Insurance claim data exchange
AssigneeHartford Fire Insurance Company
InventorsAnthony C. Ruszala, Steven A. Hatch
Life of this patent
Estimating the term…
Abstract
According to some embodiments, workers' compensation claims are received at a payor processing system from a plurality of remote bill input devices. The workers' compensation claims may be transformed in accordance with a jurisdiction-based claims processing rule. The transformed workers' compensation claims may then be transmitted to a workers' compensation adjudication engine.
Claims21
A payor apparatus to facilitate workers' compensation insurance claims processing, comprising:
- a communication device to receive, at the payor apparatus, information from a plurality of remote bill input devices;
- a processor, at the payor apparatus and coupled to the communication device;
- and
- a storage device in communication with said processor and storing instructions adapted to be executed by said processor to:
- receive at the payor apparatus a first workers' compensation claim directly from a first remote bill input device;
- receive at the payor apparatus a second workers' compensation claim directly from a second remote bill input device;
- determine a first geographic location associated with the first workers' compensation claim;
- determine a second geographic location associated with the second workers' compensation claim;
- select, from a set of potential claims processing rules, a first claims processing rule for the first workers' compensation claim based on the first geographic location;
- select, from the set of potential claims processing rules, a second claims processing rule for the second workers' compensation claim based on the second geographic location;
- transform the first workers' compensation claim in accordance with the first claims processing rule;
- transform the second workers' compensation claim in accordance with the second claims processing rule;
- and
- transmit the transformed first and second workers' compensation claims directly from the payor apparatus to a third-party workers' compensation adjudication engine.
A computer-implemented method to facilitate workers' compensation insurance claims processing, comprising:
- receiving, at a payor processing system, data indicative of workers' compensation claims from a plurality of remote bill input devices;
- storing the workers' compensation claims data in a storage device
- accessing the stored workers' compensation claims data to determine jurisdictions associated with each of the workers' compensation claims;
- automatically transforming different workers' compensation claims in accordance with different jurisdiction-based claims processing rules;
- and
- transmitting, via a communication network, the transformed workers' compensation claims directly to a workers' compensation adjudication engine.
A computer-readable medium storing instructions adapted to be executed by a processor to perform a method to facilitate workers' compensation insurance claims processing, said method comprising:
- receiving, at a payor processing system, workers' compensation claims from a plurality of remote bill input devices;
- determining jurisdictions associated with each of the workers' compensation claims;
- automatically transforming different workers' compensation claims in accordance with different jurisdiction-based claims processing rules;
- and
- transmitting the transformed workers' compensation claims directly to a workers' compensation adjudication engine.
A payor apparatus to facilitate workers' compensation insurance claims processing, comprising:
- a communication device to receive, at the payor apparatus, information from a plurality of remote bill input devices;
- a processor coupled to the communication device;
- and
- a storage device in communication with said processor and storing instructions adapted to be executed by said processor to:
- receive a first type of input data, associated with a first data transformation engine and being associated with workers' compensation claims,
- receive a second type of input data, associated with a second type of data transformation engine and being associated with workers' compensation claims, wherein the first and second types of data transformation engines comprise different plug and play module components of a claim data exchange;
- determine jurisdictions associated with each of the workers' compensation claims;
- transform, by the first type of data transformation engine, a first subset of workers' compensation claims in accordance with a first jurisdiction-based claims processing rule;
- transform, by the second type of data transformation engine, a second subset of workers' compensation claims in accordance with second jurisdiction-based claims processing rule;
- and
- transmit transformed workers' compensation claims directly to a workers' compensation adjudication engine.
Dependencies are inferred from the claim text.