Patent ID: 7672858
Filing Date: 2010-03-02
Classification: G06Q,G16H

Abstract:
1. A computerized method for calculating by way of a computerized processing engine under program control the best possible revenue a healthcare provider can lawfully expect at a given time ,the method comprising the steps: (a) storing on a computer readable medium a plurality of contracts between a healthcare provider and a corresponding plurality of third party payers, each of which contracts identifies the amounts of payment that the corresponding third party payer will pay to the health care provider for medical services and supplies provided by said health care provider to patients covered by said corresponding third party payer; (b) storing on said computer readable medium patient data which (i) identifies the patients who have received the medical services and supplies provided by the health care provider, and (ii) identifies any of said plurality of third party payers which are obligated to pay at least a portion of medical expenses incurred by said patients who have received the medical services and supplies provided by the health care provider; (c) storing on said computer readable medium patient data which identifies the medical services and supplies provided by said health care provider to said patients who have received the medical services and supplies provided by the health care provider, to define raw charge data; (d) storing on said computer readable medium payments made to said health care provider by (i) said any of said plurality of third party payers which is obligated to pay at least a portion of medical expenses incurred by said patients who have received the medical services and supplies provided by the health care provider, and (ii) said patients who have received medical services and supplies provided by said health care provider; and (e) calculating, under program control by way of the computerized processing engine, the amounts of payment due to the health care provider at the given time by executing the following steps under program control: