Systems and methods for personal medical account balance inquiries

摘要

The invention is directed to systems and methods for monitoring, retrieving, and/or reporting a personal medical account balance such as an individual flexible spending account (FSA) balance. In an example of an embodiment of the invention the monitoring, retrieval, and/or display of the personal medical account balance may accompany the processing of a claim submitted by a healthcare provider (e.g., hospital, doctor's office, pharmacy, etc.) or vendor (e.g., retail store, drug store, etc.) to an insurance provider. In such embodiments, the monitoring, retrieval, and/or display of personal medical account balance may occur in real-time (or near real-time) with the submission of the claim.

主权项

1. A method of electronically reporting personal medical account balances comprising:
receiving, at a host server associated with a third-party processor, an adjudicated claim from a payer system; identifying, by the host server, a personal medical account associated with the adjudicated claim; retrieving, by the host server, from a Flexible Spending Account (FSA) administrator system, a first account balance value associated with the personal medical account; identifying, by the host server, at least a portion of the adjudicated claim qualifying as a personal medical account expense; appending, by the host server, an electronic message associated with the adjudicated claim, the electronic message including at least the first account balance, an amount associated with the portion of the adjudicated claim qualifying as the personal medical account expense, and a second account balance reflecting a debit associated with the amount associated with the portion of the adjudicated claim qualifying as the personal medical account expense; and transmitting the electronic message to a pharmacy point-of-service (POS) device.