Abstract:
The health care payment techniques include a system, and/or a machine-readable storage media. In some embodiments of these techniques, the system includes a processor that executes instructions. The system further includes machine-readable storage media having the instructions stored therein, the instructions when executed by the computer system causing the computer system to implement a health care claim payment method. The method includes receiving a plurality of claims for a plurality of health care services provided by a plurality of health care service providers to a patient. The method further includes remitting payment for each claim in the plurality of claims in a single payment. The remitting step is performed before the participant has acknowledged the participant&#39;s obligation to pay for the health care service. The method further includes combining the claim from the health care provider and a plurality of additional health care providers into a master bill. The method further includes sending the master bill to the participant. This Abstract is provided for the sole purpose of complying with the Abstract requirement rules. This Abstract is submitted with the explicit understanding that it will not be used to interpret or to limit the scope or the meaning of the claims.

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a continuation of U.S. patent application Ser. No. 11/706,600, filed Feb. 13, 2007, entitled “System and Method for Managing Payments for Health Care Services” which claims the benefit of U.S. Provisional Application No. 60/850,034, filed on Oct. 6, 2006, entitled, “System and Method for Managing Payments for Health Care Services”. Both applications are herein incorporated by reference in their entireties. 
    
    
     BACKGROUND 
     The present invention relates generally to systems and methods for managing payments for health care services. 
     Modern health care systems often involve relationships between a number of parties including patients, health care providers, employers, insurers and other providers of health care benefit plans, and the administrators of such plans. For example, health care providers may contract with multiple health care network provider organizations such as preferred provider organizations (PPOs), health management organizations (HMOs), managed care organizations, insurers, or point-of-service plan providers. The network provider organization provides patients (or participants) with a list of the health care providers participating in the network and which accept fees in accordance with a fee schedule negotiated with the network provider organization. While participants are free to choose among the universe of providers, financial and other incentives are built into the applicable health care benefit plan for the participants to select participating providers. Access to the network provider organization may be supplied through their employer and/or other affiliation with an employer organization. For example, the participant may be a retiree or may be a dependent child of an employee. Membership may also be obtained through other types of relationships, such as through a professional organization. 
     The relationship between the network provider organization, the provider, the participant and the employer is defined by various agreements. For example, based on the agreements it is determined at what price the health care provider will discount the cost of health care services for patients having access to the network provider organization. After a health care service is provided, the health care provider will issue a bill for health care services rendered to the party responsible for administration of the benefit plan such as a third party administrator. The third party administrator or the network provider organization then reprices the claim to reflect the agreed upon fee schedule. Following repricing, the third party administrator adjudicates the bill in accordance with the terms of the applicable health care benefit plan. Adjudication includes a determination of the allocation of responsibility for payment of the bill as between the employer organization and the health care benefit plan participant. The third party administrator collects payment from the employer organization for the employer portion of the claim. Where the charge for health care service is only partially payable by the employer, the participant is responsible for payment of the remaining charge. The participant portion of the claim is typically billed directly to the participant by the health care provider. 
     The participant&#39;s personal obligation to the health care provider for health care services rendered is based upon a number of factors including the health care benefit plan terms regarding annual deductibles, required co-payments for services received, or required co-insurance payments. Therefore for example, where a participant has received medical services worth $800 on the basis of the negotiated fee schedule, and the participant has a $300 deductible, the network provider organization may pay the health care provider $500 and the health care provider may obtain the remaining balance of $300 from the participant in satisfaction of the participant&#39;s deductible. 
     In contemporary health care billing programs, there are imbedded costs associated with collecting the participant&#39;s portion of the health care claim such as the cost of generating periodic statements, the issuance of reminder notices on past due accounts and the cost of writing off uncollectible accounts receivable. These costs may be related to: (i) the retention of internal billing staff or the payment of fees to independent billing and collection services; and (ii) the time value of money lost on delayed payments. Some of these costs are specifically attributable to a lack of clarity in the current billing system resulting from bills received from providers or provider organizations unknown to the patient such as from medical laboratories, diagnosticians or ancillary health care service providers other than the patient&#39;s primary physician. The receipt of bills from unknown entities, the receipt of multiple billing invoices from multiple providers, and certain providers&#39; delay in requesting payment for services each contribute to the lack of clarity in the health care system. 
