There are a number of types of situations in which consumers or others may be entitled to full or partial reimbursement for certain expenditures that they make. One very common type of expenditure is for medical services. Many consumers may be covered by health insurance that may provide partial or complete reimbursement for medical service charges. In some insurance arrangements, the consumer is required to pay the medical service provider and at that time obtains a paper certificate proving that the payment has been made. The consumer then must submit a claim to the medical insurance company, including the paper proof of payment. This type of arrangement entails a high degree of inconvenient manual processing of paper documents on the part of both the consumer and the insurer.
In other arrangements, the consumer receives an “explanation of benefits” (EOB) on paper from the medical insurance company. The EOB is in response to a claim submitted to the insurance company from the medical services provider. The EOB contains an explanation (often difficult for the consumer to decipher) of what the provider's charges were, how much of the amount charged was disallowed or covered by insurance benefits, and the amount payable from the consumer to the medical service provider. The consumer must then pay to the medical services provider an amount billed by the medical services provider in accordance with the EOB. Among many other inconveniences and inefficiencies in this system, the consumer may be required to retain the paper EOB and to compare it with the subsequently received invoice from the medical services provider. Again this type of system entails a high degree of labor-intensive activity on the part of the consumer and other parties.
It is also common to encounter inefficient and labor-intensive practices in other situations, such as reimbursement for automobile collision insurance damage claims, real property damage insurance claims, etc.
Features and advantages of some embodiments of the present invention, and the manner in which the same are accomplished, will become more readily apparent upon consideration of the following detailed description of the invention taken in conjunction with the accompanying drawings, which illustrate preferred and exemplary embodiments and which are not necessarily drawn to scale, wherein:
In general, and for the purpose of introducing concepts of embodiments of the present invention, a service provider/merchant accepts a payment card or similar device at a point of interaction. The service provider initiates a payment card account system transaction for the amount due to be paid by a consumer/payment card account holder. In parallel, the point of interaction forwards, via another communication channel, to a supplemental processor, details of services provided to the consumer. The supplemental payment processor, in coordination with the card network, requests payment of a portion of the transaction amount from one or more insurers or other supplemental payment providers. (The supplemental payments, of whatever kind, may be referred to as “rebates”.) The request(s) for a rebate or rebates may be performed separately from the payment card account network rails and routing and processing facilities.
(In some contexts, the insurers/supplemental payment providers may be referred to as “insurance providers” or “rebate providers”.)
Upon receiving the rebate provider's authorization, the supplemental payment provider calculates a revised transaction amount, representing the original transaction amount less rebate(s). The card network forwards a revised payment card account system payment authorization request message to the issuer of the consumer's payment card account. The revised authorization request includes the revised transaction amount. The payment card account system transaction is completed to provide partial payment to the service provider. In a parallel or subsequent clearing transaction, the rebate(s) is(are) credited to the service provider.
With a system/process as described above, an insurance payment scheme or the like is largely automated and made convenient and efficient for all parties. Manual paper handling is minimized or eliminated, and the payment card account system communication channels are not overburdened with supplemental transaction details. Moreover, insurance companies or other rebate providers may become involved in an automated payment system with less expense and effort than may be required for data processing integration with a payment card network.
By way of background, a typical payment system will first be briefly described.
The system 100 includes a payment card/device 102 (which may alternatively be a payment-enabled mobile device that stores a payment card account number and runs a payment applet; other form factors for the payment device, such as a fob, are also possible). The system 100 further includes a reader component 104 associated with a POS (point of sale) terminal 106. In some known manner (depending on the type of the payment card/device 102) the reader component 104 is capable of reading the payment card account number and other information from the payment card/device 102. (Some usages include the term “point of interaction” to include both the point of sale at a retail store, plus card acceptance terminals or the like at premises of service providers, transit system entrance gate terminals, etc.)
The reader component 104 and the POS terminal 106 may be located at the premises of a retail store and operated by a sales associate of the retailer for the purpose of processing retail transactions. The payment card/device 102 is shown in
A computer 108 operated by an acquirer (acquiring financial institution) is also shown as part of the system 100 in
One well known example of a payment network is referred to as the “Banknet” system, and is operated by Mastercard International Incorporated, which is the assignee hereof.
The payment card issuer server computer 112 may be operated by or on behalf of a financial institution (“FI”) that issues payment card accounts to individual users and/or other entities. For example, the payment card issuer server computer 112 may perform such functions as (a) receiving and responding to requests for authorization of payment card account transactions to be charged to payment card accounts issued by the FI; and (b) tracking and storing transactions and maintaining account records.
