Patient financial advocacy system
View Patent ↗A patient financial advocacy system is disclosed for identifying potential funding sources for uninsured patients and for the patient portion of healthcare debts that are covered by managed healthcare plans by automating the identification of potential funding sources and automating the collection of data required by such potential funding sources. The system is an automated system ad includes three stages, namely, a detection stage; an execution stage and a measurement stage. In the detection stage, a multi-tiered questionnaire is used during a patient interview to identify potential funding sources. In accordance with an important aspect of the invention, the questionnaire is structured to find the funding source with the highest yield. A rules engine is programmed to analyze the patient's answers to the questions and identify a potential funding source. In the execution stage, the rules engine is further programmed with specific questionnaires structured to gather all of the required data of the identified funding source. The execution stage identifies all steps required for applying for the specific funding source. In the measurement stage, the system determines the best possible yield for all identified patient funding sources.
1. A computerized patient financial advocacy system for identifying a funding source for an uninsured patient for a specific healthcare service which provides the most amount of money to a health care provider for the health care service, the system comprising:
a computer programmed with rules defining a rules engine which generates standardized questions that are organized in a plurality of tiers including a highest tier that pays out the most amount of money to the health care provider for the health care service and a lowest tier that pays out the least amount of money to the health care provider for the health care service, each tier corresponding to one or more funding sources, said questions presented sequentially from the highest tier to the lowest tier until the funding source for the health care service is identified, said rules engine is further programmed to analyze patient responses to said standardized questions to identify the funding source that will pay out the most money to the health care provider for the health care service based upon said responses from said patient.
2. The patient advocacy system as recited in claim 1 , wherein said rules engine is further programmed to provide additional questions in order to obtain information required by the identified funding source.
3. The patient advocacy system as recited in claim 1 , wherein one or more of said plurality of tiers include a plurality of funding sources wherein said funding sources are organized in said tier from the potential funding sources that pays out the most amount of money to the health care provider for the health care service to the funding source that pays out the least amount of money to the health care provider for the health care service.
4. The patient advocacy system as recited in claim 1 , wherein at least one tier includes hidden coverage.
5. The patient advocacy system as recited in claim 4 , wherein said hidden coverage includes COBRA.
6. The patient advocacy system as recited in claim 4 , wherein said hidden coverage includes parental coverage.
7. The patient advocacy system as recited in claim 1 , wherein at least one tier includes government coverage.
8. The patient advocacy system as recited in claim 7 , wherein said government coverage includes Medicaid.
9. The patient advocacy system as recited in claim 1 , wherein at least one tier includes patients eligible for charity.
10. The patient advocacy system as recited in claim 1 , wherein at least one tier includes coverage for specific populations.
11. The patient advocacy system as recited in claim 10 , wherein said specific populations include crime victims.
12. The patient advocacy system as recited in claim 10 , wherein said specific populations include military personnel.
13. The patient advocacy system as recited in claim 1 , wherein at least one tier includes coverage for patients using disability as a source of coverage.
14. The patient advocacy system as recited in claim 1 , wherein at least one tier includes coverage for patients with injuries.
15. The patient advocacy system as recited in claim 14 , wherein said funding sources associated with the tier for patients with injuries includes auto insurance.
16. The patient advocacy system as recited in claim 15 , wherein said funding sources associated with the tier for patients with injuries includes worker's compensation.
17. The patient advocacy system as recited in claim 15 , wherein said funding sources associated with the tier for patients with injuries includes public liability insurance.