     As a part of the claims adjudication process, a considerable number of mailings are sent to the participant (e.g., statements of billed charges, multiple explanations of benefits, notices, and other information concerning services provided and the amounts to be paid to the providers). In many cases, there is often a significant delay between the time when the service is first provided and the time when the final bill for the service is sent to the participant, at which point the participant may have difficulty remembering what service was performed. Additionally, some of the services may have been provided by providers with whom the participant did not directly interact (e.g., laboratories that performed lab work for the participant at the request of a doctor). In such instances, the participant may receive a bill from an unknown provider for services that were performed some time ago. Moreover, many jurisdictions have local and/or federal regulations regarding the information that must be disclosed to health care participants in the medical bill. Typically, the bill is significantly lengthened as a result of these mandatory disclosures. Such bills can be very confusing and annoying for the participant, particularly if there are also billing errors as sometimes occur. 
     With contemporary billing arrangements, the providers typically bear the risks and costs associated with non-payment and/or late payment of the participant portion of the claim. In the best case scenario, the participant recognizes his or her obligation to pay and pays promptly. Even then, however, there is still significant delay between the time the service is originally provided and the time when the provider finally receives payment from the participant for the participant portion of the claim. If, on the other hand, the participant disputes the bill, or is unable to pay promptly, then the provider faces further delays in getting paid for its services and/or faces non-payment altogether. It has been estimated that 30-50% of the participant portion of medical claims is never recovered by the health care provider due to the above-mentioned inefficiencies and risks in modern billing systems. 
     It would be desirable to provide improved systems and methods for managing payments for health care services that would provide a less costly and more readily understandable mechanism for receiving payment of the participant portion of the claim. It will be appreciated that while certain features and advantages are described herein, the claims are not limited to systems and methods which achieve any one or more of these features, but rather may also encompass systems and methods having other features and advantages different than those described herein. 
     SUMMARY 
     In an exemplary embodiment, a computer-implemented method comprises receiving a plurality of claims for a plurality of health care services provided by a plurality of health care service providers to a patient. The receiving step is being performed by program logic implemented by the instructions stored in the machine-readable storage media. At least a portion of the claims is payable by a participant in a benefits plan and at least a portion of the claims is payable by a third party payor. The method further comprises remitting payment, by a payment services system logic implemented by the instructions stored in the machine-readable storage media, for each claim in the plurality of claims. The payment of the entire claim is remitted in a single payment including (i) remitting the portion of the claim payable by the third party payor, and (ii) remitting the portion of the claim payable by the participant. The remitting step is initiated and performed by a payment services manager. The remitting step is performed before the participant has acknowledged the participant&#39;s obligation to pay for the health care service. The method further comprises combining the claim from the health care provider and a plurality of additional health care providers into a master bill, and sending the master bill to the participant. 
     In another exemplary embodiment, a machine-readable storage media having stored therein instructions that when executed cause a computer system to implement a method for managing health care claims for health care services received by a patient from a health care service provider. The method comprises establishing a predetermined amount of funds for payment of at least one claim, the claim having a participant portion and a third party payor portion. The method further comprises receiving notification of the claim. The method further comprises in response to the receiving step, transferring funds, in a single payment, through a disbursement system to the health care service provider in payment of the participant portion of the claim and the third party payor portion. The transferring of funds step is performed before the participant has acknowledged the participant&#39;s obligation to pay for the health care service. The method further comprises combining, by a payment services system logic implemented by the instructions stored in the machine-readable storage media, claim information from the health care provider and a plurality of additional health care providers into a master bill to be sent to a participant enrolled in a benefits plan. The master bill contains claim information for the health care provider and the plurality of additional health care providers. The method further comprises itemizing, by the payment services system logic, claim information for each of the health care services provided to the patient by the health care provider and the plurality of additional health care providers. The method further comprises tracking, by the payment services system logic, payment of the master bill by the participant. 
     In another exemplary embodiment, a system comprising a processor that executes instructions and machine-readable storage media having the instructions stored therein. The instructions when executed by the computer system cause the computer system to implement a health care claim payment method. The method comprises receiving a plurality of claims for a plurality of health care services provided by a plurality of health care service providers to a patient. The receiving is performed by program logic implemented by the instructions stored in the machine-readable storage media. At least a portion of the claims is payable by a participant in a benefits plan and at least a portion of the claims is payable by a third party payor. The method further comprises remitting payment, by a payment services system logic implemented by the instructions stored in the machine-readable storage media, for each claim in the plurality of claims. Payment of the entire claim is remitted in a single payment, including (i) remitting the portion of the claim payable by the third party payor, and (ii) remitting the portion of the claim payable by the participant. The remitting step is initiated and performed by a payment services manager. The remitting step is performed before the participant has acknowledged the participant&#39;s obligation to pay for the health care service. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a block diagram illustrating a payment services system and the relationship between the health care provider, health care participant and network provider organization with respect to the payment services system, according to an exemplary embodiment. 
