US 10,373,245 B1Granted

On-line billing related transactions in an integrated health plan system

AssigneeCognizant TriZetto Software Group, Inc.

InventorsDavid Smith, Jeffrey Cohen

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Abstract

Disclosed is an integrated health plan computer system that enables on-line billing related transactions. The integrated health plan computer system may include a server to couple the integrated health plan computer system to a billing entity user through a network. A billing module operable with the integrated health plan computer system and the server is utilized to enable on-line billing related transactions for the billing entity user through the network. The billing module includes an invoice presentment module to perform invoice presentment transactions for the billing entity user and to display results of the invoice presentment transaction to the billing entity user. The billing entity user may be a group administrator, a broker, or an individual.

Claims18

Dependent claims

A non-transitory machine-readable medium having stored thereon instructions, which when executed by a machine of an integrated health plan computer system, cause the machine to perform the following operations comprising:

connecting at least one billing entity user to the integrated health plan computer system, wherein the at least one billing entity user is connected to a different launch page in accordance with a predetermined privilege level afforded to the at least one billing entity user by the integrated health plan computer system, and further wherein the predetermined privilege level and resulting launch page are determined by log-in information provided by the at least one billing entity at an initial display page;
and
receiving by a billing module of the integrated health plan computer system each of the following on-line billing related transactions from one or more of the at least one billing entity users, wherein the billing module includes a transaction module for performing transactions and an information display module, including a display format module, to display information that complies with a display format that is compatible with the integrated health plan computer system:
an invoice presentment transaction, wherein an invoice presentment module of the billing module of the integrated health plan computer system invokes the information display module and displays results of the invoice presentment transaction performed by the transaction module to the billing entity users,
a prospective subscriber roster transaction, including:
generating by the transaction module, by a prospective subscriber roster module of the billing module of the integrated health plan computer, a prospective subscriber roster list using at least one of
(i.) a received “as of” input date,
(ii.) a subgroup and
(iii.) a subscriber ID;
displaying by the information display module and the prospective subscriber roster list to the billing entity user, wherein based upon (i.) the prospective subscriber list includes prospective subscriber names associated with the billing entity user as of the “as of” input date, based upon (ii.) the prospective subscriber list includes prospective names associated with the received subgroup, or based upon (iii.) the prospective subscriber list includes prospective names associated with the received subscriber ID;
and
a member census transaction generated by the transaction module of the billing module based on the subscriber ID in response to a member census request from the billing entity user, wherein for prospective subscriber roster lists generated using (iii.), no separate step of receiving of a subscriber ID is required and for prospective subscriber roster lists generated using (i.) or (ii.), receiving a subscriber ID in order to generate the member census;
and
displaying by the information display module the member census to the billing entity user.

11 more elements

A method of performing on-line billing related transactions in an integrated health plan computer system, the method comprising:

connecting at least one billing entity user to the integrated health plan computer system wherein the at least one billing entity user is connected to a different launch page in accordance with a predetermined privilege level afforded to the at least one billing entity user by the integrated health plan computer system, and further wherein the predetermined privilege level and resulting launch page are determined by log-in information provided by the at least one billing entity at an initial display page;
and
receiving by a billing module of the integrated health plan computer system each of the following on-line billing related transactions from one or more of the at least one billing entity users, wherein the billing module includes a transaction module for performing transactions and an information display module, including a display format module, to display information that complies with a display format that is compatible with the integrated health plan computer system:
an invoice presentment transaction, wherein an invoice presentment module of the billing module of the integrated health plan computer system invokes the information display module and displays results of the invoice presentment transaction performed by the transaction module to the billing entity users,
a prospective subscriber roster transaction, including:
generating by the transaction module a prospective subscriber roster module of the billing module of the integrated health plan computer, a prospective subscriber roster list using at least one of
(i.) a received “as of” input date,
(ii.) a subgroup and
(iii.) a subscriber ID;
displaying by the information display module the prospective subscriber roster list to the billing entity user, wherein based upon (i.) the prospective subscriber list includes prospective subscriber names associated with the billing entity user as of the “as of” input date, based upon (ii.) the prospective subscriber list includes prospective names associated with the received subgroup, or based upon (iii.) the prospective subscriber list includes prospective names associated with the received subscriber ID;
and
a member census transaction generated by the transaction module of the billing module based on the subscriber ID in response to a member census request from the billing entity user, wherein for prospective subscriber roster lists generated using (iii.), no separate step of receiving of a subscriber ID is required and for prospective subscriber roster lists generated using (i.) or (ii.), receiving a subscriber ID in order to generate the member census;
and
displaying by the information display module the member census to the billing entity user.

11 more elements

Dependencies are inferred from the claim text.