发明授权
- 专利标题: Automated system and method for providing real-time verification of health insurance eligibility
- 专利标题(中): 提供医疗保险资格实时验证的自动化系统和方法
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申请号: US248459申请日: 1994-05-24
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公开(公告)号: US5832447A公开(公告)日: 1998-11-03
- 发明人: Edward C. Rieker , Daniel K. Mansfield
- 申请人: Edward C. Rieker , Daniel K. Mansfield
- 申请人地址: TN Nashville
- 专利权人: Envoy Corporation
- 当前专利权人: Envoy Corporation
- 当前专利权人地址: TN Nashville
- 主分类号: G06F19/00
- IPC分类号: G06F19/00 ; G06F13/00
摘要:
Data from a health care provider computer system is used to automatically request real-time electronic insurance eligibility verification information from health care insurance payors. A patient health insurance verification computer system is operatively connected to a patient registration computer system. The verification computer system obtains a data output stream such as a print image from the registration computer system. This data output stream is captured and broken down into separate data fields. The insurance carrier is determined, and the verification computer system determines which electronic data source to request patient eligibility data from. The verification computer system reformats the captured data to fit the data format required by the data source, establishes a communications link to the data source, and sends the reformatted data to the data source. The data source sends responsive patient specific eligibility data which the verification computer system uses to automatically verify insurance coverage. Health insurance verification becomes much more reliable since no human intervention is required to carry on the automatic verification process. Additionally, automatic verification can be performed conveniently without double data entry even in environments with preexisting admissions systems that cannot be easily modified.
公开/授权文献
- US4899375A More efficient call handling for operator assistance calls 公开/授权日:1990-02-06
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