         FIG. 2  is a flow chart illustrating a method for managing health care billable charges, according to any exemplary embodiment. 
         FIG. 3  is a block diagram illustrating the conversion of the billable charge issued by the health care provider into a claim and subsequent payment of the claim, according to an exemplary embodiment. 
         FIG. 4  is a block diagram illustrating a payment services system and a plurality of health care providers, according to an exemplary embodiment. 
         FIG. 5  is a block diagram illustrating a payment services system and a plurality of employer organizations, according to an exemplary embodiment. 
         FIG. 6  is a block diagram illustrating distribution to the payment services manager operating and reserve account, according to an exemplary embodiment. 
         FIG. 7  is a block diagram illustrating a lock box account, according to an exemplary embodiment. 
         FIG. 8  is a block diagram illustrating the statement with itemized explanation of benefits, according to an exemplary embodiment. 
         FIG. 9  is a block diagram of a computer system that may be used to implement the payment services system of  FIG. 1 , according to an exemplary embodiment. 
         FIG. 10  is an illustration of a payment coupon, according to an exemplary embodiment. 
         FIG. 11  is an illustration of a master bill, according to an exemplary embodiment. 
         FIG. 12  is an illustration of a master bill, according to an exemplary embodiment. 
         FIG. 13  is an illustration of a master bill, according to an exemplary embodiment. 
     
    
    
     DETAILED DESCRIPTION 
     Referring generally to  FIGS. 1-9  and specifically to  FIG. 1 ,  FIG. 1  is a block diagram of an exemplary payment services system  100  provided for assisting in the payment of health care services. The payment services system  100  interfaces with a health care participant  110  (e.g., a patient) and health care providers  120  (e.g., hospitals, laboratories, physicians, psychologists, certified specialists, general practitioners, other health care professionals, and so on) to promptly issue payment to the health care providers  120  for health care services rendered to the health care participant  110 . The payment services system  100  includes a payment services manager  160 , a third party administrator  170 , a trustee  180 , and a treasury manager  190 . The trustee  180  and the treasury manager  190  may, for example, be implemented by a financial institution  195  (e.g., an FDIC insured bank, insurance company, and so on). As will be appreciated, system  100  may include fewer or additional entities. For example, a network provider organization  150  may be included. Also, as will be appreciated, although various operations are described as being performed by different respective entities, the various operations may be performed by any combination of entities which each perform one or more of the operations described herein, and some operations may not be necessary and/or may be replaced with other operations in some embodiments. Also, although not shown as such, the operations performed by payment services system  100  may also be performed by one or more of the health care providers  120  and/or by one or more of the employer organizations  140 . Additionally, although in the exemplary embodiment, the payment services system  100  is described in the context of self-funded health plans sponsored by employers, it will be appreciated that the payment services system  100  may be used in connection with other types of plans, including insured health benefit plans. In an exemplary embodiment, the payment services system  100  is implemented in a computer system  900  that comprises the individual computers systems of the entities  110 - 190  connected through a communication network  197 , such as the Internet, as described in greater detail below in connection with  FIG. 9 . 
     Referring now to  FIGS. 2-3 ,  FIGS. 2-3  show an example of overall operation of the system of  FIG. 1  according to an embodiment.  FIG. 2  is a flowchart of a method for managing health care charges for services received by a participant, according to one exemplary embodiment.  FIG. 3  is a block diagram showing how a billable charge may be processed to result in payment to a health care provider  120 . It may be noted that, in  FIG. 3 , the reference numbers  220 - 280  correspond to steps  220 - 280  shown in  FIG. 2 . 
     In one illustrated exemplary embodiment, a health care provider  120  provides a health care service to a participant and generates a billable charge at step  210 . The health care service may be provided to the participant  110  directly (i.e., the participant  110  is the patient) or vicariously (e.g., the patient is a covered family member of the participant). At step  220 , the billable charge is transmitted to the third party administrator  170 . At step  230 , the third party administrator  170  may re-price and adjudicate the billable charge, e.g., by discounting the billable charge under a prior agreement with the health care provider  120 . 
