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公开(公告)号：US08108229B2
公开(公告)日：2012-01-31
申请号：US11901526
申请日：2007-09-18
申请人： Ravi Ika , Rudra Duddala , Madusudhana Narahari , Poladas D James , Venkat Balagani , Murali K Narasani , Sudheer Bonala , Sreekanth Belpu , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
发明人： Ravi Ika , Rudra Duddala , Madusudhana Narahari , Poladas D James , Venkat Balagani , Murali K Narasani , Sudheer Bonala , Sreekanth Belpu , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
IPC分类号： G06Q40/00
摘要： The computer implemented method and system disclosed herein automates business processes of a health plan organization using a plurality of portals. The portals comprise a sales portal, a member portal, an employer portal, an administration portal, and a provider portal. Health plans are listed using the sales portal. A sales agent proposes at least one of the health plans to a consumer using the sales portal. The administration portal generates insurance quotes for the proposed health plans. The consumer enrolls for the proposed health plans using one of the member portal and the employer portal. The consumer is billed for the enrolled health plans based on the insurance quotes using the administration portal. The consumer pays a premium amount online for the enrolled health plans using the member portal or the employer portal. The administration portal then generates commissions for the sales agent for the enrolled health plans.
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公开(公告)号：US08548832B2
公开(公告)日：2013-10-01
申请号：US13334056
申请日：2011-12-22
申请人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Venkat Balagani , Murali Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
发明人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Venkat Balagani , Murali Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
IPC分类号： G06Q40/00
摘要： The computer implemented method and system disclosed herein automates business processes of a health plan organization using a plurality of portals. The portals comprise a sales portal, a member portal, an employer portal, an administration portal, and a provider portal. Health plans are listed using the sales portal. A sales agent proposes at least one of the health plans to a consumer using the sales portal. The administration portal generates insurance quotes for the proposed health plans. The consumer enrolls for the proposed health plans using one of the member portal and the employer portal. The consumer is billed for the enrolled health plans based on the insurance quotes using the administration portal. The consumer pays a premium amount online for the enrolled health plans using the member portal or the employer portal. The administration portal then generates commissions for the sales agent for the enrolled health plans.
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公开(公告)号：US08108230B2
公开(公告)日：2012-01-31
申请号：US13044547
申请日：2011-03-10
申请人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Venkat Balagani , Murali Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
发明人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Venkat Balagani , Murali Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
IPC分类号： G06Q40/00
摘要： The computer implemented method and system disclosed herein automates business processes of a health plan organization using a plurality of portals. The portals comprise a sales portal, a member portal, an employer portal, an administration portal, and a provider portal. Health plans are listed using the sales portal. A sales agent proposes at least one of the health plans to a consumer using the sales portal. The administration portal generates insurance quotes for the proposed health plans. The consumer enrolls for the proposed health plans using one of the member portal and the employer portal. The consumer is billed for the enrolled health plans based on the insurance quotes using the administration portal. The consumer pays a premium amount online for the enrolled health plans using the member portal or the employer portal. The administration portal then generates commissions for the sales agent for the enrolled health plans.
摘要翻译： 本文公开的计算机实现的方法和系统使用多个门户自动化健康计划组织的业务流程。 门户网站包括销售门户，会员门户，雇主门户，管理门户和提供商门户。 使用销售门户列出健康计划。 销售代理商向使用销售门户的消费者提出至少一项健康计划。 行政门户为拟议的健康计划生成保险报价。 消费者使用会员门户和雇主门户之一注册拟议的健康计划。 消费者根据使用行政门户的保险报价，为已登记的健康计划收费。 使用会员门户或雇主门户，消费者在线支付注册的健康计划。 然后，管理门户为销售代理生成注册的健康计划的佣金。
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公开(公告)号：US20120095786A1
公开(公告)日：2012-04-19
申请号：US13334056
申请日：2011-12-22
申请人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Venkat Balagani , Murali Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
发明人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Venkat Balagani , Murali Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
IPC分类号： G06Q40/08
摘要： The computer implemented method and system disclosed herein automates business processes of a health plan organization using a plurality of portals. The portals comprise a sales portal, a member portal, an employer portal, an administration portal, and a provider portal. Health plans are listed using the sales portal. A sales agent proposes at least one of the health plans to a consumer using the sales portal. The administration portal generates insurance quotes for the proposed health plans. The consumer enrolls for the proposed health plans using one of the member portal and the employer portal. The consumer is billed for the enrolled health plans based on the insurance quotes using the administration portal. The consumer pays a premium amount online for the enrolled health plans using the member portal or the employer portal. The administration portal then generates commissions for the sales agent for the enrolled health plans.