The components of the system 100 as depicted in
A typical payment system like that shown in
The second broad function is processing (block 204). Again, more detailed description below will discuss such processing as including split payment processing (block 206) to obtain payment for the transaction from two or more sources.
The third broad function is payment authorization (block 208). One source of such authorization may be a payment account issuer 210 (akin to item 112 in
One or more other/supplemental funding sources (and hence sources of payment authorization) are indicated by block 212. The communication between the split payment processing function 206 and the payment account issuer 210 may be via payment card account network channels, as indicated at 214. The communication between the supplemental funding sources 212 and the split payment processing function 206 may be via internet switching/addressing, as indicated at 216.
The payment system 300 includes a point of interaction (POI) 302 at which a payment transaction is initiated. It is assumed that the POI 302 is located at the premises of a service provider, e.g., at a physician's office or a vehicle repair shop. The customer/consumer/payment account holder is indicated at 304. The consumer 304 is shown using a payment card/device 306 (akin to item 102 in
The service provider (or an employee thereof) is indicated at 308. The service provider 308 is shown inputting details of the service(s) provided to the POI 302. For example, in some embodiments, the service detail may include one or more standard insurance codes for identifying examinations, medical procedures, diagnoses and the like.
Also shown in
The system 300 should be deemed to include the components 306, 310, 312 and 314 referred to above. The system 300 further includes a supplemental payment processing block 316. The supplemental payment processing block 316 may be closely associated (and/or under common operation) with the payment network 312. In other embodiments the supplemental payment processing block 316 may be provided and operated by an entity that is independent of the payment network. Details of the supplemental payment processing block 316 will be discussed below.
The system 300 further includes one or more rebate providers (block 318). By way of example, the rebate provider(s) 318 may be one or more insurance companies, such as medical insurance providers. Block 318 should also be deemed to represent one or more computers operated by the rebate provider(s).
In some embodiments, to facilitate communications between the supplemental payment processor 316 and the rebate provider(s) 318, the supplemental payment processor 316 may run a respective dedicated client software entity for each of the rebate providers 318. Each client entity may, as required, contact a server computer (not shown in
As was the case with the system as depicted in
Referring now to
The supplemental payment processing computer 402 may include a computer processor 400 operatively coupled to a communication device 401, a storage device 404, an input device 406 and an output device 408. The communications device 401, the storage device 404, the input device 406 and the output device 408 may all be in communication with the processor 400.
The computer processor 400 may be constituted by one or more conventional processors. Processor 400 operates to execute processor-executable steps, contained in program instructions described below, so as to control the supplemental payment processing computer 402 to provide desired functionality.
Communication device 401 may be used to facilitate communication with, for example, other devices (such as one or more computers operated by the payment network 312, one or more computers operated by rebate provider(s) 318, and numerous POIs). For example (and continuing to refer to
Input device 406 may comprise one or more of any type of peripheral device typically used to input data into a computer. For example, the input device 406 may include a keyboard and a mouse. Output device 408 may comprise, for example, a display and/or a printer.
Storage device 404 may comprise any appropriate information storage device, including combinations of magnetic storage devices (e.g., hard disk drives), optical storage devices such as CDs and/or DVDs, and/or semiconductor memory devices such as Random Access Memory (RAM) devices and Read Only Memory (ROM) devices, as well as so-called flash memory. Any one or more of such information storage devices may be considered to be a computer-readable storage medium or a computer usable medium or a memory.
Storage device 404 stores one or more programs for controlling processor 400. The programs comprise program instructions (which may be referred to as computer readable program code means) that contain processor-executable process steps of the supplemental payment processing computer 402, executed by the processor 400 to cause the supplemental payment processing computer 402 to function as described herein.
The programs may include one or more conventional operating systems (not shown) that control the processor 400 so as to manage and coordinate activities and sharing of resources in the supplemental payment processing computer 402, and to serve as a host for application programs (described below) that run on the supplemental payment processing computer 402.
The programs stored in the storage device 404 may also include a software module 410 for verifying tokens and digital signatures submitted in connection with transactions handled by the system 300.
The storage device 404 may also store a software module 412 for performing a mapping function that maps account numbers to relevant rebate providers.
Still further, the storage device 404 may store data structures 414 which may be employed to perform rebate computations, as described below.
Continuing to refer to
Again continuing to refer to
In addition, the storage device 404 may store a software module 420 for initiating clearing operations with respect to rebates authorized by the rebate provider(s) 318.
The storage device 404 may also store, and the supplemental payment processing computer 402 may also execute, other programs, which are not shown. For example, such programs may include a reporting application, which may respond to requests from system administrators for reports on the activities performed by the supplemental payment processing computer 402. The other programs may also include, e.g., one or more data communication programs, device drivers, etc.