     The repricing is undertaken according to the terms of an agreement between the health care provider and payment services manager or third party administrator  170  or other party. The claim is adjudicated according to the terms of one or more agreements  310 , such as a health care benefit plan agreement, prompt payment system provider agreement, and/or other agreement. For example, the claim may be adjudicated according to a health care benefit plan which is a contract, policy, or other document defining the features of a group health care plan or benefit program, under which a payor (e.g., the participant  110  or the employer organization  140 ) is obligated to pay for health care services. For example, during the adjudication process, the third party administrator  170  may determine whether the service will be covered in its entirety by the employer, in which case the network provider organization  150  will submit any payment to the health care provider  120 . The third party administrator  170  may also determine during the adjudication process whether a deductible is to be paid (i.e., the amount a participant  110  is required to pay before a claim  320  for benefits by the participant is eligible for reimbursement by the payor). The third party administrator may also determine the apportionment of the billable charge into an employer portion  330  (which the employer organization  140  has responsibility for paying under the self-funded health plan) and the participant portion  340  (which the participant  110  has responsibility for paying under the self-funded health plan) as a result of the inclusion of deductible co-payment or co-insurance provisions of the health care benefit plan. 
     At step  240 , financial institution  195  and the employer organization  140  are notified of the total amount of the claim payable to the provider  120 . At step  250 , the employer organization  140  pays the employer portion  330  of the claim to the financial institution  195 . At step  260 , the payment services manager  160  pays the participant portion  340  of the claim. The employer portion  330  of the claim and the participant portion  340  of the claim may be paid differently in different embodiments. In an exemplary embodiment, described in greater detail below in connection with  FIGS. 4-7 , the employer organization  140  maintains an employer deposit account  410  and an employer reserve account  420  with the financial institution  195  that serves as the trustee  180  and the treasury manager  190 . The employer organization  140  may wire funds from the deposit account  410  within 48 hours of receiving notification of the claim  320 . In such an embodiment, the third party administrator  170  may notify the payment services manager  160  of the respective amounts of the employer portion  330  and the participant portion  340  of the claim, and coordinate payment of the portions  330  and  340  using funds deposited in the accounts  410  and  420  and/or using funds deposited in other accounts, as described below. In other exemplary embodiments, payment occurs in a different manner. 
     At step  270 , the participant  110  then pays the participant portion  340  of the claim to the payment services manager  160 . As may be noted, therefore, the provider  120  receives the participant portion  340  of the claim prior to the participant  110  paying this amount. As a result, the provider  120  receives payment earlier than if it received payment after the participant  110  paid this amount. In an exemplary embodiment, the provider receives payment in 30 days or less, 20 days or less, 10 days or less, or in another period of time. Also, in an exemplary embodiment, the provider  120  may be paid regardless whether the participant  110  pays the participant portion  340  of the claim. Thus, risk of non-payment of the participant portion of the claim may be shifted to another one of the entities such as to the payment services manager  160 , as described below. 
     Referring now to  FIGS. 4-7 ,  FIGS. 4-7  show aspects of the payment/funding mechanism (e.g., including the movement of money between various accounts) used in the payment services system  100  in greater detail, according to an exemplary embodiment. Specifically,  FIG. 4  is similar to  FIG. 1 , but shows aspects of the funding mechanism between the health care providers  120  and the payment services system  100  in greater detail. 
     As shown in  FIG. 4 , a billed charge is delivered by the provider  120  to the third party administrator  170  and is processed by the third party administrator  170  and the payment services manager  160 , as described above. The third party administrator  170  provides notification of the billed charge to the employer organization  140 . The payment services manager  160  coordinates payment of the claim through the financial institution  195 , which serves as the trustee  180  and the treasury manager  190 . To this end, a plurality of accounts are used including an employer deposit account  410 , an employer reserve account  420 , a claim payment account  430 , a disbursement account  440 , and provider deposit accounts  450 . 
     The employer deposit account  410 , which may comprise separate respective sub-accounts for each employer, is used to receive and hold funds from employers for the payment of the employee portion  330  of claims from the health care providers  120 . For example, at periodic intervals (e.g., once per week, on a Monday), the third party administrator  170  may notify each employer of the amount of claims to be funded for the upcoming week and may notify the trustee  180  of all expected wire transfers by employer and relevant amounts. Each employer organization  140  may then transfer funds into its respective claim payment account  430 , and the trustee  180  may notify the payment services manager  160  of the funds transfers received by employer organization and amount. The funds may be directly transferred into the claim payment account  430 . Subsequently, these funds may be transferred to the disbursement account  440  for payment of the employer portion of the health care claims. 
