IP Library Granted Patent US 7,774,214
Granted Patent B1
US 7,774,214 · App. 11/706,604 · Granted Aug 10, 2010

System and method for managing payments for health care services

Assignee: Health Payment Systems, Inc.
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Quick Facts
Patent No.
US 7,774,214
App. No.
11/706,604
Granted
Aug 10, 2010
Kind
B1
Abstract

A health care claim payment system and method receives a claim for a health care service provided to a participant in a benefits plan. The claim is received by a payment services system, and a portion of the claim is payable by the participant. The payment services system remits the portion of the claim payable by the participant on behalf of the participant so that payment can be remitted to the provider in a single payment and accepts risk of delinquency and/or non-payment by the participant. In one example, the health care provider receives payment for the participant portion and employer portion of the claim within 30 days of issuing a health care service.

Claims (35)

1. A computer system comprising:

a processor that executes instructions; and

machine-readable media having the instructions stored therein, the instructions when executed by the computer system causing the computer system to implement a health care claim payment method, the method comprising

receiving notification of a plurality of claims for a plurality of health care services provided by a plurality of health care service providers to a patient, at least a portion of the claims being payable by a participant enrolled in a benefits plan;

maintaining, by a payment services system logic implemented by the instructions stored in the machine-readable media, funds to pay the portion of the claims payable by the participant;

remitting, for each claim in the plurality of claims, payment of the claim, including (i) remitting, on behalf of the participant, payment of the portion of the claim payable by the participant, and (ii) accepting risk of delinquency and/or non-payment by the participant on the funds used to pay the portion of the claims payable by the participant;

combining, by the payment services system logic, claim information from the plurality of health care service providers into a master bill, the master bill containing claim information for the plurality of health care service providers;

itemizing, by the payment services system logic, claim information for each of the health care services provided to the patient by the plurality of health care service providers, and wherein the patient did not directly interact with at least some of the health care service providers;

sending the participant the master bill, including the claim information for the plurality of health care service providers; and

tracking, by the payment services system logic, payment of the master bill by the participant.

2. The computer system of claim 1 , wherein the instructions when executed cause the computer system to receive payment from the participant for the participant's portion of the plurality of claims.

3. The computer system of claim 1 , wherein the remitting step is performed by a payment services manager.

4. The computer system of claim 3 , wherein the payment services manager and the third party payor are different entities.

5. The computer system of claim 3 , wherein the payment services manager and the third party payor are the same entity.

6. The computer system of claim 1 , wherein the sending step is performed by a payment services manager.

7. The computer system of claim 1 , wherein the participant is the patient on whom the health care service is performed.

8. The method computer system of claim 1 , wherein the patient on whom the health care service is performed is a family member of the participant.

9. The computer system of claim 1 , wherein the third party payor is an insurer associated with the benefits plan.

10. The computer system of claim 1 , wherein the third party payor is an employer of the participant.

11. The computer system of claim 1 , wherein the master bill is sent to the participant on a periodic basis.

12. A computer system comprising:

a processor that executes instructions; and

machine-readable media having the instructions stored therein, the instructions when executed by the computer system causing the computer system to implement a health care claim payment method, the method comprising

receiving notification of a plurality of claims for a plurality of health care services provided to a patient by a plurality of health care service providers, at least a portion of the claims being payable by a participant enrolled in a benefits plan;

maintaining funds to pay the portion of the claims payable by the participant; and

remitting, by a payment services system logic implemented by the instructions stored in the machine-readable media, for each claim in the plurality of claims, payment of the claim;

accepting risk of delinquency and/or non-payment by the participant on the funds used to pay the portion of the claims payable by the participant;

combining, by the payment services system logic, claim information from the plurality of health care services providers into a master bill, the master bill containing claim information for the plurality of health care service providers;

itemizing, by the payment services system logic, claim information for each of the health care services provided to the patient by the plurality of health care service providers, and wherein the patient did not directly interact with at least some of the health care service providers;

sending the participant the master bill, including the claim information for the plurality of health care service providers; and

tracking, by the payment services system logic, payment of the master bill by the participant.

13. The method computer system of claim 12 , wherein the remitting payment for each claim in the plurality of claims is performed in a single payment, including remitting from the maintained funds, on behalf of the participant, the portion of the claim payable by the participant.

14. The computer system of claim 12 , wherein the remitting step is performed by a payment services manager.

15. The computer system of claim 12 , wherein the participant is the patient on whom the health care service is performed.

16. The computer system of claim 12 , wherein the patient on whom the health care service is performed is a family member of the participant.

Assignments (6)
TERMINATION AND RELEASE OF INTELLECTUAL PROPERTY SECURITY AGREEMENT Recorded Nov 6, 2025
From: INNOVATION CREDIT INCOME FUND II, L.P.
To: HEALTH PAYMENT SYSTEMS, INC.
Reel/Frame 073478/0499 →
TERMINATION AND RELEASE OF INTELLECTUAL PROPERTY SECURITY AGREEMENT Recorded Nov 6, 2025
From: INNOVATION CREDIT INCOME FUND II, L.P.
To: HEALTH PAYMENT SYSTEMS, INC.
Reel/Frame 073478/0556 →
SECURITY INTEREST Recorded Nov 3, 2025
From: HEALTH PAYMENT SYSTEMS, INC.
To: ESCALATE CAPITAL V, LP
Reel/Frame 072767/0303 →
SECURITY INTEREST Recorded Aug 6, 2024
From: HEALTH PAYMENT SYSTEMS, INC.
To: INNOVATION CREDIT INCOME FUND II, L.P.
Reel/Frame 068198/0518 →
SECURITY INTEREST Recorded Dec 30, 2022
From: HEALTH PAYMENT SYSTEMS, INC.
To: INNOVATION CREDIT INCOME FUND II, L.P.
Reel/Frame 062245/0854 →
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Feb 13, 2007
From: LEFCO, BRUCE; BRINDLEY, JAMES
To: HEALTH PAYMENT SYSTEMS, INC.
Reel/Frame 018995/0424 →
Continuity (1)
Provisional Application 6085003400 · Oct 6, 2006