Incentive based discount system
AssigneeAbacus Health Solutions
InventorsDavid K. Ahern, Michael J. Follick, Edward Aberger, Linda Loiselle, Joseph Wroblewski, Augustus E. Adams, III, Sean Follick
Life of this patent
Estimating the term…
Abstract
Methods, systems, and apparatus, including computer programs encoded on computer storage media, for touchpoint management. One of the methods includes receiving compliance information about a member. The method includes determining based at least in part on the compliance information that the member is in compliance with the health plan. The method includes adding the member to a list of compliant members. The method also includes providing the list of compliant members to at least one third-party.
Claims16
A computer-implemented method comprising:
- receiving data representing compliance information from a medical services provider, the compliance information specifying a health care action for a member related to a medical diagnosis of diabetes, the information specifying a date of completion related to the health care action;
- wherein the health care action comprises at least one of visiting a doctor, getting a lab test, completing an interview with a healthcare professional, performing a biometric reading through a home-based medical monitoring device or attending an educational program;
- determining a health care plan for the member, the health care plan comprising a plurality of additional health care actions for completion within a predetermined timeframe by the member, the additional health care actions being related to the medial diagnosis of diabetes;
- determining based at least in part on the compliance information that the member is compliant with the health care plan;
- adding the member to a list of compliant members;
- within a pre-determined time frame of receiving the compliance information and adding the member to the list of compliant members,
- sending notification data by a communications network to a client device associated with the member comprising a notification that the member is added to the list of compliant members;
- and
- activating, over the communications network in real time or near real time, an electronic card provided to the member by the client device, the electronic card configured to identify, in association with a request for a service by the member with the electronic card, a benefit associated with the service to be provided to the member;
- and
- providing data representing the list of compliant members to at least one third-party entity to cause the at least one third-party entity to provide the benefit associated with the service in real time or near real time in response to receiving the request, associated with the activated electronic card, for the service;
- maintaining a compliant status for the member in response to receiving compliance data for the member over the communications network;
- in response to a failure to receive compliance data for the member over the communications network, determining that the member is no longer compliant with the health care plan;
- in response to determining that the member is no longer compliant with the health care plan:
- deactivating, over the communications network, in real time or near real time, the electronic card provided to the member;
- and
- sending, over the communications network in real time or near real time, a message to the client device of the member specifying that the member is no longer compliant.
A non-transitory computer storage medium encoded with computer program instructions that when executed by one or more computers cause the one or more computers to perform operations comprising:
- receiving compliance information from a medical services provider, the compliance information specifying a health care action for a member related to a medical diagnosis of diabetes, the information specifying a date of completion related to the health care action;
- wherein the health care action comprises at least one of visiting a doctor, getting a lab test, completing an interview with a healthcare professional, performing a biometric reading through a home-based medical monitoring device or attending an educational program;
- determining a health care plan for the member, the health care plan comprising a plurality of additional health care actions for completion within a predetermined timeframe by the member, the additional health care actions being related to the medial diagnosis of diabetes;
- determining based at least in part on the compliance information that the member is compliant with the health care plan;
- adding the member to a list of compliant members;
- within a pre-determined time frame of receiving the compliance information and adding the member to the list of compliant members,
- sending notification data by a communications network to a client device associated with the member comprising a notification that the member is added to the list of compliant members;
- activating, over the communications network in real time or near real time, an electronic card provided to the member by the client device, the electronic card configured to identify, in association with a request for a service by the member with the electronic card, a benefit associated with the service to be provided to the member;
- and
- providing data representing the list of compliant members to at least one third-party entity to cause the at least one third-party entity to provide the benefit associated with the service in real time or near real time in response to receiving the request, associated with the activated electronic card, for the service;
- maintaining a compliant status for the member in response to receiving compliance data for the member over the communications network;
- in response to a failure to receive compliance data for the member over the communications network, determining that the member is no longer compliant with the health care plan;
- and
- in response to determining that the member is no longer compliant with the health care plan:
- deactivating, over the communications network, in real time or near real time, the electronic card provided to the member;
- and
- sending, over the communications network in real time or near real time, a message to the client device of the member specifying that the member is no longer compliant.
A system comprising:
- one or more computers and one or more storage devices storing instructions that are operable, when executed by the one or more computers, to cause the one or more computers to perform operations comprising:
- receiving data representing compliance information from a medical services provider, the compliance information specifying a health care action for a member related to a medical diagnosis of diabetes, the information specifying a date of completion related to the health care action;
- wherein the health care action comprises at least one of visiting a doctor, getting a lab test, completing an interview with a healthcare professional, performing a biometric reading through a home-based medical monitoring device or attending an educational program;
- determining a health care plan for the member, the health care plan comprising a plurality of additional health care actions for completion within a predetermined timeframe by the member, the additional health care actions being related to the medial diagnosis of diabetes;
- determining based at least in part on the compliance information that the member is compliant with the health care plan;
- adding the member to a list of compliant members;
- within a pre-determined time frame of receiving the compliance information and adding the member to the list of compliant members,
- sending notification data by a communications network to a client device associated with the member comprising a notification that the member is added to the list of compliant members;
- activating, over the communications network in real time or near real time, an electronic card provided to the member by the client device, the electronic card configured to identify, in association with a request for a service by the member with the electronic card, a benefit associated with the service to be provided to the member;
- and
- providing data representing the list of compliant members to at least one third-party entity to cause the at least one third-party entity to provide the benefit associated with the service in real time or near real time in response to receiving the request, associated with the activated electronic card, for the service;
- maintaining a compliant status for the member in response to receiving compliance data for the member over the communications network;
- in response to a failure to receive compliance data for the member over the communications network, determining that the member is no longer compliant with the health care plan;
- and
- in response to determining that the member is no longer compliant with the health care plan:
- deactivating, over the communications network, in real time or near real time, the electronic card provided to the member;
- and
- sending, over the communications network in real time or near real time, a message to the client device of the member specifying that the member is no longer compliant.
A computer-implemented method comprising:
- receiving data representing compliance information about a member for a health plan, the compliance information being verified in association with a transaction that is executed with an electronic card specifying the member, the electronic card configured to identify, in association with a request for a service by the member with the electronic card, a benefit associated with the service to be provided to the member;
- determining based at least in part on the compliance information that the member is in compliance with the health plan;
- adding the member to a list of compliant members;
- providing the list of compliant members to at least one third-party;
- and
- within a pre-determined time frame of receiving the compliance information and adding the member to the list of compliant members,
- sending notification data by a communications network to a client device associated with the member comprising a notification that the member is added to the list of compliant members;
- activating, over the communications network in real time or near real time, an electronic card provided to the member by the client device;
- providing data representing the list of compliant members to at least one third-party entity to cause the at least one third-party entity to provide the benefit associated with the service in real time or near real time in response to receiving the request, associated with the activated electronic card, for the service;
- maintaining a compliant status for the member in response to receiving compliance data for the member over the communications network;
- and
- in response to a failure to receive compliance data for the member over the communications network, determining that the member is no longer compliant with the health care plan;
- in response to determining that the member is no longer compliant with the health care plan:
- deactivating, over the communications network, in real time or near real time, the electronic card provided to the member;
- and
- sending, over the communications network in real time or near real time, a message to the client device of the member specifying that the member is no longer compliant.
Dependencies are inferred from the claim text.