The subject application relates to a web-based automated bill negotiation system and method. Conventional systems and methods for negotiating a patient's bills are not automated, take enormous time out of the parties daily routine, and do not calculate the best settlement offer for a patient's bills.
Accordingly, there is an unmet need for systems and/or methods that facilitate overcoming the aforementioned deficiencies.
According to one aspect, a system that facilitates negotiating a patient's bill owed to a medical provider comprises a processor that executes computer-executable instructions for calculating a settlement amount on the patient's balance bill owed to the medical provider or may offer a prospective amount to the medical provider on behalf of the patient, therewith and a memory that stores the computer-executable instructions. The system further includes a server comprising the processor and the memory and providing Internet access to the processor for calculating the settlement amount. The instructions comprise receiving patient billing information, calculating a settlement amount associated with the bill owed or an amount prospectively for the procedure to be owed to the medical provider from the patient billing information, electronically communicating the settlement amount to the associated medical provider, determining whether the medical provider accepted or declined the settlement amount, informing the patient and charging a service fee if the medical provider accepted the settlement amount, calculating a second settlement amount if the medical provider declined the settlement amount, electronically communicating the second settlement amount to the associated medical provider, determining whether the medical provider accepted or declined the second settlement amount, informing the patient and charging a service fee if the medical provider accepted the second settlement amount, and updating a bill status based on the determination of the first and second settlement amounts.
In accordance with various features described herein, systems and methods are described that facilitate negotiation of a medical bill for an individual (e.g., patients and their family members, insurance customers and their family members, etc.) via a web based cloud application which automatically calculates the best settlement offer for the individual's bills. As used herein, “algorithm” or “module” refers to a set of computer-executable instructions stored on a computer-readable medium and executable by a processor or other computing device, as will be appreciated by those of skill in the art.
With reference to
The patient billing information 22 is uploaded to, or retrieved by, the server 18 and loaded into a negotiation module 28 stored in memory 16. The negotiation module 28 utilizes the patient billing information 22 to automatically secure a settlement or discount on the patient's balance bill owed to a medical provider. Specifically, the negotiation module 28 calculates a settlement amount associated for each bill included in the patient billing information 22 to provide the greatest chance of success to decrease the amount owed to the medical provider. The settlement amount is then communicated to the medical provider whom either accepts or declines the settlement amount, by clicking on Accept or Decline within the email, which then automatically updates the server data base immediately or by e-faxing the offer back to the server. If the medical provider accepts the settlement amount, the patient is then charged by the negotiation module 28 for the settlement amount. If the settlement amount is declined, the negotiation calculates another settlement amount which is communicated to the medical provider.
To accomplish this, a patient initially inputs billing information for a bill owed to a medical provider utilizing the GUI 11. Along with the billing information, the patients input patient information including payment information such as credit card information or checking account information. In another embodiment, the payment information comprises online payment service account information such as a PayPal™ account or the like. After the patient's billing and patient information have been entered, the negotiation module 28 utilizes a negotiation algorithm to calculate the best settlement amount to offer the medical provider. For example, the negotiation module 28 will calculate the settlement amount utilizing a percentage of the owed amount for each bill. In another embodiment, the negotiation module 28 determines the settlement amount utilizing a negotiation table which stores optimal settlement amounts for various balance amounts utilizing one or more lookup tables (LUT) 30. In another embodiment, the settlement amount can be user-entered values.
After the negotiation module 28 determines a settlement amount for a particular bill, the negotiation module 28 transmits an electronic communication (email, fax, automated voice phone call, etc.) which enables the medical provider to accept or decline the settlement amount. For example, an electronic mail message is sent to the medical provider with a clickable link which includes accept or decline fields. Clicking on the accept or decline link within the email automatically updates the bill's status with the medical provider response and, if accepted, directs the medical provider to another website to signature the settlement amount with a dated time stamp which is stored in the patient billing information 22. If the medical provider does not have an electronic mail account, the negotiation module 18 transmits an electronic fax message to the medical provider's fax machine. The medical provider indicates on the transmitted document whether the settlement amount is accepted or declined and faxes the document back to the negotiation module 18. The negotiation module 18 utilizes one or more word or image recognition algorithms (e.g., optical character recognition or some other suitable algorithm) to determine whether the settlement amount was accepted or declined which is updated on the bill's status.
After a settlement amount is accepted by the medical provider, the patient is electronically informed by electronic mail and has a predetermined time to pay the medical provider the settlement amount. If the settlement amount is accepted by the medical provider, the patient is charged a service fee for the service provided. The service fee can include a one-time fee, a percentage of the settlement amount, and the like. If the settlement amount is declined by the medical provider, the patient is informed electronically and the negotiation module 18 calculates a second settlement amount via the negotiation algorithm, look-up table, or user-input which is communicated to the medical provider. If the medical provider declines the second settlement amount, the patient is informed once again and is not charged the service fee.