摘要翻译： 本文公开的计算机实现的方法和系统使用多个门户自动化健康计划组织的业务流程。 门户网站包括销售门户，会员门户，雇主门户，管理门户和提供商门户。 使用销售门户列出健康计划。 销售代理商向使用销售门户的消费者提出至少一项健康计划。 行政门户为拟议的健康计划生成保险报价。 消费者使用会员门户和雇主门户之一注册拟议的健康计划。 消费者根据使用行政门户的保险报价，为已登记的健康计划收费。 使用会员门户或雇主门户，消费者在线支付注册的健康计划。 然后，管理门户为销售代理生成注册的健康计划的佣金。
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公开(公告)号：US20110161120A1
公开(公告)日：2011-06-30
申请号：US13044547
申请日：2011-03-10
申请人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Venkat Balagani , Murali Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
发明人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Venkat Balagani , Murali Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasekar Jayaraman , Karthik Sridhar
IPC分类号： G06Q40/00
摘要： The computer implemented method and system disclosed herein automates business processes of a health plan organization using a plurality of portals. The portals comprise a sales portal, a member portal, an employer portal, an administration portal, and a provider portal. Health plans are listed using the sales portal. A sales agent proposes at least one of the health plans to a consumer using the sales portal. The administration portal generates insurance quotes for the proposed health plans. The consumer enrolls for the proposed health plans using one of the member portal and the employer portal. The consumer is billed for the enrolled health plans based on the insurance quotes using the administration portal. The consumer pays a premium amount online for the enrolled health plans using the member portal or the employer portal. The administration portal then generates commissions for the sales agent for the enrolled health plans.
摘要翻译： 本文公开的计算机实现的方法和系统使用多个门户自动化健康计划组织的业务流程。 门户网站包括销售门户，会员门户，雇主门户，管理门户和提供商门户。 使用销售门户列出健康计划。 销售代理商向使用销售门户的消费者提出至少一项健康计划。 行政门户为拟议的健康计划生成保险报价。 消费者使用会员门户和雇主门户之一注册拟议的健康计划。 消费者根据使用行政门户的保险报价，为已登记的健康计划收费。 使用会员门户或雇主门户，消费者在线支付注册的健康计划。 然后，管理门户为销售代理生成注册的健康计划的佣金。
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公开(公告)号：US20090076858A1
公开(公告)日：2009-03-19
申请号：US11901526
申请日：2007-09-18
申请人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Vankat Balaganl , Murall Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasakar Jayaraman , Karthik Sridhar
发明人： Ravi Ika , Rudra Duddala , Madu Narahari , Poladas James , Vankat Balaganl , Murall Narasani , Sreekanth Belpu , Sudheer Bonala , Sasidhar Parvatham , Chandrasakar Jayaraman , Karthik Sridhar
摘要： The computer implemented method and system disclosed herein automates business processes of a health plan organization using a plurality of portals. The portals comprise a sales portal, a member portal, an employer portal, an administration portal, and a provider portal. Health plans are listed using the sales portal. A sales agent proposes at least one of the health plans to a consumer using the sales portal. The administration portal generates insurance quotes for the proposed health plans. The consumer enrolls for the proposed health plans using one of the member portal and the employer portal. The consumer is billed for the enrolled health plans based on the insurance quotes using the administration portal. The consumer pays a premium amount online for the enrolled health plans using the member portal or the employer portal. The administration portal then generates commissions for the sales agent for the enrolled health plans.
