| 摘要 |
An integrated health savings account system which provides electronic (real-time or batch) interconnection between a health plan claims administrator and an individual healthcare spending account. An accountholder presents an identification card to a healthcare provider or pharmacy in order to receive treatment or obtain prescription drugs. A claim for reimbursement of healthcare expenses is sent to a health plan claims administrator (healthcare) or a pharmacy benefits manager (prescription drugs) for adjudication and determination of any deductibles. The adjudicated claim is sent to an individual healthcare spending account custodian/trustee for automatic determination of whether the remaining funds in the accountholder's individual healthcare spending account can cover the proposed claim. An indication of whether the amount of funds can cover the claim (in whole or in part) is transmitted back to the claims administrator or pharmacy benefits manager, and, if requested, the actual funds are transmitted in real-time or as part of a batch process. The individual healthcare spending account may be integrated with an investment account whereby an accountholder may invest excess funds (i.e., over a predefined minimum balance), for example, in mutual funds. |