The storage device 404 may also store one or more databases 422 required for operation of the supplemental payment processing computer 402.
Referring now to
The POI 302 may also include peripheral components, in communication with and/or controlled by the processor 452, such as: (a) a keyboard 454 for receiving input from the human operator of the POS terminal, together with other input devices (not separately shown, such as a numeric keypad, a mouse, and/or a touch screen); (b) a product reader 456 (shown in phantom, for some embodiments) for reading any form of unique product identifier, such as a barcode or RFID, that appears on, or is attached to, products brought to the POI 302 for purchase; (c) a cash drawer 458 (shown in phantom, for some embodiments) for storing cash received from customers; (d) one or more displays 460 for providing output (e.g., for supporting input of data by the service provider 308 (
In addition, the POI 302 may include one or more memory and/or data storage devices (indicated collectively at 466), which may comprise any combination of one or more of a hard disk drive, RAM (random access memory), ROM (read only memory), flash memory, etc. The memory/data storage device(s) 466 may store software and/or firmware that programs the processor 452 and the POI 302 to perform functionality as described herein. Thus the memory/data storage device(s) 466 may be in communication with the processor 452. Further, the POI 302 may include one or more housings (not shown) which contain and/or support one or more of the other components shown in
Further, the POI 302 may include one or more card/payment device-reader elements (block 468) such as a mag stripe reader, a contact IC card reader, a contactless IC card reader, NFC communications capabilities (for communicating with payment-enabled mobile devices), etc. The reader elements 468 may be in communication with the processor 452.
Processor 500 operates to execute processor-executable steps, contained in program instructions described below, so as to control the rebate provider computer 502 to provide desired functionality.
Storage device 504 stores one or more programs for controlling processor 500. The programs comprise program instructions (which may be referred to as computer readable program code means) that contain processor-executable process steps of the rebate provider computer 502, executed by the processor 500 to cause the rebate provider computer 502 to function as described herein.
The programs may include one or more conventional operating systems (not shown) that control the processor 500 so as to manage and coordinate activities and sharing of resources in the rebate provider computer 502, and to serve as a host for application programs (described below) that run on the rebate provider computer 502.
The programs stored in the storage device 504 may also include a software interface 510 for facilitating data communications between the rebate provider computer 502 and the supplemental payment processing computer 402.
The storage device 504 may also store a rebate request handling application program 512. The rebate request handling application program 512 may control the processor 500 to enable the rebate provider computer 502 to receive and respond appropriately to requests from the supplemental payment processing computer 402 that the rebate provider computer 502 authorize rebates as described herein.
Still further, the storage device 504 may store a rebate disbursement application program 514. The rebate disbursement application program 514 may control the processor 500 to enable the rebate provider computer 502 to disburse rebates that it has authorized in response to requests from the supplemental payment processing computer 402.
The storage device 504 may also store, and the rebate provider computer 502 may also execute, other programs, which are not shown. For example, such programs may include a reporting application, which may respond to requests from system administrators for reports on the activities performed by the rebate provider computer 502. The other programs may also include, e.g., one or more data communication programs, device drivers, etc.
The storage device 504 may also store one or more databases 516 required for operation of the rebate provider computer 502.
Processes that may be performed in the payment system 300 of
Referring initially to
Continuing to refer to
It may have been the case, in connection with the interaction between the POI 302 and the consumer device 306 at block 602, that the consumer device 306 calculated a digital signature or cryptogram using the token and other transaction-related data as inputs, and then transmitted the digital signature or cryptogram to the POI 302. The cryptogram (e.g., an AC—“application cryptogram”) may be included in the authorization request as transmitted by the POI 302.
At 606, the acquirer 310 may transmit the authorization request to the payment network 312. This also may occur in a manner typical for transmission of authorization requests to a payment network that anchors a payment card account system.
At 608, the payment network 312 may receive the authorization request and may engage in an interaction with the associated supplemental payment processor 316. Prior to such interaction taking place, the payment network 312 may obtain translation of the payment token (included in the authorization request) into a corresponding PAN (primary account number).
At block 610 in
At 612, the issuer 314 may handle the authorization request. The issuer's activity at 612 need not differ from a typical handling of an authorization request by an account issuer in a payment card account system. For example, the issuer may check the status of the consumer's account and the available balance or credit to confirm that authorization of the transaction is in order. Risk management processing may also occur.
At 614, the issuer 314 may transmit the payment card account system transaction authorization response message (typically referred to as an “authorization response”) to the payment network 312, and the payment network 312 may receive the authorization response. The authorization response may be in a standard format for such messages as defined for the payment card account system.