     The employer reserve account  420 , which may also comprise separate respective sub-accounts for each employer, is used to receive and hold a reserve of funds for the payment of the participant portion  340  of claims from the health care providers  120 . In an exemplary embodiment, the employer deposit account  420  holds a reserve amount of funds (e.g., two weeks worth of payments) which is used on an interim basis to pay the participant portion  340  of claims from the health care providers  120 . Again, these funds may be transferred to the disbursement account  440  for payment of the employer portion of the health care claims. Both the employer portion and the employee portion of the claim are remitted to the provider in a single combined payment through the payment services manager  160 . The funds that are disbursed for this purpose are subsequently replenished with funds received from the participant  110  when the participant pays the participant portion  340  of the claim ( FIG. 2 , step  280 ). Therefore, the provider  120  may receive both the employer portion  330  and participant portion  340  of the claim  320  in a single payment. Additionally, the payment is received more promptly than if the provider  120  was paid when the participant portion  340  of the claim  320  was paid by the participant  110 . 
     The claim payment account  430  is an intermediate account between the employer accounts  410 ,  420  and the disbursement account  440 . In an exemplary embodiment, claim payment account  430  is used to receive and hold funds after adjudication of related claims and prior to the transfer of such funds to the provider disbursement account  440  to pay such claims. In an exemplary embodiment, the claim payment account  430  (and/or various sub-accounts) are owned by the consortium of various employer organizations  140  and managed by trustee  180 . After a claim has been adjudicated and the employer organization  140  has paid its portion of the claim to the financial institution  195 , amounts are then transferred from the claim payment account  430  to the disbursement account  440 , where they are held until final disbursement to the provider  120 . 
     The disbursement account  440  is an intermediate account between the claim reserve account  430  and the provider accounts  450 . The trustee  180  moves amounts to the disbursement account  440  to fund the employer portion  330  and participant portion  340  of the claim. For example, each week the payment services manager  160  may provide the trustee  180  with the total amount for the claims to be paid within a predetermined period of time (e.g., within two business days). The information may be provided on an employer-by-employer basis. This information may then be used by the trustee to move the funds from the claims reserve account to the provider disbursement account  440 . 
     The provider deposit account  450 , or health care provider&#39;s account, receives payments from the payment services system  100 . For example, the payment services manager  160  may provide the treasury manager  190  with a NACHA-formatted file containing transfer requirements for claims to be funded. This information may then be used by the treasury manager  190  to transfer funds from the disbursement account  440  to the provider deposit account  450 . This information may also be used to transfer a portion of the claim payment funds to a payment services manager reserve account  610  and a payment services manager operating account  620 , as described in greater detail below in connection with  FIG. 6 . In an exemplary embodiment, the provider deposit account  450  is established at the same financial institution that provides trustee services (trustee  180 ) and treasury management services (treasury manager  190 ). In another embodiment, the provider deposit account  450  is established at another financial institution. In another exemplary embodiment, an insurance company provides trustee services, treasury management services and/or payment services manager services. 
     Referring now to  FIG. 5 ,  FIG. 5  is similar to  FIG. 1  but shows aspects of the fund transfer mechanism between the payment services system  100  and the employer organization  140  in greater detail. As shown in  FIG. 5 , in an exemplary embodiment, an employer organization  140  establishes at least one account  510  for providing funding to the employer deposit account  410  and the employer deposit account  420 , as described above. The employer also receives claims information from the payment services manager  160 , as shown. 
     Referring now to  FIG. 6 ,  FIG. 6  shows the accounts  410 - 450  shown in  FIGS. 4-5  as well as additional accounts  610  and  620 . In an exemplary embodiment, the payment services manager  160  charges at least one payment services management fee in connection with each claim satisfied through the payment services system  100 . The fee may, for example, be calculated as a percentage of each transaction or payment made to a health care services provider  120 . Thus, as shown in  FIG. 6 , the trustee transfers a portion of the funds from claim payment account  430  to the payment services manager reserve account  610  and the payment services manager operating account  620  instead of to the disbursement account  440 . In this way, the claim payment account  430  acts as a holding account. The payment services management fee compensates the payment services manager  160  for bearing the risk of loss undertaken by the payment services manager  160  with respect to the collection of delinquent payments from participants  110  of the participant portions  340  of the claims. The payment services management fee also compensates the payment services manager  160  for operating the payment services system  100 . In the illustrated embodiment, the fee is paid by the providers  120 , in as much as it is taken off the top as a percentage of the funds otherwise directed to the providers  120 . In exchange, as indicated previously, the providers receive the benefits of quicker payment and avoiding the risk of non-payment by the participant. 
