Patent Publication Number: US-2002010594-A1

Title: Method of payment for a healthcare service

Description:
REFERENCE TO RELATED APPLICATION  
     [0001] This application claims priority of U.S. provisional patent application Serial No. 60/190,688, filed Mar. 20, 2000, the entire the entire contents of which is incorporated herein by reference. 
    
    
     
       FIELD OF THE INVENTION  
       [0002] This invention relates generally to a healthcare payment system, and more specifically, to a method of payment for a healthcare service.  
       BACKGROUND OF THE INVENTION  
       [0003] A major concern within the healthcare industry is cost. Healthcare providers, such as hospitals and doctors, want to be paid a reasonable fee in a timely manner for the services they render. At the same time, the cost of these services keeps rising due to many factors both within and outside the control of the healthcare industry, including uninsured patients and the cost of malpractice insurance.  
       [0004] Typically, a healthcare provider performs a healthcare-related service for a patient, and the healthcare provider bills the patient&#39;s insurance company for the service. The insurance company is responsible for paying at least a portion of the healthcare costs incurred by a subscriber. The time period between performing the service and receipt of payment may be significant. Patients without insurance or seeking the services of a nonparticipating healthcare provider have to pay the healthcare provider directly, requiring the healthcare provider to collect any amount owed.  
       [0005] Insurance companies have implemented various systems to maintain healthcare costs and pay for services quicker, including establishing health maintenance organizations (HMO), and preferred provider organizations (PPO). The PPO and HMO contracts with a participating doctor to provide a predetermined service at a predetermined cost. While this system works well, the patient may be constrained in the choice of doctor or hospital. Similarly, the U.S. government sponsored healthcare program, Medicare, frequently establishes a fee for a predetermined service that is significantly less than the non-Medicare rate. As a result, the availability of doctors and hospitals accepting Medicare patients is more limited.  
       [0006] Thus, there is a need in the art for a credit card based payment system for healthcare services that allows a patient to immediately pay for the service at the time the service is rendered using a healthcare credit card, and the patient is billed by, and provides payment to, an intermediary, while the healthcare provider is compensated by the intermediary in a timely manner.  
       SUMMARY OF THE INVENTION  
       [0007] Accordingly, the present invention provides a method of payment for a healthcare service. The method includes the steps of an intermediary issuing a healthcare instrument such as a credit or debit card to a healthcare user, and wherein the healthcare user agrees to repay the intermediary for charges incurred in utilizing the instrument. As an alternative to carrying a physical medium, reference may be made to a subscriber&#39;s account, over the internet, for example, utilizing appropriate identification for credit or debit purposes. The method also includes the steps of the intermediary contracting with a healthcare provider, wherein the healthcare provider agrees to perform a predetermined healthcare service and charge the healthcare user a predetermined fee, and the intermediary agrees to pay the healthcare provider the predetermined fee charged the healthcare user. The method further includes the steps of the healthcare user using the healthcare instrument to pay the healthcare provider the predetermined fee for receiving the predetermined healthcare service, wherein the intermediary pays the healthcare provider the predetermined fee and the healthcare user reimburses the intermediary.  
       [0008] One advantage of the present invention is the use of the instrument in the form of a credit card in the preferred embodiment for prompt payment to a healthcare provider for a healthcare service rendered. Another advantage is the use of an intermediary to contract with a healthcare provider to provide a specific healthcare service for a fixed fee at a competitive rate. Still another advantage of the present invention is that a list of participating healthcare providers is maintained on a website that is accessible to a healthcare user via the Internet. A still further advantage is that the method enables the healthcare user to utilize the instrument for non-healthcare service related purchases.  
     
    
    
     [0009] Other advantages, features and advantages of the present invention will be readily appreciated as the same becomes better understood after reading the subsequent description when taken in conjunction with the accompanying drawings.  
     BRIEF DESCRIPTION OF THE DRAWINGS  
     [0010]FIG. 1 is a block diagram of a system for carrying out a method, according to the present invention, of payment for a healthcare service.  
     [0011]FIG. 2 is a flowchart of a method of payment for a healthcare service, according to the present invention. 
    
