Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management
Patent
1994-05-24
1998-11-03
Hayes, Gail O.
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Health care management
705 4, G06F 1300
Patent
active
058324470
ABSTRACT:
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.
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Mansfield Daniel K.
Rieker Edward C.
Envoy Corporation
Groutt Phillip
Hayes Gail O.
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