The present application claims benefit of U.S. Patent Provisional Application Ser. No. 60/462,151, filed Apr. 11, 2003, which is incorporated herein in its entirety by reference.
The present invention generally relates to recovery audits, and specifically to automated tools for web-based review, validate, approval and submission of claims identified by recovery audits.
Companies lose millions of dollars annually because of unpaid invoices, double payment, discounts and allowances not received and general overpayments. While some of these mistakes are rectified by annual audits performed by a company's accounting firm, such audits are generally not thorough enough to identify all the recoverable loses due to erroneous business transactions. As a consequence, companies hire firms to provide recovery audit services directed at identifying overpayments and collecting the monies due their clients for such erroneous payments.
The successful execution of a recovery audit is dependent on a number of factors, including the audit planning process and the collection of relevant documentation. The collection of relevant documentation is becoming more and more difficult. Where buy/sell transactions were once done almost exclusively on paper, today's business environment often results in these transactions being consummated via electronic documents. When these electronic documents are not part of a larger enterprise software solution (i.e., electronic invoicing systems), then accessing this information can be difficult. It is widely appreciated that companies are communicating with one another via e-mail in an ever-increasing fashion. Included in these e-mails are price commitments, notifications of price changes and vendor agreements with special discounts and allowances, all of which may be necessary documentation to have an effective audit.
The collection of relevant documentation is not only important in executing audits, but also in substantiating claims resulting from the audit. Typically, reviewing and approving claims can be a time consuming process for the client, the vendor, and the recovery-auditing firm. One significant reason for this time-consuming process is that the review of claims and documents supporting the claims is paper-intensive, and the multiple communications between the parties as they collaborate over a certain claim is difficult to manage and time consuming. The same claims and supporting documentation are typically reviewed individually and jointly in a meeting between the client and the recovery-auditor (also referred to herein as simply the auditor). Additionally, the validation process that occurs between the recovery-auditor and the client's vendor can also be paper intensive and may require several meetings or teleconferences to provide and review proper claim documentation.
The multiple communications between the parties can be by phone, e-mail, letter, in-person, etc., and therefore, may be difficult to track and assimilate, much less in a manner visible to all. In addition, monitoring the approval process is difficult given the decentralized manner in which it is currently done. Inefficiencies are difficult to identify, which may result in fewer claims being approved and/or an unnecessary delay from the time the claim is identified by the auditor to when the auditor can submit the approved claim to the client for payment.
Thus, an unsatisfied need exists in the industry for a more efficient means for a client to review and approve claims, and for a client to transmit the approved claim, along with the requisite documentation supporting the claim, to a vendor for review and authentication.
The systems, methods and computer program products of the present invention provide an expedited process for reviewing, validating and approving claims in a recovery audit. The claims are electronically packaged with supporting documents and securely distributed to clients. In one embodiment, a client receives an e-mail notice that one or more claims are ready for review, and via an Internet browser can review, approve and comments on one or more claims prepared by an auditor. Because the support documentation is immediately available, all parties have the same material as the basis of the claim before them to understand the source of the recovery. Once approved by the client (also referred to as the claimant), the same claim and supporting documentation can be provided to the vendor for review, and if appropriate, approval. Through this process, the present invention records communications among the parties to ensure a complete record.
While the present invention has many advantage over the prior art, some of those advantages include better control of the claim review and approval process, real-time status, immediate validation through support documentation, better claim tracking for current and historical reports, reduced time for claim deduction, reduces audit expenses associated with copying, reduction in time required by a client to meet with auditors to review claims; simplification and organization of difficult to track recovery documentation; increase in speed of the vendor approval process; attachment of back-up documentation with the claim, such that a vendor need not wait for separately provided back-up information corresponding to a claim; providing a client with better control and up to the minute status of claims, and provides electronic tracking and documentation of recovery status; and improved vendor relations through an easier to use and cleaner claim process.
Having thus described the invention in general terms, reference will now be made to the accompanying drawings, which are not necessarily drawn to scale, and wherein:
The present inventions now will be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all embodiments of the invention are described. Indeed, these inventions may be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will satisfy applicable legal requirements. Like numbers refer to like elements throughout.
It will be appreciated that the systems and methods of the present invention are described below with reference to block diagrams and flowchart illustrations. It should be understood that blocks of the block diagrams and flowchart illustrations, and combinations of blocks in the block diagrams and flowchart illustrations, respectively, may be implemented by computer program instructions. These computer program instructions may be loaded onto a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a mechanism, such that the instructions which execute on the computer or other programmable data processing apparatus create means for implementing the functions specified in the flowchart block or blocks.
These computer program instructions may also be stored in a computer-readable memory that can direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including instruction means that implement the function specified in the flowchart block or blocks. The computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer implemented process such that the instructions that execute on the computer or other programmable apparatus provide steps for implementing the functions specified in the flowchart block or blocks.
Accordingly, blocks of the block diagrams and flowchart illustrations support combinations of means for performing the specified functions, combinations of steps for performing the specified functions and program instruction means for performing the specified functions. It will also be understood that each block of the block diagrams and flowchart illustrations, and combinations of blocks in the block diagrams and flowchart illustrations, can be implemented by special purpose hardware-based computer systems that perform the specified functions or steps, or combinations of special purpose hardware and computer instructions.