    
     DETAILED DESCRIPTION OF THE INVENTION  
     [0012] Referring to FIG. 1, a system  10  for carrying out a method of payment for a healthcare service according to the present invention is illustrated. The system  10  involves a healthcare user  12 , healthcare provider  14 , and an intermediary  16 . The healthcare user  12  is an individual receiving a healthcare service. The healthcare provider  14  is a doctor or hospital, or the like, that renders the healthcare service. The intermediary  16  is an entity that contracts with the healthcare user  12  and the healthcare provider  14 , to provide the healthcare provider  14  prompt payment at a competitive rate for the healthcare service provided to a contracting healthcare user  12  using a healthcare credit card  28 , in a manner to be described. Preferably, the intermediary  16  ensures the healthcare user  12  a fair, competitive price for the service provided by the healthcare provider  14 .  
     [0013] The healthcare user  12  has a computer which preferably includes a video monitor  18   a , a processor  18   b , an input device  18   c  such as a keyboard or a mouse, and a modem (not shown). The intermediary  16  also has a computer, as shown at  20 , including a video monitor  20   a , a processor  20   b , an input device  20   c  and a modem (not shown). The computers  18 ,  20  are connected to an internet infrastructure, such as the Internet  22  via a telecommunications link  24 , such as a telephone line or a cable line. As is known in the art, the Internet  22  includes providers  26 , such as Internet Access Providers (IAPs), Internet Service Providers (ISPs) and Network Service Providers (NSPs) and routers (not shown) that provide wired and wireless digital telecommunications throughout the world using a TCP/IP networking protocol.  
     [0014] The Internet  22  includes a plurality of website servers (not shown) that interactively transfer information between the healthcare user  12  and intermediary  16  through their computers  18 ,  20 . The website server is a computer system operatively connected to a provider  26  in a conventional manner. When the healthcare user  12  visits the intermediary&#39;s website, the healthcare user  12  is served a page displayed on the display monitor  18   a . The first page is frequently referred to as a home page. The healthcare user  12  interacts with the page via the input device  18   c , such as by making selections or requests.  
     [0015] The intermediary  20  maintains a list of participating healthcare providers  14  at its website. Preferably, each healthcare user  12  is associated with a password, that is presented by the healthcare user  12  to access predetermined information, such as the list of participating healthcare providers  14 . An example of a password is a personal identification number (PIN) as is known in the art. Preferably, the website also provides for users  12  to contact the intermediary  16 , such as via an e-mail message.  
     [0016] A method, according to the present invention is depicted in FIG. 2. An example of a healthcare service is a routine physical, or a surgical procedure or the like. The healthcare service is performed by the healthcare provider  14 . The method begins in bubble  100  and advances to block  110 . In block  110 , the intermediary  16  contracts with the healthcare provider  14  to provide a participating healthcare user  12  a predetermined healthcare related service for a predetermined fixed fee.  
     [0017] Preferably, the specified contract rate for the predetermined service is generally lower than the rate obtainable by the healthcare user  12  on their own in a free market. For example, the rate may be established at some premium to the rate established by the U.S. government for Medicare payments to healthcare providers, such as 125% of the Medicare rate. Typically, Medicare payment rates are substantially below the rates the healthcare provider  14  would charge an unaffiliated user.  
     [0018] Advantageously, payment to the healthcare provider  14  at the contracted rate is clearly better than the Medicare rate for the same service. Additionally, the healthcare provider  14  receives payment at essentially the time the service is provided, rather than delaying payment by billing an insurance company and subsequently receiving payment from the insurance company, as is typical. From the standpoint of the healthcare user  12 , they are assured that the rate charged is reasonable, and substantially less than obtainable by individually contracting with the healthcare provider  14 .  
     [0019] The methodology advances to block  120  and the intermediary  16  maintains a list a participating healthcare providers  14 , and provides the healthcare user  12  access to the list. For example, the intermediary  16  makes the list of participating healthcare providers  14  available on its Internet website, in a manner previously described. The methodology advances to block  130 .  
     [0020] In block  130 , the healthcare user  12  contracts with the intermediary  16 , similar to a retail credit card agreement as is known in the art, and the intermediary  16  issues a healthcare credit card  28  to the healthcare user  12 . Preferably, the contract between the healthcare user  12  and intermediary  16  details that the intermediary  16  will arrange with a predetermined healthcare provider  14  to provide a predetermined healthcare service at a predetermined fee; the intermediary  16  will provide the healthcare user  12  an instrument such as a debit or credit card  28  to pay for the healthcare service; and the intermediary  16  will pay the healthcare provider  14  and the healthcare user  12  will reimburse the intermediary  16 .  
     [0021] In the preferred embodiment, the intermediary  16  will establish a credit card account with the healthcare user  12  and issue a healthcare credit card  28  to the healthcare user  12 . The healthcare user  12  receives a periodic statement, such as monthly, detailing the services and charges generated during the time period, which the healthcare user  12  is obligated to pay according to conventional terms. It should be appreciated that the contract between the intermediary  16  and the healthcare providers  14  may include a discount, such as 1-5%, to provide a margin of profit for the intermediary  16 , similar to a conventional retail credit card operation. Advantageously, the healthcare credit card  28  is available for other purchases, similar to a conventional retail credit card, thus enabling the intermediary to enjoy the financial benefits of a large base of credit card holders.  
     [0022] The methodology advances to block  140 . In block  140 , the healthcare user  12  accesses the intermediary&#39;s website using their computer  18 , to select a participating healthcare provider  14 . Preferably, the healthcare user  12  is also able to communicate with the intermediary  16  via e-mail, or contract with the intermediary  16  through the intermediary&#39;s website.  
     [0023] The methodology advances to block  150 , and the healthcare user  12  receives a service from the selected healthcare provider  14 . The methodology advances to block  160 . In block  160 , the healthcare user  12  utilizes the healthcare credit card  28  to pay the service fee charged by the healthcare provider  14 . The methodology advances to block  170 .  
     [0024] In block  170 , the intermediary  16  pays the healthcare provider  14 . It should be appreciated that the healthcare provider  14  receives payment for the service in a timely manner, since the fee is prearranged. The healthcare provider  14  thus avoids the delays in payment usually associated with billing an insurance company and waiting for payment from the insurance company. The methodology advances to block  180 .  
     [0025] In block  180 , the intermediary  16  bills the healthcare user  12  for the service provided by the healthcare provider  14 . Preferably, the healthcare user  12  is billed on a periodic basis, such as monthly. The methodology advances to block  190 , and the healthcare user  12  pays the intermediary  16  according to the terms agreed upon in the contract between the healthcare user  12  and the intermediary  16  for the charges on the healthcare credit card  28 . The methodology advances to bubble  200  and ends.  
     [0026] The present invention has been described in a illustrative manner. It is to be understood that the terminology which has been used is intended to be in the nature of words of description rather than of limitation.  
     [0027] Many modifications and variations of the present invention are possible in light of the above teachings. Therefore, within the scope of the appended claims, the present invention may be practiced other than as specifically described.