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WO2000067173A1 - Systeme de facturation base sur un navigateur web pour le traitement des demandes de paiement des fournisseurs de soins de sante - Google Patents

Systeme de facturation base sur un navigateur web pour le traitement des demandes de paiement des fournisseurs de soins de sante Download PDF

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Publication number
WO2000067173A1
WO2000067173A1 PCT/US2000/011429 US0011429W WO0067173A1 WO 2000067173 A1 WO2000067173 A1 WO 2000067173A1 US 0011429 W US0011429 W US 0011429W WO 0067173 A1 WO0067173 A1 WO 0067173A1
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WO
WIPO (PCT)
Prior art keywords
information
provider
healthcare
healthcare provider
data
Prior art date
Application number
PCT/US2000/011429
Other languages
English (en)
Inventor
Joe Sostarich
John Freeman
Original Assignee
Zirmed.Com
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Zirmed.Com filed Critical Zirmed.Com
Priority to AU44981/00A priority Critical patent/AU4498100A/en
Publication of WO2000067173A1 publication Critical patent/WO2000067173A1/fr

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Classifications

    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q30/00Commerce
    • G06Q30/04Billing or invoicing

Definitions

  • the present invention relates to submission of health care provider claims from a remote user computer and particularly submission and formation of submitted claims through the internet interfaced with standard internet web browser compatible software.
  • the present invention is directed toward an electronic health care claim submission system which is entirely web browser based and which combines multiple pre-defined databases in order to make entry of claim and provider information more efficient.
  • One object of the present invention is thus to provide an efficient and easily definable data entry table.
  • Another object of the present invention is to provide a health care claims submission system which relies on the open software architecture commonly found on the internet and thus allows any entity or individual with an internet browser to utilize the claims submission system.
  • a further object of the present invention is to provide an open software architecture claim submission system which has data correction and error checking ability inherent in the claims submission process screen forms.
  • An additional object of the present invention is to combine multiple databases containing information on providers, prior claims, insurance information, insured, insured information, patients, third party payers, claim submission rules and other rules information while securely transmitting such information over an open network.
  • a further object of the present invention is to provide multiple methods of billing and payment to the health care provider through the use of a web browser compatible site.
  • a further object of the present invention is to provide a health care provider claim submission system wherein particular rules relating to claim submission, required data and other matters may be defined by the health care provider.
  • An even further object of the present invention is to provide a claim submission system fully compatible with standard internet web browser software which does not require dedicated software tailored specifically toward health care claim submission on the providers computer systems.
  • An additional object of the present invention is to provide a health care claim submission system which is fully internet browser compatible and which has three levels of security protection securing the database of information stored on the system servers database.
  • An additional object of the present invention is to provide a health care submission system which is fully internet browser compatible wherein records stored in the systems databases are inter-related with each other so that particular records are associated with specific data elements such as insured and patient diagnosis, facility and provider, among others.
  • Figure la is a schematic overview of the data flow and connectivity for the system of the present invention.
  • Figure lb is a more detailed schematic overview of the data flow and procedures for the system of the present invention.
  • Figure 2 is a schematic overview of the definition of the look-up database of the present invention.
  • Figure 3 is a schematic overview of the claims database of the present invention.
  • Figure 4 is a representation of the options available on the system of the present invention.
  • Figure 5 is a flow chart detailing the overall process for use with the system of the present invention.
  • Figure 6 is an overview of the patient set up procedure
  • Figure 7 is an overview of the provider setup procedure of the present invention
  • Figure 8 is a schematic detailing the procedure for policy holder and payer set up within the system of the present invention
  • Figure 9 is a schematic overview of the functional elements for the claims database of the present invention.
  • Figure 10 is a flow chart depicting entering a new claim on the system of the present invention.
  • Figure 11 is a flow chart representing the claim entering process on the system for the present invention.
  • Figure 12 is a representative page on the system of the present invention wherein provider information is entered into the appropriate database
  • Figure 13 is a representative page on the system of the present invention wherein policy holder information is correctly associated with insurance or payer information;
  • Figure 14 is a representative page for claim entry on the system of the present invention.
  • Figure 15 is a representative page on the system of the present invention wherein a new patent is entered
  • Figure 16 is a flow chart detailing review of claims process on the system of the present invention.
  • Figure 17 is a representative page on the system of the present invention wherein the claims are presented to the user.
  • Figure 18 is a representative page of the system of the present invention wherein a new policy holder is entered into the database.
  • Computer 12 of a healthcare provider contains a web browser interface 14 for browsing web based servers on the internet or other open network.
  • the web browser interface 14 may be any standard web browser interface which is capable of interpreting HTML or similar code such as, for example Internet Explorer or Netscape Navigator series of browsers.
  • the web browser interface 14 is executed on the computer and is utilized to interface with the web site server 18 of the claim provider.
  • the benefit of utilizing a claim provider server 18 which may be interfaced with any web browser is that there are very limited compatibility issues with users as long as they are connected to the internet.