At 616, the payment network 312 may route the authorization response to the acquirer 310, and the acquirer 310 may receive the authorization response. At 618, the acquirer 310 may transmit the authorization response to the POI 302 and the POI 302 may receive the authorization response.
Referring now to
At 704, the POI 302 may transmit the service details to the supplemental payment processor 316. The messaging to the supplemental payment processor 316 may include a transaction number that can be used to link the service details to the payment card account system transaction discussed in connection with
At 706, the supplemental payment processor 316 may perform rebate processing in a manner to be described in more detail below in connection with
At 708, the supplemental payment processor 316 may generate at least one rebate request. The supplemental payment processor 316 also may transmit the rebate request(s) to each appropriate respective rebate provider 318. At 710, the rebate provider 318 (for each rebate request) may handle the request. This may involve determining whether the requested rebate is in fact properly payable by the rebate provider in question.
At 712, the rebate provider 318 (for each rebate request) may transmit a response to the supplemental payment processor 316 concerning the requested rebate. Then, at 714, the supplemental payment processor 316 may send a confirmation to the POI 302 concerning the rebate(s) requested by the supplemental payment processor 316. Again, this communication may be via an IP network such as the internet. It may also be the case that the communication between the supplemental payment processor 316 and the rebate provider(s) 318 may be via the internet or other IP network.
At 716, the supplemental payment processor 316 may manage/oversee clearing of the requested rebates. This may involve clearing funds transfer(s) from a bank or banks that serve the rebate provider(s) 318 to the service provider's bank for the benefit of the service provider.
Reference will now be made to
At 802 in
At 804, the supplemental payment processor 316 (or a token service provider function associated therewith, and not separately shown) may perform standard measures to verify that the token and an accompanying cryptogram are valid.
At 806, the supplemental payment processor 316 (or a token service provider function associated therewith) may convert the token into a PAN, e.g., by reference to a token vault that maps tokens to PANs. It will be appreciated that the PAN obtained at 806 identifies a payment card account that has been issued to the consumer 304.
A decision block 808 may follow block 806. At decision block 808, the supplemental payment processor 316 may determine whether, based on the PAN obtained at 806, it is possible that a rebate may be payable in connection with the payment card account system transaction. This may be done, for example, by mapping the PAN to a rebate provider (such as e.g., a medical insurance company that has issued medical insurance coverage to the consumer 304). For example, in order to perform such a mapping, the supplemental payment processor 316 may refer to a database that associates PANs with medical insurance companies or other rebate providers that have obligations to provide supplemental payments to benefit the consumers associated with the PANs.
In some embodiments, the mapping to rebate providers may, in at least some cases, be based on tokens rather than PANs.
If a positive determination is made at decision block 808 (i.e., if the supplemental payment processor 316 determines that at least one rebate provider is associated with the PAN obtained at 806), then decision block 810 may follow decision block 808. At decision block 810, the supplemental payment processor 316 may determine, according to rules applicable to the rebate provider(s) in question, whether the current payment card account system transaction is eligible for a rebate. This determination may, for example, be based on factors such as the identity of the service provider (e.g., as indicated by a merchant i.d., and/or merchant category code contained in the authorization request) and/or based on the nature of the services provided, as described in the service details received by the supplemental payment processor 316 at 704 in
If a positive determination is made at decision block 810 (i.e., if the supplemental payment processor 316 determines that the transaction in question is eligible for a rebate), then block 812 may follow decision block 810. At block 812, the supplemental payment processor 316 may retrieve one or more rules for calculating the amount of the rebate that applies to the transaction. (It may be the case, at decision block 810, that the supplemental payment processor 316 determines that more than one rebate applies to the current transaction. If this is so, then this processing step and following steps may be performed by the supplemental payment processor 316 with respect to each rebate for which the transaction is eligible.)
At 814, the supplemental payment processor 316 calculates the rebate based on the rule(s) retrieved at 812. To give one example, and assuming that the services provided were at a visit to a physician's office, the rule may indicate that a rebate of 80% of the office visit charge is payable from medical insurance company A. To extend the example, and assuming that additional medical insurance coverage from medical insurance company B applies, then a rule applicable to the latter rebate may indicate that a rebate is payable from medical insurance company B for the balance of the office visit charge.
At 816, the supplemental payment processor 316 may submit a request to a respective rebate provider 318 for each rebate calculated at 814. Communications between the supplemental payment processor 316 and the rebate provider 318 may be via one or more suitable APIs (application program interfaces) and/or via other data communication arrangements such as client/server interactions via the internet.