As previously mentioned, the system 10 comprises the processor 14 that executes, and memory 16 that stores, computer-executable instructions and/or computer-readable data (e.g., a software package or product) for performing the various techniques and/or methods described herein. The memory 16 may be a computer-readable recording medium on which a control program or software product is recorded, such as a disk, hard drive, or the like. Common forms of computer-readable media include, for example, floppy disks, flexible disks, hard disks, magnetic tape, or any other magnetic storage medium, CD-ROM, DVD, or any other optical medium, a ROM, a PROM, an EPROM, a FLASH-EPROM, or other memory chip or cartridge, or any other tangible medium from which a computer can read and use. Alternatively, the methods may be implemented in a transmittable carrier wave in which the control program is embodied as a data signal using transmission media, such as acoustic or light waves, such as those generated during radio wave and infrared data communications, and the like.
The method illustrated in
The computer can include a processing unit such as the processor 16 of
The system bus can be any of several types of bus structure including a memory bus or memory controller, a peripheral bus, and a local bus using any of a variety of commercially available bus architectures. The computer memory includes read only memory (ROM) and random access memory (RAM). A basic input/output system (BIOS), containing the basic routines that help to transfer information between elements within the computer, such as during start-up, is stored in ROM.
The computer can further include a hard disk drive, a magnetic disk drive, e.g., to read from or write to a removable disk, and an optical disk drive, e.g., for reading a CD-ROM disk or to read from or write to other optical media. The computer typically includes at least some form of computer readable media. Computer readable media can be any available media that can be accessed by the computer. By way of example, and not limitation, computer readable media may comprise computer storage media and communication media. Computer storage media includes volatile and nonvolatile, removable and non-removable media implemented in any method or technology for storage of information such as computer readable instructions, data structures, program modules or other data. Computer storage media includes, but is not limited to, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disks (DVD) or other magnetic storage devices, or any other medium which can be used to store the desired information and which can be accessed by the computer.
Communication media typically embodies computer readable instructions, data structures, program modules or other data in a modulated data signal such as a carrier wave or other transport mechanism and includes any information delivery media. The term “modulated data signal” means a signal that has one or more of its characteristics set or changed in such a manner as to encode information in the signal. By way of example, and not limitation, communication media includes wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared and other wireless media. Combinations of any of the above can also be included within the scope of computer readable media.
A number of program modules may be stored in the drives and RAM, including an operating system, one or more application programs, other program modules, and program non-interrupt data. The operating system in the computer can be any of a number of commercially available operating systems.
A user may enter commands and information into the computer through a keyboard (not shown) and a pointing device or stylus (not shown), such as a mouse. Other input devices (not shown) may include a microphone, an IR remote control, a joystick, a game pad, a satellite dish, a scanner, or the like. These and other input devices are often connected to the processing unit through a serial port interface (not shown) that is coupled to the system bus, but may be connected by other interfaces, such as a parallel port, a game port, a universal serial bus (USB), an IR interface, etc.
A monitor (not shown), or other type of display device, may also be connected to the system bus via an interface, such as a video adapter (not shown). In addition to the monitor, a computer typically includes other peripheral output devices (not shown), such as speakers, printers etc. The monitor can be employed with the computer to present data that is electronically received from one or more disparate sources. For example, the monitor can be an LCD, plasma, CRT, etc. type that presents data electronically. Alternatively or in addition, the monitor can display received data in a hard copy format such as a printer, facsimile, plotter etc. The monitor can present data in any color and can receive data from the computer via any wireless or hard wire protocol and/or standard.
The computer can operate in a networked environment using logical and/or physical connections to one or more remote computers, such as a remote computer(s). The remote computer(s) can be a workstation, a server computer, a router, a personal computer, microprocessor based entertainment appliance, a peer device or other common network node, and typically includes many or all of the elements described relative to the computer. The logical connections depicted include a local area network (LAN) and a wide area network (WAN). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets and the Internet.
When used in a LAN networking environment, the computer is connected to the local network through a network interface or adapter. When used in a WAN networking environment, the computer typically includes a modem, or is connected to a communications server on the LAN, or has other means for establishing communications over the WAN, such as the Internet. In a networked environment, program modules depicted relative to the computer, or portions thereof, may be stored in the remote memory storage device. It will be appreciated that network connections described herein are exemplary and other means of establishing a communications link between the computers may be used.
It will be appreciated that various of the above-disclosed and other features and functions, or alternatives thereof, may be desirably combined into many other different systems or applications. Also that various presently unforeseen or unanticipated alternatives, modifications, variations or improvements therein may be subsequently made by those skilled in the art which are also intended to be encompassed by the following claims.
Number | Date | Country | |
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61831895 | Jun 2013 | US |