Patent ID: 8762163
Filing Date: 2014-06-24
Classification: G06Q

Abstract:
1. A computer-implemented method, comprising: routing, to a claims processor computer, a healthcare claim transaction received from a healthcare provider computer; receiving an adjudicated reply, from the claims processor computer, to the healthcare claim transaction; responsive to a determination that the adjudicated reply indicates that the claim transaction was paid, route the adjudicated reply indicating that the claim was paid to the healthcare provider computer; responsive to a determination that the adjudicated reply indicates that the claim transaction was not paid, further determining whether the healthcare claim transaction has not been approved as a result of a host processor error associated with the claims processor computer; responsive to a determination that the claim has not been rejected as a result of a host processing error, route the adjudicated reply indicating that the claim was not paid to the healthcare provider computer; responsive to a determination that the claim has not been approved as a result of a host processing error, perform the following steps: wherein the above operations are performed by one or more computers associated with a service provider.