IP Library Granted Patent US 8,645,168
Granted Patent B2
US 8,645,168 · App. 11/797,316 · Granted Feb 4, 2014

Interactive electronic bill payment system

Inventors: Mike Schmidt (Etobicoke, CA); Ilan Grosman (Thornhill, CA); David Johnston (Toronto, CA)
Assignee: Emergis Inc.
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Quick Facts
Patent No.
US 8,645,168
App. No.
11/797,316
Granted
Feb 4, 2014
Kind
B2
Abstract

A system for coordinating the submission and processing of a bill according to predictive payment data of a plan. The system comprises a provider interface and an integrated database for receiving a predictive payment plan submitted from the provider interface. The system also has a predictive payment request of the plan storable in the database, the request including a plurality of predictive payment parameters. An adjudication engine is coupled to the integrated database, and an insertion function is used for inserting the predictive payment parameters into an adjudication rule set of the adjudication engine. The adjudication rule set is used for eventual adjudication of the predictive payment data, wherein adjudication of the predictive payment data results in the generation of the bill. The system also has a workflow engine for coordinating the processing of the electronic bill and for updating the bill information in response to processing.

Claims (29)

1. A method executed within an electronic bill processing network for coordinating the submission and processing of a predictive based electronic invoice according to predictive payment data of an insurance plan, the predictive based electronic invoice including a request for payment for insurance services defined in the insurance plan, the method comprising the steps of:

storing, in a memory of a database coupled to an adjudication engine, the predictive payment data corresponding to the insurance plan, the contents of the insurance plan including definitions for a plurality of valid insurance services and including corresponding valid expenses for performing each of the plurality of valid insurance services;

triggering generation of the predictive based electronic invoice at a predefined interval according to a predictive payment parameter, the electronic invoice including the predictive payment data represented in the contents of the insurance plan;

inserting the predictive based electronic invoice in a queue of the memory for eventual adjudication of the predictive payment data;

providing from the queue the predictive based electronic invoice to the adjudication engine for processing; and

upon recognizing completion of processing of the predictive based electronic invoice, generating a processing result of the predictive based electronic invoice as defined by the predictive payment data once adjudicated.

2. The method according to claim 1 , wherein the queue has a plurality of electronic invoices including direct electronic invoices and the predictive based electronic invoice.

3. The method of claim 2 , wherein the plurality of electronic invoices in the queue are both read and write accessible via a provider interface configured for receiving an inquiry invoice request including a search parameter from a respective provider of a plurality of providers, the search parameter for use in identifying from the plurality of electronic invoices an invoice matching the search parameter.

4. The method of claim 3 further comprising the step of limiting a degree of access of the plurality of electronic invoices by said read and write accessible by various individual access levels.

5. The method of claim 4 , wherein the degree of access is determined by role based features of the individuals.

6. The method of claim 4 , wherein the degree of access permits sequential rather than parallel editing of the plurality of electronic invoices.

7. The method of claim 2 , wherein the provider interface is configured to save an electronic invoice of the plurality of electronic invoices as a draft invoice subject to future editing and submission.

8. The method according to claim 1 , wherein the predictive payment parameter is part of a parameter set defined in the predictive payment data of the insurance plan, the parameter set including at least one parameter selected from the group comprising: the predefined interval; service codes; expense codes; payment amounts of the valid expenses; payment frequency; start and end dates for the generation of the electronic invoice; units; and payee information.

9. The method of claim 1 , wherein the plurality of valid insurance services include services selected from the group comprising: a service; a treatment and a product.

10. The method of claim 1 further comprising the step of using a scheduling table in coordinating scheduling of the predictive based electronic invoice with respect to other electronic invoices for processing by the adjudication engine, wherein the contents of the scheduling table facilitate implementation of a scheduling action selected from the group comprising: hold the predictive based electronic invoice for additional action before insertion into the queue; and direct insertion into the queue.