     The payment services manager reserve account  610  is a reserve fund maintained by the payment services manager  160  in the event of delinquency of a participant in paying the participant portion  340  of a claim. As indicated previously, the participant portion  340  of claims is initially paid using funds from the employer deposit account  420  for the respective employer  140  of that participant  110 . Assuming the participant  110  pays in a timely manner, the funds received from the participant  110  are deposited back into the employer deposit account  420  to replenish the funds that were earlier disbursed. However, if the participant  110  is delinquent in paying for more than a predetermined period of time (e.g., the participant is more than 60 days delinquent), then the funds used to replenish the employer deposit account  420  are obtained from the payment services manager reserve account  610 . Thus, as previously indicated, the payment services manager  160  bears the risk of delinquent payment by the participant  110 . The funds that flow into the payment services manager reserve account  610  are used to fund the liabilities incurred by the payment services manager  160  in connection with this risk. To the extent that an accumulated excess builds up in the payment services manager reserve account  610 , these funds compensate the payment services manager  160  for accepting the risk of delinquency. In another embodiment, rather than having an accumulated excess build up, the payment services manager  160  may manage the amount of funds flowing into the payment services manager reserve account  610  to approximately meet the incurred liabilities, and then take as compensation unused funds from the payment services manager operating account  620 . 
     The payment services manager operating account  620  holds and disburses operating funds for business purposes of the payment services manager  160 . The payment services manager  160  may derive compensation from funds that are deposited in the payment services manager operating account  620  that are in excess of the funds needed to operate the payment services system  100 . 
     As will be appreciated, other entities involved in the payment services system  100  may receive compensation in other ways. For example, one or more of the accounts  410 - 450  may be non-interest bearing accounts, thereby permitting the financial institution  195  to receive compensation in the form of access to interest-free funds maintained on deposit. As another example, the financial institution  195  (e.g., the trustee  180  and/or the treasury manager  190 ) may charge fees on a per transaction basis. The fee may be charged to the payment services manager  160 , may be charged to the providers  120 , or may be charged to another entity. Other financial benefits may be exchanged between the entities  110 - 190 . For example, in an exemplary embodiment, each provider  120  may agree to provide a discount to participants  110  affiliated with the network provider organization  150 . The discount may, for example, be greater than the discount(s) provided to any other network provider organization  150  (e.g., except than programs maintained by the state or federal government, such as Medicare and Medicaid). 
     Referring now to  FIG. 7 , in an exemplary embodiment, a lock box account  710  is used to receive payments received from participants  110 . As shown in  FIG. 7 , the lock box account  710  may be used for the receipt of payments from participants  110  and the transfer of such payments into the appropriate employer deposit account  420  or the payment services manager reserve account  610 . Participants may mail payments to the financial institution  195  for disbursement into the lock box account  710 . The financial institution  195  processes the remittance and deposits the funds into the lock box account  710 . If a participant  110  was previously delinquent on a payment, and the payment services manager  160  had transferred funds from the payment services manager reserve account  610  to the employer reserve account  420 , then the funds may be transferred to the payment services manager reserve account  610 . Otherwise, the funds are deposited into the employer reserve account  420 , as previously described. 
     Referring now to  FIG. 8 , in an exemplary embodiment, the payment services manager  160  sends a master statement or master bill  800  or statement for collection to the health care participants  110 . In an exemplary embodiment, the master bill  800  may be generated by the computer platform  965  and mailed out to the participant on a periodic basis (e.g., on a monthly basis). The master bill  800  may comprise a statement of all outstanding claims owed by the participant  110 . The statement  800  may include an itemized explanation of benefits  810  including a line item listing  820  of health care service provided by various providers  120  during the prior period (e.g., during the prior month) and an identification  830  of the apportionment of the participant portion  340  and employer portion  330  of the claim  320  for each. The statement may also include information from individual bills from individual providers  120  concerning the services rendered by the individual providers  120 . For example, the billing information that would otherwise be sent by the providers  120  may be included as attachments in the master bill  800 . The statement  800  may also be sent on a non-periodic basis (e.g., a predetermined number of days after a service is provided by a provider, and including any additional itemizations for any additional services provided during the intervening period until the master bill  800  is sent). 
     In one embodiment, the statement  800  includes a payment coupon  840 , as illustrated in  FIG. 10 , that the participant may use to remit payment to the lock box account  710 . The funds are forwarded to the bank treasury manager  190 . The payment coupon  840  may, for example, include the statement number, an account number or participant identification number, the total amount due, the amount owed, payment due date, and/or other information. If the amount required to be paid is less than the entirety of the participant portion  340 , the payment coupon may include a minimum payment amount as well as a full payment amount. The coupon may also have a projected pay off date and/or the specific monthly payment relative to the entire series of payments. The participant may then render funds to the financial institution  195 . Payment is received and deposited into the lock box account  710 . The trustee  180  or treasury management  190  will adequately distribute the funds to the employer deposit account  420  to replenish funds that were previously used to pay the participant portion  340  of the claim and/or into the payment services manager reserve account  610 , as described above in connection with  FIG. 7 . 