At 818, the supplemental payment processor 316 receives—from the rebate provider(s) 318—a response or responses to the request(s) transmitted at 816. Assuming the response(s) indicate(s) that the rebate(s) (is)are authorized by the rebate provider(s), then at block 820 the supplemental payment processor 316 may calculate a revised transaction amount. This calculation may include subtracting—from the original transaction amount—the amount of the rebate (if only one rebate applies) or the sum of the amounts of the rebates (if two or more rebates apply).
It will be noted that via the mapping of PAN (or token) to rebate provider(s), and submission of rebate requests thereto, the supplemental payment processor 316 effectively performs a switching function with respect to supplemental payment/rebate administration in the system 300.
At 822, the supplemental payment processor 316 (or the payment network 312, based on input from the supplemental payment processor 316) may generate a revised authorization request that includes the revised transaction amount as the transaction amount to be submitted to the account issuer 314. From this point, the payment card account system transaction may resume, as discussed in connection with block 612 and the following blocks in
In the event that a negative determination is made at decision block 808 or 810, the process of
With a payment system as described in
Still another possible application of the payment system 300 may be for VAT (value added tax) refund/exemption processing for purchases by travelers in countries that apply VAT to their own citizens but not to eligible purchases by visitors. In such a case, the “service provider” as depicted in
In yet another possible application of the payment system 300, the rebate provider may be a government agency that subsidizes purchase of food items or medicines for low-income individuals. Again, in this application, the POI 302 may be operated by a merchant that sells goods eligible for subsidy via a government benefit.
In the process of
In the above description, particularly with reference to
The system 300 as depicted in
Referring again to the payment system 300 of
In the payment system 300 as portrayed in
The POS 302, as described above herein, may resemble a conventional point-of-sale terminal in many respects. Alternatively, however, the POS 302 may be constituted by a suitably programmed mobile device, such as a tablet computer. An embodiment of the POS 302 of the latter type may be conducive to supporting both payment system messaging as well as the internet-based communications also described with respect to the payment system 300. With a POI embodied as a mobile device, and equipped with a digital camera (as many mobile devices are), the service details may be input to the POI 302 by presenting to it a QR code or other suitable barcode, to be scanned/read by the POI 302.
To facilitate the establishment and/or roll-out of the payment system 300, a software development kit (SDK) may be made available to encourage and support suitable programming of the POIs (only one shown) to incorporate therein functionality such as that described herein.
Embodiments described above have been primarily been illustrated with the assumption that rebates were provided in the form of medical expense reimbursements with the insurance provider(s)/rebate provider(s) being medical insurance companies, government medical benefit providers, or the like. However, the teachings of this disclosure are also applicable to other contexts, such as (a) rebates/insurance reimbursements for motor vehicle repairs provided under motor vehicle collision or comprehensive insurance coverage or motor vehicle warranty coverage; (b) building/home repairs covered under real property damage insurance coverage; (c) repairs to home appliances under insurance and/or warranty programs, and so forth.
As used herein and in the appended claims, the term “computer” should be understood to encompass a single computer or two or more computers in communication with each other.
As used herein and in the appended claims, the term “processor” should be understood to encompass a single processor or two or more processors in communication with each other.
As used herein and in the appended claims, the term “memory” should be understood to encompass a single memory or storage device or two or more memories or storage devices.
As used herein and in the appended claims, the term “transaction processor” refers to a transaction acquirer or other entity that performs at least some functions of a transaction acquirer.
The terms “insurance provider” and “rebate provider” are used interchangeably herein.
The flow charts and descriptions thereof herein should not be understood to prescribe a fixed order of performing the method steps described therein. Rather the method steps may be performed in any order that is practicable, including simultaneous performance of at least some steps and/or omitting one or more steps.
As used herein and in the appended claims, the term “payment card system account” includes a credit card account or a deposit account that the account holder may access using a debit card. The terms “payment card system account” and “payment card account” are used interchangeably herein. The term “payment card account number” includes a number that identifies a payment card system account or a number carried by a payment card, or a number that is used to route a transaction in a payment system that handles debit card and/or credit card transactions. The term “payment card” includes a credit card or a debit card.
As used herein and in the appended claims, the term “payment card system” refers to a system for handling purchase transactions and related transactions. An example of such a system is the one operated by Mastercard International Incorporated, the assignee of the present disclosure. In some embodiments, the term “payment card system” may be limited to systems in which member financial institutions issue payment card accounts to individuals, businesses and/or other organizations.
Although the present invention has been described in connection with specific exemplary embodiments, it should be understood that various changes, substitutions, and alterations apparent to those skilled in the art can be made to the disclosed embodiments without departing from the spirit and scope of the invention as set forth in the appended claims.