METHOD OF IDENTIFYING AND FORWARDING PAST MEDICAL CLAIMS PROCESSED BY A FIRST INSURANCE COMPANY TO A DIFFERENT SECOND INSURANCE COMPANY

摘要

A method that includes storing claim records for patients. Each record stores (a) personal information associated with one of the patients, and (b) claim information received from a claim data provider. The claim information stored in some of the records was submitted to different insurance companies. The claim information stored in some of the records was received from different claim data providers. A member identifier is automatically generated for each of the records as a function of a portion of the personal information stored in the record, and the record is associated with the member identifier. A member identifier is automatically generated as a function of a portion of personal information associated with a particular patient. A record associated with the same member identifier generated for the particular patient is identified and a portion of the claim information stored in the identified record is forwarded to a recipient insurance company.

主权项

1. A computer-implemented method comprising:
storing, with a computing system, a plurality of claim records for a plurality of patients insured by a plurality of insurance companies, each claim record storing (a) personal information associated with one of the plurality of patients, and (b) claim information for that patient received from one of a plurality of claim data providers, the claim information stored in at least some of the plurality of claim records having been submitted to different ones of the plurality of insurance companies, the claim information stored in at least some of the plurality of claim records having been received from different ones of the plurality of claim data providers; automatically generating, with the computing system, a member identifier for each of the plurality of claim records as a function of at least a portion of the personal information stored in the claim record, the claim record being associated with the member identifier generated for the claim record; obtaining, by the computing system, personal information associated with a particular patient; automatically generating, with the computing system, a member identifier for the particular patient as a function of at least a portion of the personal information associated with the particular patient; identifying, with the computing system, one of the plurality of claim records associated with the same member identifier generated for the particular patient; and forwarding at least a portion of the claim information stored in the identified claim record to a recipient insurance company.