Medical payment system

Abstract

A medical payment system is described in which a provider of medical goods and/or services submits, via telephone or other communications medium, a request for payment amount determination for a patient encounter. A price determination system determines which of a plurality of fee schedules negotiated by the provider applies to the patient encounter and calculates, based at least in part on information entered by the provider, a payment amount for the encounter. In one embodiment, the provider receives the payment amount information while the patient is at the point of service. In one embodiment, the provider may use the system to submit a claim for payment by at least one responsible party.

What is claimed is: 
     
         1 . A computer system of facilitating payment of health care benefits comprising:
 multiple fee schedules;   healthcare provider identification information; and   computer hardware configured to:
 identify a payer that has agreed to pay a healthcare provider on behalf of a patient subject to conditions; 
 select at least one fee schedule from the multiple fee schedules based at least in part on the healthcare provider identification information; and 
 calculate a payment amount based at least in part on the selected fee schedule; 
 verify that the payment amount is a bona fide medical expense; 
 approve the payment amount only when the payment amount has been verified; and 
 send the verification of the payment amount to an account associated with the patient; and 
 transmit a copy of the payment amount to the healthcare provider. 
   
     
     
         2 . The system of  claim 1  wherein the account is a bank account. 
     
     
         3 . The system of  claim 2  wherein the bank account is associated with a card that is at least one of the group consisting of: a stored value card, a medical credit card, and a medical plan card. 
     
     
         4 . The system of  claim 1  wherein the computer hardware is further configured to approve multiple payment amounts. 
     
     
         5 . The system of  claim 1  wherein the computer hardware is further configured to receive and store multiple payment amounts. 
     
     
         6 . The system of  claim 1  wherein the computer hardware is further configured to process and store multiple payment amounts associated with multiple patient encounters. 
     
     
         7 . The system of  claim 1  further comprising an interactive voice response system configured to prompt the healthcare provider to enter information about a patient encounter. 
     
     
         8 . The system of  claim 1  further comprising an interactive voice response system configured to communicate information about the approval of the payment amount. 
     
     
         9 . The system of  claim 1  further comprising an interactive voice response system configured to communicate information about the account. 
     
     
         10 . The system of  claim 1  wherein the computer hardware is further configured to determine a portion of the payment amount to be paid by the patient and a portion of the payment amount to be paid from a source of medical funds. 
     
     
         11 . The system of  claim 10 , wherein the source of medical funds is a third-party payor. 
     
     
         12 . The system of  claim 10 , wherein the source of medical funds is a flexible savings account.