Web-based managed care system having a common administrative account

A web-based managed care transaction system accessible over a computer network using a client browser, comprising:

• a transaction server;
• a database for storing a set of linked data tables organized into a persistent logical entity wherein said logical entity maintains data on each member in spite of status changes;
• wherein the set of linked data tables includes for each member:
• a master account table including account setup information for at least one of utilization and login actions for said web-based managed care transaction system;
• a member table including identity information for at least one member and their dependents;
• and
• a set of one or more member history tables associated with the member table, each member history table associated with a given employer plan;
• a plurality of linked tables representing a plurality of health providers, the plurality of tables including for each health provider in the plurality of health providers:
• a provider information table including identity information for the health provider;
• a provider specialty table identifying specialties practiced by the health provider;
• a site specialty table identifying specialties practiced by the healthcare provider at one or more sites;
• a hospital affiliation table identifying one or more hospitals affiliated with the health provider;
• and
• a provider affiliation table linked to the provider information table and said employer plan, the provider information table providing an intersection of the specialties in the provider specialty table and specialties allowed by said employer plan;
• wherein the web-based managed care transaction system is adapted to enable, via the linked set of data tables, an administrative account to be moved across health plans of the at least one member and their dependents throughout their life;
• wherein the web-based managed care transaction system is adapted to allow the at least one member to review, manage, and update the administrative account via the client browser, the administrative account comprising a history of health plans including past and present health plans of the at least one member and their dependents;
• wherein the administrative account is owned by the at least one member;
• wherein the web-based managed care transaction system provides a personal healthcare network for each member, the personal healthcare network comprising the member, at least one employer, and at least one health provider;
• wherein the personal healthcare network facilitates secure communication of healthcare-related information therethrough;
• and
• wherein the web-based managed care transaction system limits communication of the member's healthcare-related information to selected parties of the personal healthcare network of the member.

A network-based managed care system comprising a network based server;

• at least one client machine on which a graphical user interface operates;
• a network based subsystem comprising:
• a multiplexer;
• a plurality of functional modules;
• a transaction processor;
• and
• a database wherein a logical entity retains data representative of users received healthcare within said database persistent across changes to a user's healthcare plan
• wherein the database includes:
• a master account table for retaining account setup information for at least one of utilization and login actions for said network-based managed care system;
• and
• a member table including identity information for at least one member and their dependents;
• a plurality of linked tables representing a plurality of health providers, the plurality of tables including for each health provider in the plurality of health providers:
• a provider information table including identity information for the health provider;
• a provider specialty table identifying specialties practiced by the health provider;
• a site specialty table identifying specialties practiced by the healthcare provider at one or more sites;
• a hospital affiliation table identifying one or more hospitals affiliated with the health provider;
• and
• a provider affiliation table linked to the provider information table and said employer plan, the provider information table providing an intersection of the specialties in the provider specialty table and specialties allowed by said employer plan;
• a managed care organization (MCO) subsystem interfaced to said transaction processor;
• wherein the network-based managed care system is adapted to enable, via the database, an administrative account to be moved across health plans of the at least one member and their dependents throughout their life;
• wherein the administrative account comprises a history of health plans including past and present health plans of the at least one member and their dependents;
• wherein the administrative account is owned by the at least one member;
• and
• wherein the network-based managed care transaction system provides a personal healthcare network for each member, the personal healthcare network comprising the member, at least one employer, and at least one health provider;
• wherein the personal healthcare network facilitates secure communication of healthcare-related information therethrough;
• and
• wherein the network-based managed care system limits communication of the member's healthcare-related information to selected parties of the personal healthcare network of the member.