Patent ID: 7016856

Claim:
In an information collection and processing system having a processor, an input arrangement, an output arrangement, and an information storage arrangement, an automated method for use by an alliance of organizations providing managed and non-managed health care to a given population, wherein at least a portion of said population is covered by a capitation agreement, comprising the steps of: a. storing information relating to a plurality of contractual relationships existing between the alliance, a plurality of providers of goods and/or services, and a plurality of payors; b. storing information relating to a plurality of patients in the given population, said information including a patient identifier and a record of encounters between each patient and each provider; c. storing information relating to transactions between the alliance, the providers and the payors; d. storing a plurality of identifiers for each of the plurality of providers and payors; e. processing said stored information to associate information relating to a particular patient with said patient's identifier, and to associate information relating to a particular provider or payor with each stored identifier for that provider or payor; f. periodically generating capitation accounts receivables for transactions covered by said capitation agreement; g. comparing respective capitation payments to the accounts receivables; and h. initiating an action if the capitation payments do not fall within a predetermined percentage of the capitation accounts receivables.