摘要翻译： 本文公开的计算机实现的方法和系统使用多个门户自动化健康计划组织的业务流程。 门户网站包括销售门户，会员门户，雇主门户，管理门户和提供商门户。 使用销售门户列出健康计划。 销售代理商向使用销售门户的消费者提出至少一项健康计划。 行政门户为拟议的健康计划生成保险报价。 消费者使用会员门户和雇主门户之一注册拟议的健康计划。 消费者根据使用行政门户的保险报价，为已登记的健康计划收费。 使用会员门户或雇主门户，消费者在线支付注册的健康计划。 然后，管理门户为销售代理生成注册的健康计划的佣金。
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7.发明授权Process, knowledge, and intelligence management through integrated medical management system for better health outcomes, utilization cost reduction and provider reward programs 有权流程，知识和智力管理，通过综合医疗管理系统，实现更好的健康结果，降低利用成本，提供奖励计划公开(公告)号：US07996241B2
公开(公告)日：2011-08-09
申请号：US12118768
申请日：2008-05-12
申请人： Solomon Zak , Rudra Duddala , Craig Johnson , Poladas James , Madusudhana Narahari , Bala Ankarfa , Streesha Parvatham , Sashidhar Kokku
发明人： Solomon Zak , Rudra Duddala , Craig Johnson , Poladas James , Madusudhana Narahari , Bala Ankarfa , Streesha Parvatham , Sashidhar Kokku
摘要： Disclosed herein is a computer implemented method and system for rewarding health care providers using an integrated medical management system. A web application analyzes performance of the health care providers. The web application acquires information from integrated medical management system. The acquired information includes information of health care quality improvement analysis, disease and case based management, utilization analytics, physician profiling, authorizations management, lab and imaging information, and health risk assessment information. The web application determines performance indices for the health care providers based on the acquired information. The performance indices include a quality index, an economic index, and a relative value unit index of the health care providers. The web application analyzes the performance of the health care providers based on the performance indices. The analysis includes identifying health care providers eligible for a reward. The health care providers are then rewarded based on the analyzed performance.
摘要翻译： 本文公开了一种计算机实现的方法和系统，用于使用综合医疗管理系统来奖励医疗保健提供者。 Web应用程序分析医疗保健提供者的绩效。 网络应用程序从综合医疗管理系统获取信息。 所获得的信息包括卫生保健质量改进分析，疾病和病例管理，利用分析，医师剖析，授权管理，实验室和成像信息以及健康风险评估信息的信息。 Web应用程序根据获取的信息确定医疗保健提供者的绩效指标。 绩效指标包括医疗保健提供者的质量指数，经济指标和相对价值单位指数。 网络应用程序根据绩效指标分析医疗保健提供者的绩效。 该分析包括确定有资格获得奖励的医疗保健提供者。 然后，医疗保健提供者将根据分析的表现获得奖励。
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公开(公告)号：US20090055218A1
公开(公告)日：2009-02-26
申请号：US11895319
申请日：2007-08-25
申请人： Ravi Ika , Solomon Zak , Rudra Duddala , James Poladas
发明人： Ravi Ika , Solomon Zak , Rudra Duddala , James Poladas
摘要： Disclosed herein is a computer implemented method and system for improving the quality of health care in a health plan. The members of the health plan eligible for undergoing predetermined measures of health care are identified. The primary care physicians (PCPs) for the identified members are notified to ensure implementation of the predetermined measures. The health plan staff is notified to ensure coordination between the identified members and PCPs. The status of the identified members is updated based on the implemented predetermined measures. Quality indexes for the PCPs are calculated for the implemented predetermined measures. A performance score of the health plan is calculated to indicate the quality of health care. Identifying and notifying the members, the PCPs and the health plan staff reduces the level of clinical chart review by the health plan staff and improves the quality of health care in a health plan.