     In the exemplary embodiments illustrated  FIGS. 11-13 , the participant  110  may be provided with a single, consolidated bill or “master bill” for all health care services received, e.g., during the preceding month. The master bill  800  may include a summary of account activity listing all previous balances, payments and additional chargers and/or new patient responsibilities. Each payment is correlated with a specific service date, a designated reference number and the total amount owed to the health care service provider. The bill  800  may include more detailed information for the health care service received in an appended section. The master bill  800  includes references to the page number(s) where the health care service is discussed in greater detail. In this way, the master bill  800  acts as a table of contents for more descriptive portions of the medical bill. Accordingly, the health care participant may determine the particular health care service in which previous payments were applied. The master bill  800  may contain charges from various individual providers  120  and may provide the participant  110  with the ability to pay for the health care services from the various providers  120  in a single transaction (e.g., a single check paid in connection with the payment coupon  840 ) as illustrated in  FIG. 12 . Additionally, by providing the information in a consolidated format, the participant  110  is given the ability to recognize the correlation between different related services provided by different providers  120 . For example, the lab services provided by a provider  120  that would otherwise be unrecognized by the participant may be correlated by the participant  110  with a doctor visit in which the participant  110  recalls that lab services were ordered. In another embodiment, the master bill  800  includes a legend having detailed descriptions for medical terms, codes and/or acronyms related to medical services referenced in other portions of the master bill, e.g., the explanation of benefits section. 
     Referring now to  FIG. 9 ,  FIG. 9  shows a computer system  900  which implements the payment services system  100 . As shown in  FIG. 9 , the health care providers  120 , the employer organizations  140 , the network provider organizations  150 , the payment services manager  160 , the third party administrator  170 , the trustee  180 , and the treasury manager  190  may each have respective computer systems  915 - 990  (e.g., including one or more servers and one or more user computers) that are interconnected through a communication network  197 , such as the Internet. The computer system  900  permits the entities  110 - 190  interact with each other electronically. 
     In another exemplary embodiment, an identification card (e.g., a smart card or other credit card-sized device) which has patient information stored in a computer accessible medium is employed with the payment services system. The card may store information concerning patient care, insurance, health history, and so on. The card may be utilized in conjunction with the health care provider&#39;s data management system to streamline the process of transferring information between the participant and provider. 
     As may be appreciated, the operations described herein as being performed by entities  110 - 190  may in practice be performed by the computer systems  910 - 990  associated with each of the respective entities  110 - 190 . That is, each of the computer systems  910 - 990  may include program logic  915 - 995  configured to perform the operations described herein as being performed by entities  110 - 190 . Thus, for example, health care provider computer systems  920  may have bill generation and tracking program logic  925  which may, for example, be one or more software applications executing on a computer and used to generate bills and track payment of the bills. Such program logic  925  may electronically communicate claim information to claim adjudication logic  975  executing on the third party administrator computer systems  970 , and so on. 
     In an exemplary embodiment, as previously described, the payment services manager  160  coordinates overall operation of the payment services system  100 . As such, operations not specifically identified as being performed by another entity may be performed by the payment services manager computer system  960 . As will also be appreciated, such functions may be outsourced to an application service provider that provides a network-accessible platform on behalf of the payment services manager  160  and/or on behalf of another one of the entities  110 - 190 . 
     The participants  110  may also be provided with access (e.g., through an internet-enabled web browser) to view account information that is stored by the payment services system logic  965 . For example, the participants  110  may be provided with the ability to log onto a website, provide user ID/password information, and obtain access to health care service information for services provided by multiple ones of the providers  120 , including their master bill  800  for the current and/or preceding periods. Thus, the payment services system logic  965  may provide the participant with a central repository of billing and payment information for health care services that the participant  110  has received. As will be appreciated, communication with the health care participants  110 , such as to send out the master bills  800 , may also occur through postal mail or in another manner. 
     Additionally, as indicated above, during operation of payment services system  100 , various information may be communicated between the entities  110 - 190  using the computer systems  910 - 990 . Examples of events involving the communication of such information by the computer system  960  of the payment services manager  160  are as follows (many of which have been previously mentioned): The payment services manager  160  may send a master statement or master bill  800  or statement for collection to the health care participants  110 . The payment services manager  160  may provide the trustee  180  with an aging report on any unpaid or delinquent participant accounts. The payment services manager  160  may advise the trustee  180  of the need or desire to set up the claim payment account  430  and disbursement account  440  on the behalf of the employer organization  140 . The payment services manager  160  may advise the employer organization  140  of an account or deposit number associated with the employer accounts. The payment services manager  160  may notify the employer of the reserve amount and may send the financial institution  195  wire instructions to transfer the reserve amount into the claim payment account  430 . The payment services manager  160  may advise each employer organization  140  of the amount needed for weekly claims (e.g., every Monday or the next business day thereafter in the case of a holiday). The payment services manager  160  may provide a weekly wire transfer file to the bank to pay the third party administrator  170 . The payment services manager  160  may notify (e.g., throughout the fiscal calendar) the trustee  180  of running totals on the employer reserve account  910  and the disbursement account  440 . The payment services manager  160  may advise the trustee  180 , for each transaction, of an employer identification number and whether the appropriate funds are withdrawn from the correlating employer reserve account. 
     Examples of events involving the communication of such information by the computer system  980  and  990  of the financial institution  195  (including the trustee  180  and the treasury manager  190 ) are as follows (many of which have been previously mentioned): The financial institution  195  may notify the payment services manager  160  account on a periodic basis the dollars received by the participant. The financial institution  195  may periodically issue to the payment services manager  160  a claims reserve report regarding the status of the claim reserve account  430  (e.g., an electronic report of all debits and credits to the claim payment account  430  daily). The trustee  180  verifies with the payment services manager  160  each day the wires received and the amounts expected. The trustee  180  may deliver to the payment services manager  160  an electronic report of all amounts received in the lock box account. The trustee  180  and the payment services manager  160  may issue an electronic report of all debits and credits to each employer reserve account. The trustee  180  may periodically deliver to the payment services manager  160  an electronic report of all debits and credits to the provider disbursement account  440 . 
     It should be appreciated, of course, that the details associated with the payment services system  100  described herein merely represent one possible implementation. Other applications for this platform include, for example, medical, dental, vision, short-term disability insurance, COBRA/HIPAA administration, flexible spending accounts, and health savings accounts. 
     The foregoing description of embodiments of the invention has been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise form disclosed, and modifications and variations are possible in light of the above teachings or may be acquired from practice of the invention. The embodiments were chosen and described in order to explain the principals of the invention in various embodiments and with various modifications suited to the particular use contemplated. 
     The invention is described herein with reference to drawings. These drawings illustrate certain details of specific embodiments that implement the systems and methods and programs of the present invention. However, describing the invention with drawings should not be construed as imposing on the invention any limitations that may be present in the drawings. The present invention contemplates methods, systems and program products on any machine-readable media for accomplishing its operations. The embodiments of the present invention may be implemented using an existing computer processor, or by a special purpose computer processor incorporated for this or another purpose, or by a hardwired system. 
     Embodiments within the scope of the present invention include program products comprising machine-readable media for carrying or having machine-executable instructions or data structures stored thereon. Such machine-readable media can be any available media which can be accessed by a general purpose or special purpose computer or other machine with a processor. By way of example, such machine-readable media can comprise RAM, ROM, EPROM, EEPROM, CD-ROM or other optical disk storage, magnetic disk storage or other magnetic storage devices, or any other medium which can be used to carry or store desired program code in the form of machine-executable instructions or data structures and which can be accessed by a general purpose or special purpose computer or other machine with a processor. When information is transferred or provided over a network or another communications connection (either hardwired, wireless, or a combination of hardwired or wireless) to a machine, the machine properly views the connection as a machine-readable medium. Thus, any such connection is properly termed machine-readable medium. Combinations of the above are also included within the scope of machine-readable media. Machine-executable instructions comprise, for example, instructions and data which cause a general purpose computer, special purpose computer, or special purpose processing machine to perform a certain operation or group of operations. 
     Embodiments of the present invention may be practiced in a networked environment using logical connections to one or more remote computers having processors. Logical connections may include a local area network (LAN) and a wide area network (WAN) that are presented here by way of example and not limitation. Such networking environments are commonplace in office-wide or enterprise-wide computer networks, intranets, the Internet and a wide variety of different communication protocols. Those skilled in the art will appreciate that such network computing environments will typically encompass many types of computer system configurations, including personal computers, hand-held devices, multi-processor systems, microprocessor-based or programmable consumer electronics, network personal computers, minicomputers, mainframe computers, and the like. Embodiments of the invention may also be practiced in distributed computing environments where tasks are performed by local and remote processing devices that are linked (either by hardwired links, wireless links or by a combination of hardwired and wireless links) through a communications network. In a distributed computing environment, program modules may be located in both local and remote memory storage devices.