CA2078671C - Systeme de gestion d'assurance-sante et d'information fonctionnant en temps reel - Google Patents

Systeme de gestion d'assurance-sante et d'information fonctionnant en temps reel

Info

Publication number
CA2078671C
CA2078671C CA002078671A CA2078671A CA2078671C CA 2078671 C CA2078671 C CA 2078671C CA 002078671 A CA002078671 A CA 002078671A CA 2078671 A CA2078671 A CA 2078671A CA 2078671 C CA2078671 C CA 2078671C
Authority
CA
Canada
Prior art keywords
block
patient
benefits
plan
computer system
Prior art date
Legal status (The legal status 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 status listed.)
Expired - Fee Related
Application number
CA002078671A
Other languages
English (en)
Other versions
CA2078671A1 (fr
Inventor
William D. Alcott Iii
Findley C. Doyle, Jr.
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of CA2078671A1 publication Critical patent/CA2078671A1/fr
Application granted granted Critical
Publication of CA2078671C publication Critical patent/CA2078671C/fr
Anticipated expiration legal-status Critical
Expired - Fee Related legal-status Critical Current

Links

Classifications

    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06Q—INFORMATION 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
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/02—Banking, e.g. interest calculation or account maintenance
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06Q—INFORMATION 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
    • G06Q10/00—Administration; Management
    • G06Q10/10—Office automation; Time management
    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; COUNTING
    • G06Q—INFORMATION 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
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G16H10/65—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records stored on portable record carriers, e.g. on smartcards, RFID tags or CD

Landscapes

  • Business, Economics & Management (AREA)
  • Engineering & Computer Science (AREA)
  • Accounting & Taxation (AREA)
  • Strategic Management (AREA)
  • Finance (AREA)
  • Theoretical Computer Science (AREA)
  • General Physics & Mathematics (AREA)
  • General Business, Economics & Management (AREA)
  • Physics & Mathematics (AREA)
  • Marketing (AREA)
  • Economics (AREA)
  • Health & Medical Sciences (AREA)
  • Primary Health Care (AREA)
  • Technology Law (AREA)
  • General Health & Medical Sciences (AREA)
  • Development Economics (AREA)
  • Entrepreneurship & Innovation (AREA)
  • Medical Informatics (AREA)
  • Epidemiology (AREA)
  • Public Health (AREA)
  • Human Resources & Organizations (AREA)
  • Operations Research (AREA)
  • Data Mining & Analysis (AREA)
  • Tourism & Hospitality (AREA)
  • Quality & Reliability (AREA)
  • Management, Administration, Business Operations System, And Electronic Commerce (AREA)
  • Medical Treatment And Welfare Office Work (AREA)
  • Medicinal Preparation (AREA)
  • Information Retrieval, Db Structures And Fs Structures Therefor (AREA)

Abstract

Un utilitaire temps réel d'information et d'administration d'assurance médicale qui comprend un terminal de prestation de services (18), en communication bidirectionnelle avec une unité centrale de traitement (3) et une base de données centrale actualisable (6). Le terminal de prestation de services (18) comprend un lecteur de cartes pour la saisie des données d'identification des membres du groupe, un clavier qui permet d'interroger la base de données centrale en ce qui concerne l'admissibilité au plan des membres du groupe et les remboursements prévus pour divers traitements proposés, ainsi qu'un écran pour l'affichage des données fournies en réponse aux requêtes. L'employeur est également doté d'un terminal (185) en communication bidirectionnelle en ligne avec l'unité centrale de traitement, de sorte que l'admissibilité du membre du groupe peut être actualisée en ligne.
CA002078671A 1990-04-09 1991-04-05 Systeme de gestion d'assurance-sante et d'information fonctionnant en temps reel Expired - Fee Related CA2078671C (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US50670490A 1990-04-09 1990-04-09
US506,704 1990-04-09

Publications (2)

Publication Number Publication Date
CA2078671A1 CA2078671A1 (fr) 1991-10-10
CA2078671C true CA2078671C (fr) 1998-09-29