  • a healthcare provider claims submission system 10 which is completely interfaced utilizing an internet web browser.
  • the internet web browser is the only software required for submission of claims through the web site server 18.
  • data flow from the computer 12 to the web site server 18 is in both directions and is complemented with a connection from the web site server 18 to the database storage 20.
  • Particularly beneficial to the design of the present invention is the ability to dynamically change the interface or claim submission forms which appear on the web site server 18 without requiring continual updates of software and other technology on the client computer 12. This is a significant enhancement over prior art systems in that dynamic changes can be implemented in the claim submission process without requiring user intervention apart from merely logging on to the web site server 18.
  • FIG. la and lb an overall schematic of the data flow is shown wherein the web browser interface 14 communicates with the web server 18. Data is entered through the web browser which communicates directly to the server 18. Web server 18 is connected to multiple tables stored in database 20.
  • the main database as shown in Figure lb, are the lookup database 100 and the claims database 200. Populated within each of these databases are a plurality of tables which will be defined herein. These databases contain information regarding patients, providers, insurance policy, facilities, referring physicians, payer information and claim information entered for each claim entry.
  • Web server 18 accesses lookup database 100 and claim database 200, both of which contain a plurality of tables. Direct connection of the web server 18 to the multiple databases, tables and the required rules set for entering claims allows for real time validation of claim information.
  • the provider enters a claim through browser 14 which is forwarded to the web server 18.
  • Web server 18 verifies the data according to the various databases and tables which are available to it and which are correlated with the appropriate healthcare provider.
  • the healthcare provider may incorporate different rules required for entering various claims for that particular healthcare provider's procedures, all of which may be different for the various providers utilizing the system 10 of the present invention.
  • Appropriate claim information after, submission to the web server 18, is verified and formatted in order to convert the data into valid claim submission format utilizing a paper free ECDI gateway to clearinghouse 50.
  • the clearinghouse 50 formats the claim so that the data entered by the medical healthcare provider is in appropriate form for acceptance by the primary medical clearinghouse 50 or third party payer 38 and 39 shown in Figure lb.
  • the internal clearinghouse 50 validates and then formats submitted claims according to predefined rules which are provided by payers 38 or third party clearinghouses 39. These rules may be completely independent of the format for data entry allowed by the healthcare provider or defined by the system 10.
  • a particular benefit of the overall design of the system 10 of the present invention shown in Figures la and lb is that it allows the healthcare provider to submit claims according to predefined rules and required data parameters which may be independent of the claim submission format required by a either a third party clearinghouse 39 or payer 38. Further, the claim submission process may be dynamically changed by the web site server 18 in such a way that regardless of the changes incorporated in the system design or interface, all of the data entry requirements are compatible with each other due to the web browser interface and its ability to be dynamically updated and changed independent of the requirements of the web site server 18 or as may be defined by the healthcare provider.
  • utilization of a generic third party interface which supports HTML or other internet based languages such as Java or Java script, to name a few, allows the system to be updated solely based upon the code content located on the web server 18 and completely independent of the browser interface 14 located on the healthcare provider computer 12.
  • the computer 12 within the healthcare provider office is connected through the internet 16 and contains a web browser interface 14 thereon.
  • the system of the present invention 10 resides upon the web site server 18 shown in Figure la.
  • the user Upon entry into the system 10 of the present invention by user names and password, for example, the user enters the appropriate data contained within the lookup database 100 at step 21. A further description of the appropriate lookup data will be described herein.
  • validation occurs of the information entered at step 22 occurs and if the lookup data fails the validation process at step 24, the user is required to reenter the particular data information.
  • lookup data validation at step 25 the appropriate information is saved in the lookup database lOOand the user may then begin utilizing tj e lookup data for entry of claim information.
  • Claim entry at step 27 allows the healthcare provider to enter claim information based upon previously entered lookup data which details patient information, policy holder information, specific insurance, provider information and other detailed information required in the claims submission process.
  • additional information is entered which specifically states the requisite information mandated for healthcare provider claim submission to third party payors 38.
  • claim entry information is validated and if the claim data fails validation at step 29, an error message is received and the user is invited to reenter information. Such validation may occur in real time utilizing a real time claim data validation data set or may occur during a batch submission of the claims to the internal clearinghouse.
  • the claim data passes validation at step 31
  • the claim data is saved in the claim database 200 at step 32.
  • claims may be submitted independently at step 33 for review by clearing house 50 which reviews the claim information for valid data type and service information as well as other requisite information required by each of the payers.
  • Clearing house 50 may then update the submitted claim status contained within claim database 200 such that status information is stored in a history table associated with each claim at step 34.
  • the procedure for entering claim information consists of a plurality of steps set forth in Figure 5.
  • healthcare providers must be set up within the lookup database 100.
  • next in the overall procedure is the requirement at step 52 for the healthcare provider to define the policy holders and other information.