11. A computer based network system for coordinating the submission and processing of a predictive based electronic invoice according to predictive payment data of an insurance plan, the predictive based electronic invoice including a request for payment for insurance services defined in the insurance plan, the system comprising:

a storage for storing the predictive payment data corresponding to the insurance plan, the contents of the insurance plan including definitions for a plurality of valid insurance services and including corresponding valid expenses for performing each of the plurality of valid insurance services;

a scheduling module configured for use in triggering generation of the predictive based electronic invoice at a predefined interval according to a predictive payment parameter, the predictive based electronic invoice including the predictive payment data represented in the contents of the insurance plan;

a queue of the memory configured for receiving the predictive based electronic invoice for eventual adjudication of the predictive payment data; and

an adjudication engine configured for receiving the predictive based electronic invoice from the queue for processing and for generating a processing result of the predictive based electronic invoice once adjudicated.

12. The system according to claim 11 , wherein the queue has a plurality of electronic invoices including direct electronic invoices and the predictive based electronic invoice.

13. The system of claim 12 further comprising a provider interface, wherein the plurality of electronic invoices in the queue are both read and write accessible via the provider interface configured for receiving an inquiry invoice request including a search parameter from a respective provider of a plurality of providers, the search parameter for use in identifying from the plurality of electronic invoices an invoice matching the search parameter.

14. The system of claim 13 , wherein the provider interface is configured for limiting a degree of access of the plurality of electronic invoices by said read and write accessible by various individual access levels.

15. The system of claim 14 , wherein the degree of access is determined by role based features of the individuals.

16. The system of claim 14 , wherein the degree of access permits sequential rather than parallel editing of the plurality of electronic invoices.

17. The system of claim 12 , wherein the provider interface is configured to save an electronic invoice of the plurality of electronic invoices as a draft invoice subject to future editing and submission.

18. The system according to claim 11 , wherein the predictive payment parameter is part of a parameter set defined in the predictive payment data of the insurance plan, the parameter set including at least one parameter selected from the group comprising: the predefined interval; service codes; expense codes; payment amounts of the valid expenses; payment frequency; start and end dates for the generation of the electronic invoice; units; and payee information.

19. The system of claim 11 , wherein the plurality of valid insurance services include services selected from the group comprising: a service; a treatment and a product.

20. The system of claim 11 further comprising a scheduling table in the storage for use in coordinating scheduling of the predictive based electronic invoice with respect to other electronic invoices for processing by the adjudication engine, wherein the contents of the scheduling table facilitate implementation of a scheduling action selected from the group comprising: hold the predictive based electronic invoice for additional action before insertion into the queue; and direct insertion into the queue.

Assignments (4)
CHANGE OF NAME Recorded Mar 29, 2022
From: TELUS CASH MANAGEMENT SOLUTIONS GP
To: DND CASH MANAGEMENT SOLUTIONS GP
Reel/Frame 059529/0900 →
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Oct 5, 2021
From: TELUS HEALTH SOLUTIONS INC.
To: TELUS CASH MANAGEMENT SOLUTIONS GP
Reel/Frame 057701/0170 →
ASSIGNMENT OF ASSIGNOR'S INTEREST Recorded Aug 18, 2021
From: EMERGIS HEALTH SOLUTIONS INC.
To: TELUS HEALTH SOLUTIONS INC.
Reel/Frame 057221/0028 →
CHANGE OF NAME Recorded Aug 18, 2021
From: EMERGIS INC.
To: EMERGIS HEALTH SOLUTIONS INC.
Reel/Frame 057221/0033 →
Priority Claims (2)
CA 2401956 · Sep 6, 2002 · national
CA 2409078 · Oct 21, 2002 · national
Continuity (5)
Continuation 10960984 · Oct 12, 2004
Continuation 10656265 · Sep 8, 2003
Continuation In Part 10277205 · Oct 22, 2002
Provisional Application 60408884 · Sep 9, 2002
Related Publication 20070203760A1 · Aug 30, 2007