Interactive health insurance system

A method of administering healthcare using a dynamic cost-sharing database, the method comprising:

• storing a fee schedule;
• storing a provider's preselected cost-share level and practice characteristics;
• receiving inputs from an individual relating to cost-share levels and practice characteristics;
• transmitting information for selecting a provider based on the individual's inputs;
• receiving a request for reimbursement from a provider;
• and
• reimbursing the provider based on the stored fee schedule.

A method of administering delivery of healthcare services using a dynamic cost-sharing database for reimbursement of single transactions between a healthcare provider and an individual, the method comprising:

• receiving and storing a fee schedule for paying healthcare providers per single transaction;
• receiving and storing cost-share levels for each transaction selected by the healthcare provider based on cost-share selection data received from the provider;
• receiving inputs from the individual for a single transaction and provider criteria;
• and
• transmitting information to the individual for selecting a provider based on the individual's inputs and database information.

A method of assisting an individual in selection of a provider of services, the method comprising:

• maintaining a dynamic cost-sharing database, which contains provider-selected cost-share levels and practice characteristics;
• accessing the database from an individual's computer terminal;
• inputting, at the individual's computer terminal, information regarding treatment requirements and provider selection criteria;
• displaying, at the individual's computer terminal, results of a search based on the information input by the individual;
• and
• selecting a provider from the search results.

A method of administering a healthcare plan, the method comprising:

• receiving, from a healthcare administrator, a fee schedule setting reimbursements per single transaction;
• supplying, to a database maintained by the healthcare administrator, a provider-selected cost-share level required per single transaction;
• supplying provider practice characteristics information to the database;
• collecting a cost-share from a member on a per transaction basis;
• providing service to the member on a per transaction basis;
• and
• requesting reimbursement per transaction from the healthcare administrator based upon the fee schedule.

A method of administering reimbursement for healthcare services using a computer network which includes healthcare administrator terminals, provider terminals, and individual terminals, the method comprising:

• receiving provider-selected cost-sharing and practice characteristics information from a provider terminal;
• storing the cost-share and practice characteristics information in a dynamic cost-sharing database;
• receiving healthcare requirements and provider selection criteria from an individual terminal;
• and
• transmitting results of a search of the dynamic cost-sharing database based on the healthcare requirements and provider selection criteria to the individual terminal.

A method of conducting an auction of services over a computer network in an insured environment, the method comprising:

• storing an insurer's reimbursement schedule for services provided to a plan's members in a dynamic cost-sharing database;
• storing provider practice characteristics and a provider-selected individual cost-share amount that members must pay at a time of service in the database;
• receiving provider selection criteria from a member;
• and
• transmitting information for selecting a provider based on the provider selection criteria and information stored in the database.

A method of maintaining a healthcare database, the method comprising:

• storing database information provided by multiple healthcare providers, the database information including, for each provider, a provider-selected cost-sharing level for each category of service performed by the provider and provider practice characteristics;
• receiving inputs from an individual regarding healthcare requirements and provider selection criteria;
• and
• transmitting information to the individual regarding search results based on the individual's inputs and stored database information.

A method of creating a reimbursement schedule for a dynamic cost-sharing database, the method comprising:

• creating provider specialty-specific utilization profiles;
• categorizing each specialty utilization profile into copayment families;
• designating a utilization-weighted reimbursement factor to each procedure within the copayment family;
• calculating a normalized weight for each procedure within a copayment family from the reimbursement factors;
• identifying an amount an administrator will reimburse a provider for each procedure;
• identifying a target range of total reimbursement to the provider for each procedure;
• and
• calculating corresponding cost-sharing levels for each procedure.

A dynamic cost-sharing database, the database comprising:

• procedures and services of providers categorized into copayment families;
• administrator reimbursement amounts for each procedure and service;
• and
• cost-sharing levels for each procedure and service.

A method for a provider belonging to a healthcare network to select a copayment level, the method comprising:

• identifying copayment levels;
• identifying patient volumes;
• displaying financial impacts on the provider's practice;
• and
• selecting a reimbursement scenario with an ideal financial impact.