  • each patient information must be entered at step 54 tying all of the policy information to specific patients which are being treated by the healthcare provider.
  • the insurance or payer information must be entered in for each patient and each policy holder. This information is entered at step 56 and links all patient information with particular insurance claim information in the lookup database 100.
  • claim data may be entered into the system at step 58 at which time the claim data, after entry, may be saved at step 60. All of the claim data entered into the system may be reviewed real time for certain basic information requirements and will be reviewed again by the clearinghouse for format and other criteria. Once the claim data has been saved, it may then be submitted for review to the clearing house engine 50 shown in Figure lb. Thus, at step 64, the saved claims may be submitted for processing at clearinghouse 50 for a determination of all adequate information required by each insurance payer or by other third party clearinghouse services to which the information may be submitted.
  • the lookup database 100 is populated with a plurality of tables which include: patient information table 102; provider information table 104; policy information table 106; facility information table 108; referring physician information table 110 and payor data table 112 among others.
  • the patient information table 102 contains specific information regarding each individual patient.
  • Each table entry includes particular information about each patient such as name, address, contact information, date of birth and a secondary insured policy holder as well as the payor ascribed to that policy holder.
  • An example of an entry page for new patient information is shown in Figure 15.
  • the table record will include all relevant information as well as links to the appropriate insurance and primary policy holder.
  • the patient information table 102 displayed contains various information regarding each patient as well as links to other tables contained within the lookup database 100.
  • a policy information table 106 contains data regarding each individual policy and the relevant policy holder for that policy. Links may also be placed within the policy information table 106 to the various patients covered under the policy information table entry as well as links to payor information, insured identifier and other requisite information related to that policyholder.
  • policy holders will be listed particularly in the policy information table 106 as well as the insurance payor for each policy contained therein.
  • a policy holder has been entered into the policy information table 106 and a insurance payor is being linked to the policy holder entry.
  • insurance information specifically responsible for payment of claims to that policy holder is entered into the system. All of this information is retained within the policy information table 106 or linked thereto as shown in Figure 2.
  • provider information table 104 is stored within the lookup database 100.
  • Provider information table 104 contains specific information regarding the healthcare provider including whether or not the healthcare provider is the billing, rendering, referring, supervising or ordering physician.
  • An example of the relevant information requested for the provider information table entries is shown in Figure 12.
  • each provider entry stored in the provider information table 104 seeks to associate specific information regarding the healthcare provider necessary for proper billing of any services provided to the appropriate payor. All of the provider information is appropriately stored within the provider information table 104 and retained within the lookup database 100.
  • a provider table entry may be indicated as the healthcare provider and also as the rendering and billing provider.
  • the provider information for each specific healthcare provider may be modified such that the provider is listed as a billing or rendering provider.
  • different providers may have different supervising, rendering or billing responsibilities.
  • each table entry in table 104 may be indicated as appropriate.
  • a facilities table 108 is also shown in Figure 2 and all of those facilities may be linked to specific providers within the provider information table 104.
  • providers having a plurality of facilities will have record entries within the facilities table 108 as well as specific provider information within the provider information table 104.
  • An additional table found within the lookup database 100 includes the referring physician table 110, which is directly linked through the provider information table 104, whereby referring physicians are recorded within the system and retained for adequate billing purposes. As some third party payors require information regarding the referring physician information, this information may be required for acceptance of claims information from third party payors. Thus, on any claim entry form, specific information regarding the patient and the referring physician as well as the specific healthcare provider will be required to be entered, all of the information pulled from the various tables described herein and retained within the lookup database 100.
  • the payer data table 112 contains specific information regarding the particular insurance payer responsible for payment of healthcare provider claims.
  • An example web page for entry of specific payer information is shown in Figure 13 wherein the insurance information is directly linked to policy holder information which is retained within the policy information table 106.
  • payer data entries within table 112 will be linked appropriately to the various other tables within the lookup database 100.
  • the claims database 200 of the system 10 of the present invention is comprised of a plurality of tables including: diagnosis table 202; detailed information table 204; visit information table 206 and charge information table 208 among others.
  • diagnosis table 202 diagnosis table 202
  • detailed information table 204 visit information table 206
  • charge information table 208 charge information table 208 among others.
  • Figure 14 a sample claim entry web page is shown in Figure 14.
  • a claim entry within the claims database will include specific information which may include: provider; patient; rendering physician; facility; referring physician and supervising physician.
  • diagnosis information will be required for entry within the claims database 200 for each claims entry therein.
  • this information includes diagnosis codes, specific information regarding the reason for treatment as well as detailed information regarding the date of service and codes for the claim.
