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Payment of health care insurance claims using short-term loans

  • US 7,072,842 B2
  • Filed: 01/08/2001
  • Issued: 07/04/2006
  • Est. Priority Date: 01/08/2001
  • Status: Expired due to Fees
First Claim
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1. In a server system capable of communicating with a payment entity, a carrier, and a client computer associated with a health care provider, a method of advancing payment for health care services rendered by the health care provider, in response to an insurance claim, and prior to the carrier making payment on the insurance claim, the method comprising the acts of:

  • receiving an insurance claim from a client computer, the insurance claim including patient information, insurance information, and treatment information;

    determining by a server system whether the insurance claim is eligible for advance payment by determining;

    whether the treatment information corresponds to health care services that are approved for payment using an accepted medical practice database, andwhether the patient is an approved beneficiary of the carrier using a patient eligibility database;

    transmitting, by the server system, claim information associated with the insurance claim to the payment entity, wherein, upon receiving the claim information, the payment entity advances a first portion of an advance payment to a first account accessible to the health care provider and a second portion of the advance payment to a second account prior to the carrier making payment on the insurance claim, wherein a remaining part of the second portion of the advance payment is credited to the first account after debiting the second portion for at least one of service fees, interest, or unpaid balances;

    transmitting the insurance claim to the carrier;

    receiving payment from the carrier at the payment entity after the carrier adjudicates the insurance claim; and

    distributing the payment to the payment entity to pay, wherein, upon receiving the insurance claim, the carrier makes payment on the insurance claim to the payment entity after adjudicating the insurance claim, thereby paying for the money advanced to the health care provider.

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