The present invention provides methods, systems and computer program products for web-based claim review, validation and approval, all of which can be performed in expedited manner. In the present invention, each claim is packaged electronically along with all relevant supporting documentation evidencing the basis for the claim. The claim and relevant back-up information are made accessible to the client via the Internet using a web browser. The client can access, review, validate and approve each claim at her or his convenience. Once reviewed and approved by the client, the claim along with its appropriate documentation is retrievable by a vendor for review, validation and approval. Because this process occurs via the Internet, the claim and its supporting information are easily accessible and available to all parties, which can view the same information and understand the source of the recovery.
With the present invention, the client can choose the time that is convenient to him or her. Because the claim and all of its documentation reside together, the client can see exactly how the claim was constructed, review its rationale and logic, and approve it at his or her convenience. Additionally, the client will have an organized record of all approvals and be able to see the status and vendor action on each approved claim.
With reference to the figures,
The claim processing system 10 includes a web server 20, an e-mail server 22 and a database 24. The components of the claim processing system 10 may be collocated on a single computing device, such as a server or personal computer, or distribute over a LAN and/or WAN between multiple computing devices. Further, the components of the claim processing system 10 may be distributed themselves, such as database 24, which may comprise multiple databases operating under the control of a single or multiple database applications.
The web server 20 comprises a claim manager 26 and a document viewer 28. The claim manager 26 comprises the logic implementing the claim review, validation and approval functionality of the present invention, as described herein. The viewer 28 can be any viewer suitable for the secure viewing of document or images over a network. For example, the NetVue™ server commercially available from AccuSoft Corporation, Northborough, Me., may be suitable. BravaViewer from Informative Graphics Coporation, Scottsdale, Ariz. The viewer 28 enables the auditor 12, client device 14 and vendor device 16 to remotely view documents stored in database 24.
The database 24 comprises data and images. The data includes records of the claims identified by auditors and the images include supporting documentation associated with those claims. As an example, a claim record may include one or more of the following: claim date, claim amount, vendor name, vendor number, claim type, claim description, cancel amount, payback amount, client approval date, client approval amount, vendor approval date, vendor approval amount, age of claim, date last updated by client or vendor. The claim processing system 10 may include a document scanning and management system that enables one to scan and upload all pertinent documents used to support the claim. One such system is ImDex™, conceived and developed by the assignee of the present invention. Alternatively, the supporting documentation may be provided through remote access to such a system and/or transferred from such a system for local storage. The claims, once identified by the auditors, are stored as records on the database 24 for use by the claim manager 26. The claim processing system 10 also may include an audit system that is capable of identifying claims in an automated or manual fashion, or utilizing both automation and manual processes. Such systems often utilize filters to screen and cross-reference the electronic documents obtained from a system such as ImDex™ to identify recoverable claims against a vendor. Once identified, a record of the claim is generated, and the documents supporting the claim are associated therewith. For purposes of the review, validation and approval processes of the present invention, the claim records stored in database 24 can be generated by any suitable system or process.
The auditor device 12, client device 14 and vendor device 16 may be any suitable computing device with communication means suitable for interfacing with the network 18. The communication link between these devices and the network 18 may be wired, wireless, or a combination thereof. The devices themselves may be personal computer, thin client computers, PDAs, laptops, tablet computers, or any other suitable computing device. In the illustrative embodiment, the devices 12,14,16 include a web browser application such as Microsoft Explorer or Apple Safari to facilitate communication with the claim processing system 10, for example, over the Internet.
The operation and functionality of the claim processing system 10 will now be further described in the context of an illustrative embodiment provided in the flow diagrams and user interfaces of
Because all communications and activity associated with a claim can be recorded by the present invention, reports pertaining to virtual any aspect of the process can be generated. For example, the auditor may want to generate reports pertaining to how long it takes to get a claim approved and which steps take the longest, whereas the client may want to generate reports pertaining to claims generated by vendor. If desired, reports can also be generated pertaining to vendor related issues, such as total claims approved.
The e-mail notices include a link to a secure website where the recipient can gain access to the claim(s) and supporting documentation for their review and approval, as discussed below with reference to
According to one aspect of the present invention, the claim manager 26 may comprise a software product for generating graphical user interface via web server 20 for user interaction with the claim processing system 10. Therefore, it will be understood that each of the accompanying graphical user interfaces can be implemented by computer program instructions. These computer program instructions may be loaded onto a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions which execute on the computer or other programmable data processing apparatus create means for implementing the functions illustrated by and described with reference to the illustrative user interfaces provided below.
These computer program instructions may also be stored in a computer-readable memory that can direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including instruction means that implement the function illustrated by the interfaces. The computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer implemented process such that the instructions that execute on the computer or other programmable apparatus provide steps for implementing the functions specified herein.