  • All of this information is stored within tables within the plurality of tables contained within the claims database 200. These entries may also include links to various other tables contained within the lookup database 100. Thus, as can be seen from Figure 14, there may be links 201 as depicted in Figure 3, which allows the entry claim information to be readily available through pull down menus as is depicted in Figure 14 for information relating to known data as provider information or other data. Specific information required for each claim will be entered into a claim table, Claim Line Item table 205, for submission to the clearinghouse 50.
  • the Claim line item table contains all relevant information regarding any given claim such that it is located in a single entry within the claims database 200. Such single entry location of the claim information and data allows the system of the present invention easy access to particular claim information and allows proper tracking of the claim information submitted to external third party clearinghouse and payers.
  • a claim history information table 207 is provided to track all information regarding submitted and non-submitted claims.
  • current status of claim data can be obtained from the table 207 to determine errors contained in the claim, whether the claim has been submitted, any responses received from the third party payers or clearinghouses, final payment of the claim or any other relevant information which can be displayed to the provider on any of the claim status screens provided. All updates and communications received and relevant to a claim is logged in the history table 207 which links directly to each unique claim submission identifier within the claim detail information table 204.
  • Reports shown in Figure 4 and available for selection may include reports directed at clearinghouse information, payer reports, information and status on rejected claims, final payment on accepted claims and other information on claims which have been entered but which are incomplete or have yet to be submitted.
  • the provider may readily track pertinent information on data previously entered into the system of the present invention and determine status of currently pending claims.
  • provider information which is stored in the lookup database 100 incorporates specific information regarding each of the healthcare providers and billing providers located within the system. Additional information regarding policyholders indicating those who are insured and other relevant policy information is also maintained within the lookup database 100. This information may be linked specifically to patient information and payer information, payer information indicating the insurance responsible for payment of claims to the patients. Further, as previously indicated and shown in Figure 4 within the lookup database, facilities, preferences, and other information may be added or updated within the system 10 in order to implement proper billing of claims. All of these functions are available within the maintenance activities, the selection which may be inserted into the sample web pages of Figures 13-15.
  • each of the incomplete 222 or unsubmitted claims 224 are available for action by the user and the system determines if any claim is selected by the user at step 3 or 4. The system will then allow any action selected on the specific claims which includes viewing the specific claim information, editing the claim information, reviewing the claim history table entries for the claim and deleting the claim. If any claims are selected for submission as is depicted in step 306, the system will submit the claims to the clearinghouse 50 for review of the requisite information and for later submission to third party payers or clearinghouses. These claims will be submitted at step 307 and at step 308 the individual claim history record within the claim database 200 will be updated.
  • the procedure for a patient set up is shown.
  • the user may enter the patient set up area 41c of the maintenance activities 41 tasks and select to add a new patient record at step 72.
  • An example of such a web page is shown in Figure 15 as previously indicated. All relevant data may be entered into the system at step 74 as well as connection of the patient information directly to specific insured policyholder information and payer information also contained within the lookup database 100. All of this information is indicated in the tables shown in Figure 2 and the entries in the various tables may linked to various other entries in tables contained therein to display the relevant information shown in Figure 15. This includes linking the patent record with a payer record as indicated at step 76.
  • the exemplary provider setup procedure is depicted in Figure 7.
  • the provider set up procedure may be entered by the user and a new provider may be initiated within the lookup database 100.
  • the system of the present invention requests particular information for each provider such as whether the provider is the billing, referring or other selections as is depicted at 227 and as previously described.
  • the user may enter the relevant provider information 228 for storage of the provider data within the lookup database 100 and specifically within the provider information table 104.
  • the system of the present invention will review all entered information to determine and ensure that all of the adequate information within the provider information table 104 is appropriately entered.
  • the provider set up procedure mandates or requires entry of requisite information for the claims submission process. All of this information is stored within the lookup database 100 through the various tables located thereon.
  • the user may select to add a new provider at step 82.
  • the appropriate position (s) of the provider may be entered, as depicted in Figure 12 as 227, and then the user may enter the provider data 228 into the database at step 86.
  • the system will then review the data for accuracy and errors at step 88.
  • the policyholder menu may be selected as is depicted at step 90 in Figure 8 and a list of all policyholders for the particular provider may be displayed. The provider may select to add a new policyholder and thereby provide all of the relevant information for the policy holder needed for creation of a policy information record in the policy holder table 106 of Figure 2.
  • FIG. 18 An example of the web page for adding a new policy holder is displayed in Figure 18. As can be seen, fields for all of the requisite policyholder information 229 are provided for entry by the healthcare provider. In correspondence with the schematic of Figure 8, data may be entered at step 93 and then the system will determine if a patient record for this policyholder is to be created at step 94. It is apparent that there are corresponding functions available for selection by the user in the sample web page shown in Figure 18. Upon addition of a new policy holder, the system of the present of the present invention will request at step 96 whether or not to add a payer or insurance to the policy holder which was just entered.