摘要翻译： 本文公开了一种用于提高健康计划中的医疗保健质量的计算机实现的方法和系统。 确定有资格接受预防措施的卫生保健计划的成员。 通知确定成员的初级保健医师（PCP），以确保实施预定措施。 卫生计划人员被通知，以确保所识别的成员和PCP之间的协调。 所确定的成员的状态将根据实施的预定措施进行更新。 为实施的预定措施计算PCP的质量指标。 计算健康计划的绩效分数，以表明保健质量。 识别和通知成员，PCP和健康计划人员减少卫生计划人员的临床图表审查水平，并提高健康计划中的医疗保健质量。
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公开(公告)号：US08290786B2
公开(公告)日：2012-10-16
申请号：US11895319
申请日：2007-08-25
申请人： Ravi Ika , Solomon Zak , Rudra Duddala , James Poladas
发明人： Ravi Ika , Solomon Zak , Rudra Duddala , James Poladas
IPC分类号： G06Q10/00
摘要： Disclosed herein is a computer implemented method and system for improving the quality of health care in a health plan. The members of the health plan eligible for undergoing predetermined measures of health care are identified. The primary care physicians (PCPs) for the identified members are notified to ensure implementation of the predetermined measures. The health plan staff is notified to ensure coordination between the identified members and PCPs. The status of the identified members is updated based on the implemented predetermined measures. Quality indexes for the PCPs are calculated for the implemented predetermined measures. A performance score of the health plan is calculated to indicate the quality of health care. Identifying and notifying the members, the PCPs and the health plan staff reduces the level of clinical chart review by the health plan staff and improves the quality of health care in a health plan.
摘要翻译： 本文公开了一种用于提高健康计划中的医疗保健质量的计算机实现的方法和系统。 确定有资格接受预防措施的卫生保健计划的成员。 通知确定成员的初级保健医师（PCP），以确保实施预定措施。 卫生计划人员被通知，以确保所识别的成员和PCP之间的协调。 所确定的成员的状态将根据实施的预定措施进行更新。 为实施的预定措施计算PCP的质量指标。 计算健康计划的绩效分数，以表明保健质量。 识别和通知成员，PCP和健康计划人员减少卫生计划人员的临床图表审查水平，并提高健康计划中的医疗保健质量。
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公开(公告)号：US20090099865A1
公开(公告)日：2009-04-16
申请号：US11973754
申请日：2007-10-10
申请人： Solomon J. Zak , Rudra Duddala , Craig Johnson , Poladas James
发明人： Solomon J. Zak , Rudra Duddala , Craig Johnson , Poladas James
IPC分类号： G06Q50/00
摘要： Disclosed herein is a computer implemented method and system that addresses the need for utilization analysis and performance evaluation of providers in a health care organization. The health care data comprising health plan information of consumers, providers, claims, and hospitals is collected, translated, and organized in a structured relational format and stored in standard tables. The organized health care data is analyzed by calculating consumer statistics for a health plan using the health plan information of the consumers. The claims of the consumers are processed to classify the claims based on age, gender, disease, and comorbid conditions of the consumers. A plurality of costs of the health care organization is determined using one or more of the health plan information. The performance of the providers is assessed using the determined plurality of costs. The providers comprising primary care physicians are analyzed based on entire population of the associated consumers.
摘要翻译： 这里披露了一种计算机实现的方法和系统，其解决了在医疗保健组织中提供者的利用分析和性能评估的需要。 包括消费者，提供者，索赔和医院的健康计划信息的医疗保健数据以结构化关系格式收集，翻译和组织，并存储在标准表中。 通过使用消费者的健康计划信息计算卫生计划的消费者统计数据来分析有组织的保健数据。 对消费者的要求进行处理，根据消费者的年龄，性别，疾病和共病情况对索赔进行分类。 使用一个或多个健康计划信息来确定医疗机构的多个费用。 使用确定的多个成本来评估提供商的表现。 基于相关消费者的整体人群分析包括初级保健医师在内的提供者。
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