According to one aspect of the invention, the various access rights are established by the username and password provided by a person logging onto the web-based system. This information, as is known in the art, may also be embodied in cookies provided by the web server serving the pages or in other communications, such as e-mail links, which may be used to access particular information via the interfaces, as described below. Finally, it will be appreciated that the web pages described herein may be created and served to users via the web server 20 under the control of the claim manager 26.
As shown in
Upon selecting a project to view and open, the user is presented with the claims manager interface 106 showing detailed claim information, as shown in
As shown in
The claims may be searched and filtered by the auditor by selecting the search button 114 or selecting a pre-saved search (i.e., filter) via pull-down menu 116. When the auditor selects the search button 114, search interface 120 of
The claims manager interface 106 presents the auditor with four activity buttons 122 for use in processing the claims. The auditor can select, via the selection buttons 124, one or more claims to review in greater detail. After selecting a claim and selecting the open button 126, detailed claim information is provided via the claim details interface 130, as shown in
The Claim Information section provides the basic claim information shown in the claims manager interface 106 and additional information such as the approval date, the auditor, a description, an audit claim status, and detailed amount information, such as the payback amount, net amount and approval amount. The auditor has the options of submitting a response to the claim via button 140 and approving the claim via button 142. The Comments section 134 enables the auditor to view, edit and search the comments submitted on the present claim. The Document section 136 enables the auditor to view, download or send (i.e., upload) claim documents associated with the claim via individually selectable buttons 144. Lastly, the Category History section enables the auditor to change the categories and/or stage via selectable button 146, as discussed below.
If the auditor selects the Respond to Claim button 140 at the claim detail interface 130, the user is taken to the add comment/file interface 150 shown in
From the claim detail interface 130, the auditor may also approve a claim by selecting the Enter Approval button 142, which takes the auditor to the approve claim interface 160 shown in
From the claim detail interface 130, the auditor may also view, download and send a document from the Documents section 136. By selecting the View button 162, the document will be presented to the auditor in the format requested by the viewer 28 of web server 20. An illustrative presentation of a document is provided in
Referring back to the claims manager interface 106, the auditor may submit a comment or add a document by selecting one or more claims via selection boxes 124 and selecting the Add Comment/File button 180. This takes the auditor to a add comment/file interface 182, as shown in
When one or more claims have been approved and are ready to be packaged and sent to the client and/or vendor, the auditor may select the Package Selected Claims button 190 of the claims manager 106. This takes the auditor to a package claims interface 192, as shown in
The above-described graphical user interfaces therefore allow an auditor simple and immediate access to claim information, including status, and support documents evidencing the basis for the claims. Because the interfaces are web-enabled, an auditor only needs a web-browser and an Internet connection to access the interfaces. The following user interfaces are those generated for the client and vendor when accessing the claim for review, validation and approval. Many of the interfaces common to the auditor, client and vendor are not reproduced but discussed in reference to the corresponding auditor interface described above.
In the processing of claims, as discussed above, each client will have their particular rules regarding approval. For example, a client may not require its approval over claims below a certain dollar value. Alternatively, the auditor may require sole approval rights over certain claim types. There also may be vendor requirements that must be considered in the processing of claims, such as the length of time that a claim is considered valid. Regardless of the processing limitations, the claim manager of the present invention is highly configurable so as to enable most any claim processing scheme. In most case, claims will be initial sent to the client for approval prior to being sent to the vendor. Accordingly, the following discussion will discuss the claim processing at the client and the vendor, though the present invention is not limited to any particular processing order.
The client receives an e-mail notice, such as the one illustrated in
The client also has the option from the claims manager interface 200 to set the category and stages for defining the process flow of how a claim is process internally. While the auditor has the same option from their claims manager interface, this feature is described herein from the perspective of the client. By selecting the Set Category/Stages button 220 on the claims manager interface 200, the client is taken to the category/stage interface 230, as illustrated in
Once the claim has been approved by the client, or in cases where the client approval is not needed, the claim is sent to the vendor. The auditor may review the claim once it has been approved by the client to evaluate any comments or changes made by the client. The auditor then packages the claim for delivery to the vendor, which results in an e-mail to the vendor. This e-mail will be substantially the same as that illustrated in
As with the auditor and client, the vendor must log into the claim processing system 10 via interfaces substantially similar to those illustrated in
By selecting the Add Comment/File button 252, the vendor is taken to an add comment/file interface 260, as illustrated in
Once the vendor approves the claim, the claim record is immediately updated and the audit can review the claim and submit to the client for deduction. If the audit finds an issue with the approval (e.g., a partial approval that is questionable), the audit may have further conversations with the vendor through the claim interface until the claim is resolved. Without the present invention, this process could take much longer and in some cases due to the manual nature of the current process, the claim may never be resolved as it can become lost or forgotten.
Many modifications and other embodiments of the inventions set forth herein will come to mind to one skilled in the art to which these inventions pertain having the benefit of the teachings presented in the foregoing descriptions and the associated attachments. Therefore, it is to be understood that the inventions are not to be limited to the specific embodiments disclosed and that modifications and other embodiments are intended to be included within the scope of the present disclosure. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.
Number | Date | Country | |
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60462151 | Apr 2003 | US |