HEALTHCARE POINT OF SERVICE ADJUDICATION AND PAYMENT SYSTEM

摘要

Systems and methods are described that facilitate providing an online, automated payment architecture that aggregates funds from multiple health-related accounts (e.g., a member's HSA, an employer's advance account, etc.) and automatically transfers the aggregated funds to a healthcare provider's account to pay a bill or invoice. According to other aspects, healthcare fraud is prevented by storing electronic images of members and their dependents, wherein the images can be recalled by a healthcare provider at the point of service to verify that the member or dependent is actually a covered member. In other aspects, the described systems and methods permit members to negotiate reduced invoice payments in exchange for prompt delivery of payment funds.

主权项

1. A system that facilitates online healthcare fund aggregation for payment of healthcare provider invoices, comprising:
a processor that executes computer-executable instructions for aggregating funds from multiple healthcare-related accounts for payment to a healthcare provider; a memory that stores the computer-executable instructions; and a server comprising the processor and the memory and providing Internet access to the processor for fund aggregation and healthcare invoice payment; wherein the instructions comprise:
receiving an electronic invoice from a healthcare provider;accessing a member account belonging to a member of a healthcare plan;withdrawing funds to pay the invoice amount from the member account, if funds are available in the member account;accessing an employer account maintained by an employer providing the healthcare plan to the member;withdrawing additional funds from the employer account to satisfy the invoice amount when the member account does not have sufficient funds to satisfy the invoice amount;aggregating the funds from the member account and the additional funds from the employer account in an aggregating account (AA); andtransferring the aggregated funds from the aggregating account to a healthcare provider account to pay the invoice amount.