Patent ID: 7904305

Claim:
A health care provider terminal for verifying the accuracy of health insurance company processing of medical insurance claims generated by a health care provider, comprising: an electronic input device for receiving from a health care provider medical insurance claim data input into a health care provider terminal, wherein the medical insurance claim data includes one or more insurance claims representing one or more patient services provided by the health care provider; an electronic data communication device for transmitting the medical insurance claim data from the health care provider terminal to a health insurance company that processes the medical insurance claim data to determine a reimbursement amount payable by the health insurance company to the health care provider for the one or more patient services under at least one health insurance policy, wherein the communication device also receives processed claim data generated by the health insurance company in response to the medical insurance claim data, and wherein the processed claim data includes the reimbursement amount determined by the health insurance company to be payable to the health care provider for the one or more insurance claims in the medical insurance claim data; an electronic database in the health care provider terminal for storing the medical insurance claim data and the processed claim data; and a computer processor in the health care provider terminal programmed to: compare the medical insurance claim data submitted to the health insurance company by the health care provider terminal and the processed claim data generated by the health insurance company to determine whether the medical insurance claim data has been processed by the health insurance company in accordance with predetermined processing rules agreed to by the health insurance company and the health care provider, generate comparison data that indicates whether the medical insurance claim data has been processed by the health insurance company in accordance with the predetermined processing rules and identifies any processing errors in the processed claim data, wherein the processing errors include (a) incorrect reimbursement of the health care provider for one or more of the insurance claims in the medical insurance claim data and (b) failure to reimburse the health care provider for one or more of the insurance claims in the medical insurance claim data, and generate revised medical insurance claim data when the comparison data indicates that the medical insurance claim data has not been processed by the health insurance company in accordance with the predetermined processing rules, wherein the revised medical insurance claim data includes the one or more of the insurance claims in the medical insurance claim data for which processing errors are identified; and wherein the communication device resubmits the revised medical insurance claim data from the health care provider terminal to the health insurance company for corrected processing.