  • the system of the present invention will then link the payer to the policyholder which was just entered as is depicted in the sample web page of Figure 13.
  • the system of the present invention maintains a list of all payers for the provider and allows the user to simply pull the appropriate payer information from a pull down menu.
  • the policy information record entered into the policy information table 106 will be linked to appropriate payer data in the payer data table 112.
  • the claims selection tab by the user allows the user to select functional actions such as adding new claims 122, reviewing unsubmitted claims 124, reviewing claims wherein action is required at step 126 or searching through the entered claims at 125.
  • Representative example of the claims functional menu is shown in Figure 14 wherein the add new claim information has been selected. However, as may be seen, all functions are available for selection by the user.
  • system 10 of the present invention provides pull down menus for various fields
  • These fields as indicated in Figure 14 may include the provider field, patient field, rendering physician, facility, referring physician and supervising physician, among various potential selections.
  • new provider information as is depicted in Figure 12 may be entered. However, assuming all relevant information has previously been entered into the lookup database 100, the user may simply select from the various pull down menus 230depicted in Figure 14 in order to make entry of claim data relatively easy.
  • the system will combine all claim data into a record table within the claims database 200 at step 146 and then mark such claim entry as unsubmitted but saved.
  • the user may then, at a later date, submit the saved claim data to the internal clearinghouse 50 for review and further retransmission to either a third party clearinghouse or third party payer.
  • the record will be forwarded to the clearing house at step 148 for further processing and data review.
  • Such real time review may be limited or may be extensive through the integration of a rules set for data validity or the existence of required data alternatively real time data checking may be rather extensive by integration of the rule set existent in the clearinghouse 50.
  • the rule set for valid claim data within the clearinghouse 50 may be rather extensive and insures the adequacy of all data and proper formatting for later submission to third party clearinghouse or payors.
  • the user may save the claim data to the claim database 200 at step 158. All the stored claim records within the claim database 200 may then be reviewed by the healthcare provider at a later time for submission to the clearing house and for subsequent payment. Thus, if the user were to select the unsubmitted function within the claims area of the system of the present invention, a listing of all unsubmitted claims will be displayed for review by the provider. All unsubmitted and saved claims may also be displayed at step 160 and the user may then elect to submit each claim as appropriate for processing at step 162, as is depicted in Figure 17 or may act upon those claims listed as previously described.
  • lb sensitive information may be stored requiring appropriate encryption for data security.
  • secured socket layer technology may be utilized at the web browser interface 14 to provide multi-bit encryption.
  • a secondary layer of security may be utilized allowing the healthcare provider access to the web site server and the various data bases associated with only their user ID and prespecified password.
  • data in the various databases 20 stored on the system of the present invention may be fully encrypted on the database storage device so that inadvertent access through the internet connection would be insufficient for viewing the contents of the databases 100 and 200. Encryption of the data stored on the server 18 thereby insures a triple layer of security for the data and the healthcare provider claim information stored on the system 10 of the present invention.
  • Claim information stored in the claim database 200 and submitted to clearinghouse 50 may be formatted for the clearinghouse into the required formatting perimeters defined by the third party clearinghouses 39 or payers 38.
  • Internal claim submission clearinghouse 50 will review all of the claims for missing or incorrect information, as previously indicated, and thereby submit those claims directly to the payer 38 and clearinghouse 39.
  • the electronic submission of these claims increases the efficiency of service provided not only by the healthcare provider but also by the third party payers. Additionally, through electronic submission of claims, the turn-around times between submission of claims and ultimate payment to the provider may be reduced significantly.
  • Claim data which is formatted by the clearinghouse 50 and forwarded onto the third party clearinghouse 39 or payer 38 may be incorrect or contain missing information.
  • the third parties 38 and 39 may then reply to the internal clearing- house 50 via e-mail or other electronic communication in order to notify the provider that additional information is required for specific claims.
  • the system 10 of the present invention readily accepts these electronic communications from the third parties 38 and 39 in order to recontact the provider and obtain the requested information.
  • Particularized request for claim information will be forwarded to the provider in order to obtain further information to correct the claim data, as is depicted in Figure 17 with the display of incomplete claims 222.
  • Electronic communication of problem claim data also increases the efficiency of the claim submission process and allows incorrectly entered claims to be corrected an resubmitted with relative ease.
  • each claim entry within the claim database 200 contains a history status field indicating the current status of the claim and whether or not a response has been received by the third parties requesting additional information and requiring intervention by the healthcare provider.
  • All of the screens for claims submission, insurance submission, provider information and payer information as well as the other data previously outlined are available to the healthcare provider through a generic internet web browser.
  • the freedom of the healthcare provider to utilize an existing internet service provider as well as standard web browser interface software provides a significantly less expensive system for the healthcare provider to utilize in electronic claims submission. Further, adjustments to the software or to the interface may be done solely on the webserver 18 and therefor not require upgrade software to be provided to the ultimate users.

