System and Method For Managing Account Receivables

Abstract

A system for managing account receivables is provided. The system comprises a rules module or engine for receiving at least one encounter from a first party and for assessing the at least one encounter based on rules associated with a payer; and a transactions module or engine for outputting at least one claim to the payer based on the rule module's assessment of the at least one encounter.

1 - 33 . (canceled) 
     
     
         34 . A method for aging an account receivable, comprising:
 receiving a receivable at an aging engine;   determining the payer associated with the receivable;   determining past payment patterns of the payer; and   aging the account receivable on a periodic basis.   
     
     
         35 . The method of  claim 34 , where the aging occurs according to the past payment patterns of the payer. 
     
     
         36 . The method of  claim 34 , where the aging occurs according to predetermined parameters. 
     
     
         37 . The method of  claim 36 , where the predetermined parameters comprise a number of days past due. 
     
     
         38 . The method of  claim 34 , further comprising:
 classifying the receivable as either payment, denial, or no-response.   
     
     
         39 . The method of  claim 38 , where the no-response classification is determined based on patient receivables that age beyond a certain point. 
     
     
         40 . The method of  claim 38 , further comprising:
 generating an incident report for receivables designated as denial or no-response.   
     
     
         41 . The method of  claim 38 , further comprising:
 contacting an insurance company, contacting a patient, or billing a patient based on the incident report.   
     
     
         42 . The method of  claim 38 , were the contacting occurs automatically. 
     
     
         43 . The method of  claim 38 , further comprising:
 writing off the receivable or sending the receivable to appeal.   
     
     
         44 . A system for aging an account receivable, comprising:
 an aging engine for receiving an account receivable; and   an aging module for (1) determining the payer associated with the receivable and the past payment patterns of the payer and (2) aging the account receivable on a periodic basis.   
     
     
         45 . The system of  claim 44  where the aging module is configured to age the account receivable according to the past payment patterns of the payer. 
     
     
         46 . The system of  claim 44  where the aging module is configured to age the account receivable according to pre-determined parameters. 
     
     
         47 . The system of  claim 46 , where the pre-determined parameters comprise a number of days past due. 
     
     
         48 . The system of  claim 44 , where the aging module classifies the receivable as either payment, denial, or no-response. 
     
     
         49 . The system of  claim 48  where the classification module or engine is configured to determine the no-response classification based on the age of the receivable. 
     
     
         50 . The method of  claim 44 , further comprising:
 a management module or engine for contacting an insurance company, contacting a patient, or billing a patient.   
     
     
         51 . The method of  claim 50  where the management module is configured to contact automatically.