Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management
Reexamination Certificate
1997-12-30
2001-03-27
Stamber, Eric W. (Department: 2765)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Health care management
C705S002000
Reexamination Certificate
active
06208974
ABSTRACT:
FIELD OF THE INVENTION
The invention relates to a computer-implemented method for managing and enrolling new clients in wellness plans.
BACKGROUND OF THE INVENTION
With rising health care costs, it is imperative that health care providers provide health services efficiently and cost effectively. At the same time, the administrative demands of medical record keeping, billing and managing a medical practice have become more burdensome. In particular, health care providers must be thorough and keep detailed records of medical exams to accurately document observations and services that have been provided.
One health care product growing in popularity is a wellness plan. The principal objective of a wellness plan is to keep a patient well. A wellness plan provides a way for a patient to pre-pay or pay on a schedule for medical services. Under a typical plan, the patient is entitled to preventative care services and discounts on other types of medical services. By establishing periodic visits at least once a year, wellness plans enable health problems to be identified and treated early. It is generally understood that the cost of healthcare rises exponentially the longer a health problem is postponed. Thus, wellness plans can drastically reduce healthcare costs by encouraging office visits that help identify and resolve health problems early.
While wellness plans are an effective means for keeping patients healthy, they are difficult and costly to administer and promote. As such there is a need for a more effective approach to managing wellness plans.
SUMMARY OF THE INVENTION
The invention is directed to a method and system for managing wellness plans for a medical care practice. While specifically adapted to a veterinary practice, the invention can be applied to other types of medical practices as well.
The invention is implemented in software that provides an interactive user interface and maintains patient, client and employee records associated with wellness plans. In this implementation, the software presents an interactive user interface that enables members of a provider team to help clients select from among a variety of wellness plans. Each of the plans is represented in memory as a set of predetermined product and service items and plan discounts. Once the client has accepted a wellness plan, the software updates the patient's records to include a list of the service items covered by the selected plan.
The wellness plan software is integrated with software used to manage a patient visit to a medical facility. This software is used to track the service and product items provided to a patient. As items are provided to a patient, the items are also recorded in memory. The software can generate cost estimates based on the service items provided to the patient during a visit, including an indicator of the cost savings due to the wellness plan. When the visit is complete, the software generates an invoice and checks whether selected service items are wellness plan items. If they are covered under the patient's plan, the software applies the discounts under the plan to the selected service items.
The wellness plan software also tracks promotional activities of provider team members. When the software detects a program action associated with promotion of a wellness plan, it records an event identifying the provider responsible for the event. These events are recorded and evaluated to compute bonuses for the providers.
Another aspect of the wellness plan software is that also performs a variety of billing and accounting related functions. A typical medical facility equipped with the software has a computer network that executes software for managing patient visits and keeping patient records. This network is linked with a central computer that automatically handles billing, collection and account maintenance functions. When a new plan is established at the facility, a server computer communicates plan contract and billing information to the central computer. From this information, the central computer determines when bills are due and produces a payment file of debit and credit card transactions that it sends electronically to a bank for payment. The central computer notifies the respective medical facilities about the status of the accounts, including, for example, indicating when a patient's account is overdue.
Additional features and advantages of the invention will become more apparent from the following detailed description and accompanying drawings.
REFERENCES:
Maroney, Martha, “Leapin' Lizards: Business Solution I,”Microsoft Developer Network News, May/Jun., 1995.
Brochure, “Client-Server Solutions-Vetsmart,” ©Microsoft Corporation 1994.
Brochure, “Client-Server Solutions-Vetsmart,” ©Microsoft Corporation 1995.
Campbell Scott Douglas
Howard Mark
Kazimi Hani. M.
Klarquist Sparkman Campbell & Leigh & Whinston, LLP
Medical Management International, Inc.
Stamber Eric W.
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