Family

ID=24015681

Family Applications (1)

Application Number Title Priority Date Filing Date
CA002078671A Expired - Fee Related CA2078671C (fr) 1990-04-09 1991-04-05 Systeme de gestion d'assurance-sante et d'information fonctionnant en temps reel

Country Status (5)

Country Link
EP (1) EP0525056A4 (fr)
JP (1) JPH05509424A (fr)
AU (1) AU667457B2 (fr)
CA (1) CA2078671C (fr)
WO (1) WO1991015817A1 (fr)

Families Citing this family (24)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
NL9200793A (nl) * 1992-05-01 1993-12-01 Pacing Management & Consultanc Werkwijze en systeem voor zorgvragergerichte optimalisering van zorghandelingenvolgorde en zorgvrageridentificatiekaart voor gebruik in een dergelijke werkwijze of dergelijk systeem.
FR2692385B1 (fr) * 1992-06-16 1999-12-31 Gemplus Card Int Systeme automatique d'impression d'un formulaire administratif medical.
JPH07319971A (ja) * 1994-05-19 1995-12-08 At & T Global Inf Solutions Internatl Inc 遠隔アクセス可能な医療ネットワーク
US6003007A (en) 1996-03-28 1999-12-14 Dirienzo; Andrew L. Attachment integrated claims system and operating method therefor
US9619841B2 (en) 1996-03-28 2017-04-11 Integrated Claims Systems, Llc Systems to assist in the creation, transmission, and processing of health insurance claims
US6915265B1 (en) * 1997-10-29 2005-07-05 Janice Johnson Method and system for consolidating and distributing information
EP0923040A3 (fr) * 1997-12-12 2002-01-02 Texas Instruments Inc. Système d'information digitale et dispositif portable pour ledit
US6208973B1 (en) 1998-02-27 2001-03-27 Onehealthbank.Com Point of service third party financial management vehicle for the healthcare industry
US6879959B1 (en) 2000-01-21 2005-04-12 Quality Care Solutions, Inc. Method of adjudicating medical claims based on scores that determine medical procedure monetary values
WO2001099027A2 (fr) * 2000-06-20 2001-12-27 Freeman Mark B Systeme de distribution d'informations a utiliser lorsque le facteur temps est essentiel
US7624026B2 (en) 2000-11-21 2009-11-24 The Trizetto Group, Inc. Health plan management method and apparatus
KR100392331B1 (ko) * 2001-02-02 2003-07-22 서오텔레콤(주) 통신망을 이용한 의료보험 관리시스템 및 그 방법
US7921123B2 (en) * 2001-02-20 2011-04-05 Hartford Fire Insurance Company Method and system for processing physician claims over a network
US8090599B2 (en) 2003-12-30 2012-01-03 Hartford Fire Insurance Company Method and system for computerized insurance underwriting
US7783505B2 (en) 2003-12-30 2010-08-24 Hartford Fire Insurance Company System and method for computerized insurance rating
US8768729B2 (en) 2004-10-14 2014-07-01 Trizetto Corporation System and method for using a first electronic representation of contract terms for generating a second electronic representation of the contract terms
US8000979B2 (en) 2004-11-24 2011-08-16 Blom Michael G Automated patient management system
US7739129B2 (en) 2006-04-10 2010-06-15 Accenture Global Services Gmbh Benefit plan intermediary
US8204764B2 (en) 2010-08-03 2012-06-19 Zepherella, Inc. Systems and methods of managing appointments in a health care system
US8756075B1 (en) 2011-05-18 2014-06-17 Trizetto Corporation System and method for processing payment bundles
US10296976B1 (en) 2011-09-23 2019-05-21 Cognizant Trizetto Software Group, Inc. System and method for calculating estimated payment based on partial coding data
US10318923B1 (en) 2012-08-01 2019-06-11 Cognizant Trizetto Software Group, Inc. Payment assurance and claim pre-validation
US10410187B2 (en) 2013-09-25 2019-09-10 Patientpay, Inc. Managing installment payments in a healthcare system
EP3101618A4 (fr) * 2014-06-20 2017-05-10 Panasonic Healthcare Holdings Co., Ltd. Procédé d'aide à la prescription de médicament, programme d'ordinateur pour une aide à la prescription de médicament, et dispositif d'aide à la prescription de médicament

