28. A method of facilitating billing for medical treatment services involving treatment of a patient wherein a patient treatment chart is used in conjunction with the treatment of the patient, said method comprising the steps of:

logging onto a computerized billing system when the patient treatment chart is located at a predetermined location in a treatment facility; and

generating a billing alert in response to said logging on step so as to ensure patient treatment provided at said location will be billed out.

29. A method as claimed in claim 28 wherein said logging on step comprises logging on responsive to use of a scanning device located at said predetermined location to scan a patient identifier on said patient treatment chart.