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Abstract

Cette invention se rapporte à un système de facturation basé sur un navigateur Web (14), pour la présentation des demandes de paiement de la part des fournisseurs de soins de santé, le fournisseur de soins se connectant directement au système faisant l'objet de cette invention par l'intermédiaire d'un réseau ouvert utilisant un logiciel navigateur. On prévoit un serveur de site (18) dans lequel sont incorporées les bases de données (20) du système de cette invention et qui permet d'associer les informations créées par les fournisseurs de soins directement aux informations relatives à la demande de paiement et aux données concernant le fournisseur de soins, la procédure, le diagnostic, l'assuré et le patient. Le système faisant l'objet de cette invention ne nécessite qu'une interface de navigateur Web (14) pour l'utilisation des services du site et reçoit les données relatives aux demandes de paiement en vue de leur formatage et de leur présentation ultérieure à une chambre de compensation de traitement des demandes de tierces parties ou pour leur présentation directe à la tierce partie payeuse. Le système faisant l'objet de cette invention évite aux fournisseurs de soins de santé de prendre en charge un logiciel spécialisé mandaté et conçu juste pour la présentation des demandes de paiement, dès lors que toutes les données et le logiciel de support sont fournis par le serveur de site (18).
PCT/US2000/011429 1999-04-30 2000-04-28 Systeme de facturation base sur un navigateur web pour le traitement des demandes de paiement des fournisseurs de soins de sante WO2000067173A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU44981/00A AU4498100A (en) 1999-04-30 2000-04-28 Web browser based billing system for health care provider claims

Applications Claiming Priority (2)

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US13186999P 1999-04-30 1999-04-30
US60/131,869 1999-04-30

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WO2000067173A1 true WO2000067173A1 (fr) 2000-11-09

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US7617116B2 (en) 2000-08-04 2009-11-10 Athenahealth, Inc. Practice management and billing automation system
US8099302B2 (en) 2000-01-21 2012-01-17 The Trizetto Group, Inc. Method of increasing efficiency in a medical claim transaction, and computer program capable of executing same
US10318923B1 (en) 2012-08-01 2019-06-11 Cognizant Trizetto Software Group, Inc. Payment assurance and claim pre-validation
US10846434B1 (en) * 2015-11-25 2020-11-24 Massachusetts Mutual Life Insurance Company Computer-implemented fraud detection

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