Merchant portal system with explanation of benefits
A method for facilitating the delivery of electronic funds and conveying an explanation of benefits (EOB) to a service provider is described herein. A claim for payment by a service provider (such as a physician's office) is adjudicated by a third party administrator which authorizations payment in an amount and also provides an EOB explaining the payment authorization. A virtual payment card is generated and transmitted to the provider or the merchant acquirer for the provider. When the service provider logs into its merchant portal to view and reconcile payment card deposits, the EOB is viewable with its associated payment deposit record.
1. A method for displaying on an electronic device a user interface for displaying an explanation of benefits (EOB) and contemporaneously displaying virtual payment card deposits in a user interface of a computer application portal to a service provider, the method comprising the steps of:
displaying a user interface on a computer screen, the user interface having an iframe embedded therein, wherein the user interface is displayed within a preexisting, merchant account application portal administered by the merchant account of the service provided;
receiving, by a payment processor computer application, an electronic adjudicated claim file, the electronic file containing EOB data;
obtaining, by the application, payment information which includes a payment obligation amount and a provider identity from parsing the electronic file;
storing, by the application, EOB data in an EOB data store;
storing, by the application, a cross-reference value that links the payment information and the EOB;
generating a request by the application for a virtual payment card in an amount equal to that authorized by the adjudicated claim file, the virtual payment card including an account number, an expiration date and an amount value;
directing the transmission of the virtual payment card by the application to the service provider directly or to merchant acquirer for the service provider as a straight through transaction, wherein the virtual payment card is processed in the authorized amount as payment to the service provider;
accessing, by the application, the EOB data;
decoding the EOB data to render the EOB data embeddable within the user interface;
embedding, by the application, the EOB data within the iframe embedded within the user interface of the portal used for displaying payment card deposits such that the EOB data is displayed within the user interface at the direction of the application responsive to a service request by the portal using the cross-reference value; and
responsive to an inquiry by the service provider through the user interface of the online portal for the payment information for the adjudicated claim, displaying, within the user interface, the embedded EOB data linked to the payment information based on the cross reference, whereby the payment information is retrieved from the merchant account and the explanation of benefits is retrieved from the EOB data store.
2. The method of claim 1 further comprising the step of establishing IP restrictions for the portal connections wherein connections not within a whitelist by a portal for EOB data are refused by the application.
3. The method of claim 1 further comprising the step of establishing a virtual private network connection between the application and the portal.
4. The method of claim 1 further comprising the step of capturing by the application, an authorization code generated responsive to processing the virtual payment card and using the authorization code as an authentication factor for displaying the embedded EOB data within the online portal to the service provider.
5. A method for displaying on a computer screen a user interface for displaying an explanation of benefits (EOB) and contemporaneously displaying virtual payment card deposits in a user interface of a computer application portal to a service provider, the method comprising the steps of:
displaying a user interface on a computer screen, the user interface having an iframe embedded therein, wherein the user interface is displayed within a preexisting, online merchant account application portal administered by the merchant account of the service provider and encrypted with a first secure socket layer connection;
receiving, by a payment processor computer application, an electronic adjudicated claim file, the electronic file containing both payment information and a EOB data, the payment information including an amount to be paid and the identity of the service provider;
storing, by the application, EOB data in an EOB data store;
storing, by the application, a cross-reference value that links the payment information and the EOB;
generating a request by the application for a virtual payment card in an amount equal to that authorized by the adjudicated claim file;
directing the transmission of the virtual payment card by the application to the service provider directly or to merchant acquirer for the service provider as a straight through transaction, wherein the virtual payment card is processed in the authorized amount as payment to the service provider;
accessing, by the application, the EOB data embeddable within the user interface;
displaying, by the application, the EOB data within the iframe of the user interface with a second secure socket layer connection within the portal used for displaying payment card deposits such that the EOB data is delivered to the user interface at the direction of the application responsive to a service request by portal using a uniform resource locator path within iframe, the path derived using the cross-reference value; and
responsive to an inquiry by the service provider through the user interface of the online portal for the payment information for the adjudicated claim, displaying, on the user interface, the embedded EOB data through the iframe in context with the payment information, whereby the payment information is retrieved from the merchant account and the explanation of benefits is retrieved from the EOB data store.
6. The method of claim 5 further comprising the step of establishing IP restrictions for the portal connections wherein connections not within a whitelist by a portal for EOB data are refused by the application.
7. The method of claim 5 further comprising the step of establishing a virtual private network connection between the application and the portal.
8. The method of claim 5 further comprising the step generating a GUID value as a cross-reference between the EOB and the payment data wherein the GUID value forms part of the path to the iframe source.
