Patent ID: 7058585

Claim:
A method for reducing fraud in a healthcare program, wherein the method consists of the steps of: a. registering a service provider with a healthcare provider and issuing a service provider identification code; b. registering at least one service or at least one good of the service provider with the healthcare provider and identifying a claim code for each registered service or registered good; c. issuing and storing a first individual identification code to a first individual related to the healthcare program, wherein the first individual identification code is linked to a biometric data of the first individual; d. comparing second biometric data from a second individual against the first individual identification code to determine if the second individual is eligible for benefits from the healthcare program; e. sending a first transmission from the service provider to the healthcare provider, wherein the first transmission comprises: i. the service provider identification code; ii. the individual identification code; iii. proposed information selected from the group consisting of proposed product information for the second individual; proposed service information for the second individual; corresponding claim codes for the proposed product; and corresponding claim codes for the proposed service; and iv. a request to confirm: 1. the second individual's eligibility for benefits under the healthcare program; 2. a validation that the proposed good or service is approved for the individual; 3. the service provider's eligibility to render services or provide goods under the healthcare program; and 4. a request to participate in an accelerated payment program for the proposed good or the proposed service; f. sending a second transmission from the healthcare provider to the service provider, wherein the second transmission comprises: i. the second individual's eligibility for benefits under the healthcare program; ii. a validation that the proposed good or proposed service is approved for the second individual; iii. a validation of the service provider's eligibility to render services under the healthcare program; iv. a confirmation that an accelerated payment program is available; and v. providing an authorization code to provide the proposed product or proposed service; g. sending a third transmission from the service provider to the healthcare provider, wherein the third transmission comprises of: i. a claim codes list for services rendered; ii. acknowledgement by the individual that information on the product or service was provided to the second individual; iii. acknowledgement that the product or service has been received from the service provider; and iv. a request for accelerated payment by the healthcare provider to the service provider.