Patent ID: 7698153

Claim:
An information collection and processing system for use by an organization providing managed and non-managed health care to a given population, wherein at least a portion of said population is covered by a negotiated agreement, comprising: an information storage arrangement having: a. a first portion for storing information relating to a plurality of contractual relationships existing between the organization, a plurality of providers of goods and/or services, and a plurality of payors; b. a second portion for storing information relating to a plurality of patients in the given population; c. a third portion for storing information relating to at least one of: 1. utilization management functions; 2. demand management functions; 3. catastrophic case management functions; and 4. chronic and preventive services management functions; and d. a fourth portion for storing information relating to transactions between the organization, the providers and the payors; a processor for reading and writing information from and to the storage arrangement, and for processing said information; an input device and an output device for communicating information to and from the processor and the storage arrangement; automated means for processing claims relating to transactions covered by said negotiated agreement; and means for periodically generating projected receivables for transactions covered by said negotiated agreement, means for comparing respective payments received to the projected receivables, and means for initiating an action if a received payment does not fall within a predetermined percentage of a respective projected receivable.