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4491725A (en) * 1982-09-29 1985-01-01 Pritchard Lawrence E Medical insurance verification and processing system
US4667292A (en) * 1984-02-16 1987-05-19 Iameter Incorporated Medical reimbursement computer system
US4648037A (en) * 1984-03-15 1987-03-03 Metropolitan Life Insurance Company Method and apparatus for benefit and financial communication
US4831526A (en) * 1986-04-22 1989-05-16 The Chubb Corporation Computerized insurance premium quote request and policy issuance system
US4858121A (en) * 1986-12-12 1989-08-15 Medical Payment Systems, Incorporated Medical payment system
US4916611A (en) * 1987-06-30 1990-04-10 Northern Group Services, Inc. Insurance administration system with means to allow an employer to directly communicate employee status data to centralized data storage means

Also Published As

Publication number Publication date
AU667457B2 (en) 1996-03-28
JPH05509424A (ja) 1993-12-22
WO1991015817A1 (fr) 1991-10-17
EP0525056A4 (en) 1993-11-24
EP0525056A1 (fr) 1993-02-03
AU7766691A (en) 1991-10-30
CA2078671A1 (fr) 1991-10-10

Similar Documents

Publication Publication Date Title
CA2078671C (fr) Systeme de gestion d'assurance-sante et d'information fonctionnant en temps reel
US6820058B2 (en) Method for accelerated provision of funds for medical insurance using a smart card
US4916611A (en) Insurance administration system with means to allow an employer to directly communicate employee status data to centralized data storage means
US5070452A (en) Computerized medical insurance system including means to automatically update member eligibility files at pre-established intervals
US10289804B2 (en) Method of increasing efficiency in a medical claim transaction, and computer program capable of executing same
US6012035A (en) System and method for supporting delivery of health care
US7197468B1 (en) Method and system for processing transactions involving accounts for reimbursing medical expenses or patient responsible balances with multiple transaction substantiation modes
US20020077869A1 (en) Insurance administration system
US20110288882A1 (en) System to Prevent Medical Billing Fraud
US20020138306A1 (en) System and method for electronically managing medical information
US20070198407A1 (en) Self-pay management system and process for the healthcare industry
US20070162433A1 (en) System and method for a secure process to perform distributed transactions
US20060064320A1 (en) System and method for centralized management and monitoring of healthcare services
US20070005402A1 (en) Healthcare system and method for real-time claims adjudication and payment
US20030135397A1 (en) Medical billing system to prevent fraud
US20050209893A1 (en) System and method for identifying and servicing medically uninsured persons
WO1995003569A2 (fr) Systeme destine a determiner les sources primaire et secondaire de couverture medicale
US20060149594A1 (en) Health care facility admission control system
US20060265255A1 (en) System for monitoring health insurance coverage milestones, tracking member expenses & payments and administration tool for health/medical saving accounts
US20040103061A1 (en) Smart card for accelerated payment of medical insurance
WO2000066367A1 (fr) Procede, systeme et reseau permettant de coordonner la communication de donnees pour une transaction liee a la sante
Cuzmanes et al. Automation of Medical Records: The Electronic Superhighway and Its Ramifications for Health Care Providers
KR20060029127A (ko) 국민 건강보험 재정안정화 시스템
Young et al. Payments to the Civilian Health and Medical Program of the Uniformed Services
KR20060035546A (ko) 국민건강보험재정안정화 시스템

Legal Events

Date Code Title Description
EEER Examination request
MKLA Lapsed
MKLA Lapsed

Effective date: 20090406