9. The method of claim 8 wherein the GUID value is a first authentication factor for the iframe source path and further comprising the step of capturing by the application an authorization code generated by the processing of the virtual payment card, the authorization code forming a second authentication factor whereby the iframe source path includes both the GUID value and the authorization code.
10. The method of claim 5 further comprising the step of requiring a passcode propriety to the provider, keyed in through the iframe prior to displaying the EOB data associated with the payment.
11. The method of claim 5 further comprising the steps of:
retrieving the address of the provider by the application;
retrieving the IP address of the provider accessing the portal by the application;
referencing the IP address against a geoIP location table,
verifying that the IP addresses is within a geographic boundary threshold of the address known for the provider; and
displaying the EOB data through the iframe upon successful verification that the entity accessing the portal is doing so through a computer connected to the Internet within the geographic boundary threshold.
12. A system for displaying on an electronic device a user interface for displaying an explanation of benefits (EOB) and contemporaneously displaying virtual payment card deposits in a user interface of a computer application portal to a service provider, the system comprising:
a computer screen displaying a user interface, the user interface having an iframe embedded therein;
a payment processor computer application that receives an electronic adjudicated claim file, the electronic file containing payment information that specifies the identity of the provider, an amount to be paid to the provider and EOB data;
a storage module in the application that stores the EOB data in an EOB data store and further stores a cross-reference value that links the payment information to associated EOB;
a payment card request module in the application that requests a virtual payment card in an amount equal to that authorized by the adjudicated claim file;
a card transmission module in the application that directs the transmission of the virtual payment card by the application to the service provider directly or to merchant acquirer for the service provider as a straight through transaction, wherein the virtual payment card is processed in the authorized amount as payment to the service provider; and
a service request module that transmits the EOB data through a merchant account portal accessed by the service provider via the user interface whereby the user interface displays a deposit to the service provider resulting from the processing of the virtual payment card in association with EOB data retrieved from the EOB data store by linking to the cross-reference value.
13. The system of claim 12 further comprising IP restrictions for the portal connections wherein connections not within a whitelist by a portal for EOB data are refused by the application.
14. The system of claim 12 further comprising a virtual private network connection between the application and the portal.
15. The system of claim 12 further comprising a GUID value generated by the application as a cross-reference between the EOB and the payment data wherein the GUID value forms part of the path to the iframe source.
16. The system of claim 15 wherein the GUID value is a first authentication factor for the iframe source path and further comprising the step of capturing by the application an authorization code generated by the processing of the virtual payment card, the authorization code forming a second authentication factor whereby the iframe source path includes both the GUID value and the authorization code.
17. The system of claim 12 further a web module requiring a passcode propriety to the provider, keyed in through the iframe prior to displaying the EOB data associated with the payment.
18. The system of 12 further a geolocation authentication module that performs the steps of:
retrieving the address of the provider by the application;
retrieving the IP address of the provider accessing the portal by the application;
referencing the IP address against a geoIP location table,
verifying that the IP addresses is within a geographic boundary threshold of the address known for the provider; and
displaying the EOB data through the iframe upon successful verification that the entity accessing the portal is doing so through a computer connected to the Internet within the geographic boundary threshold.
19. A method for displaying on an electronic device a user interface for displaying an explanation of benefits (EOB) and contemporaneously displaying virtual payment card deposits in a user interface of a computer application portal to a service provider, the method comprising the steps of:
displaying a user interface on a computer screen, the user interface having an iframe embedded therein, wherein the user interface is displayed within a preexisting, online merchant account application portal administered by the merchant account of the service provider and encrypted with a first secure socket layer connection;
receiving, by a payment processor computer application, an electronic adjudicated claim file, the electronic file containing both payment information and EOB data;
storing, by the application, EOB data in an EOB data store;
generating a request by the application for a virtual payment card in an amount equal to that authorized by the adjudicated claim file;
directing the transmission of the virtual payment card by the application to the service provider directly or to merchant acquirer for the service provider as a straight through transaction, wherein the virtual payment card is processed in the authorized amount as payment to the service provider;
providing, by the application, a unique uniform resource locator (URL) string associated with a processed virtual card payment to an online merchant account application portal administered by the merchant account of the service provider, whereby a reference in the portal linking to the URL is displayed in context with processed virtual card payment transaction record viewable in the user interface; and
displaying, by the application, within the iframe of the user interface, the EOB data at the URL provided and through a second secure socket layer connection responsive to a request by a user accessing the portal on behalf of the provider.
20. The method of claim 19 wherein the portal is accessible through a web browser.
21. The method of claim 19 wherein the portal is accessible through a proprietary client side application run by the provider.
22. The method of claim 21 wherein the proprietary client side application retrieves a plurality of processed virtual card transactions from the merchant account and associated EOB records together in batch and populates a data store within the client side application with the transaction and EOB data.