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.

1 . A computer system of facilitating payment of health care benefits comprising:
 healthcare provider identification information; and   computer hardware configured to:
 receive information about goods or services provided by a healthcare provider to a patient; 
 identify a payor that has agreed to pay the healthcare provider on behalf of the patient; 
 automatically verify that the goods or services are related to a medical expense; 
 approve a payment amount only when the medical expense has been verified, the payment amount comprising a patient portion paid by the patient; and 
 electronically send the patient portion of the payment amount to an account associated with the patient. 
   
     
     
         2 . The system of  claim 1  wherein the account is a bank account. 
     
     
         3 . The system of  claim 2  wherein the computer hardware is further configured to electronically debit the patient account. 
     
     
         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 the patient portion of the payment amount to be paid by the patient and the payor portion of the payment amount is based on medical codes. 
     
     
         11 . The system of  claim 10 , wherein the payor portion is send to a third-party payor. 
     
     
         12 . The system of  claim 10 , wherein the patient portion is sent to a bank account. 
     
     
         13 . A method of facilitating payment of health care benefits to a health care provider comprising:
 identifying a healthcare provider that renders goods or services to a patient in anticipation of payment;   electronically receiving with computer hardware, information about the goods or services provided by the healthcare provider to the patient;   identify with the computer hardware, a payor that has agreed to pay the healthcare provider on behalf of the patient;   automatically verifying with computer hardware that the goods or services are related to a medical expense;   automatically approving with computer hardware a payment amount only when the medical expense has been verified, the payment amount comprising a patient portion of the payment amount to be paid by the patient; and   electronically sending the patient portion of the payment amount to an account associated with the patient.   
     
     
         14 . The method of  claim 13  wherein the account is a bank account. 
     
     
         15 . The method of  claim 13  further electronically debiting the patient account. 
     
     
         16 . The method of  claim 13  further comprising approving multiple payment amounts. 
     
     
         17 . The method of  claim 13  further comprising receiving and storing multiple payment amounts. 
     
     
         18 . The method of  claim 13  further comprising processing and storing multiple payment amounts associated with multiple patient encounters. 
     
     
         19 . The method of  claim 13  further comprising prompting a provider with an interactive voice response system to enter information about a patient encounter. 
     
     
         20 . The method of  claim 13 , wherein the payor portion is paid by a third-party payor. 
     
     
         21 . The method of  claim 13 , wherein the patient portion is sent to a financial institution for payment.