System and method of facilitating the coordination of benefits for a plurality of health plans
AssigneeCouncil for Affordable Quality Healthcare, Inc.
InventorsAkshay KAPUR, Atul PATHIYAL
Life of this patent
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AssigneeCouncil for Affordable Quality Healthcare, Inc.
InventorsAkshay KAPUR, Atul PATHIYAL
Estimating the term…
The disclosure relates to systems and methods of facilitating the coordination of benefits for a plurality of health plans that individually have at least some responsibility to pay for healthcare services received by members covered by more than one health plan. The coordination of benefits may be facilitated before payments are made, streamlining the payment process. The system may correlate health plan information received from various health plans and determine that a particular member is covered by more than one health plan based on the correlated health plan information. The system may generate, update, and provide a COB registry that includes coverage information related to other health plans that cover the particular member. The COB registry may include primacy information used to identify health plans having primary, secondary, and/or other responsibility to pay for a given healthcare service for a member covered by the identified health plans.
A computer-implemented method of managing a central coordination of benefits registry to facilitate a coordination of benefits for a plurality of health plans that individually have at least some responsibility to pay for one or more medical expenses for healthcare services received by members covered by more than one health plan, the coordination of benefits being made prior to a request for a payment for the healthcare services, the method being implemented on a computer that includes one or more physical processors programmed with computer program instructions that, when executed by the one or more physical processors, program the computer to perform the method, the method comprising:
A system of managing a central coordination of benefits registry to facilitate a coordination of benefits for a plurality of health plans that individually have at least some responsibility to pay for one or more medical expenses for healthcare services received by members covered by more than one health plan, the coordination of benefits being made prior to a request for payment for the healthcare services, the system comprising:
A non-transitory computer readable medium comprising computer program instructions for managing a central coordination of benefits registry to facilitate a coordination of benefits for a plurality of health plans that individually have at least some responsibility to pay for one or more medical expenses for healthcare services received by members covered by more than one health plan, the coordination of benefits being made prior to a request for payment for the healthcare services, wherein the computer program instructions, when executed by one or more physical processors of a computer, program the computer to:
Dependencies are inferred from the claim text.