Method and system for determining healthcare eligibility
OwnerBarbara Patterson, Stacy Pourfallah +2inventors
InventorsBarbara Patterson, Stacy Pourfallah, Janet Pruitt, Loc Nguyen
Life of this patent
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Abstract
A method for determining healthcare insurance coverage eligibility is disclosed. The method includes receiving patient information at a terminal operated by a healthcare provider. An eligibility authorization request message is created, and is sent to an acquirer processor, where the acquirer processor sends the eligibility authorization request message to a transaction processing system, which routes the eligibility authorization request message to a healthcare processor. A response message is then received.
Claims20
A method comprising:
- receiving patient information at a terminal operated by a healthcare provider;
- creating a non-financial eligibility authorization request message which relates to healthcare insurance coverage using the patient information;
- sending the eligibility authorization request message to an acquirer processor or its designated third party processor, wherein the acquirer processor sends the authorization request message to a transaction processing system, and wherein the authorization request message is evaluated in view of information from an issuer processor or a healthcare processor;
- and
- receiving a response message in response to the eligibility authorization request message.
A computer readable medium comprising:
- code for receiving patient information at a terminal operated by a healthcare provider;
- code for creating a non-financial eligibility authorization request message which relates to healthcare insurance coverage using the patient information;
- code for sending the eligibility authorization request message to an acquirer processor, wherein the acquirer processor sends the authorization request message to a transaction processing system, and wherein the authorization request message is evaluated in view of information from an issuer processor or a healthcare processor;
- and
- code for receiving a response message in response to the eligibility authorization request message.
A method comprising:
- receiving patient information comprising a patient identification number at a terminal operated by a healthcare provider, wherein the patient information is stored or displayed in a portable consumer device in the form of a card;
- creating a non-financial eligibility authorization request message which relates to healthcare insurance coverage using the patient information, wherein creating the eligibility authorization request message comprises adding data to a data field to indicate that the authorization request message relates to a non-financial eligibility transaction;
- sending the eligibility authorization request message to an acquirer processor, wherein the acquirer processor sends the authorization request message to a transaction processing system, and an issuer processor, and then optionally to a healthcare processor;
- and
- receiving a response message from the healthcare processor or the issuer processor.
Dependencies are inferred from the claim text.