Insurance claim filing system and method

G - Physics – 06 – Q

Patent

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G06Q 30/00 (2006.01)

Patent

CA 2410922

A method and system for enabling a service provider (PRACTICE MANAGEMENT SYSTEM) to file insurance claims via the internet (INTERNET) with the payer (PAYERS' WEB SITES). The system has three major components. The first component is a software application that is installed on the service provider's local computer system that seeks out billing information stored on that system and creates data files suitable for filing of properly formatted claims with the payers' web sites. The second component is a web portal that interacts with both the first component and the payers' web sites to keep the former up to date with formatting requirements of the various payers and to facilitate the filing of claims electronically. The third component enables the first component to communicate via an internet connection to non-internet payers.

La présente invention concerne un procédé et un système devant permettre à un fournisseur de service (PRACTICE MANAGEMENT SYSTEM / système de gestion des cabinets) d'établir via l'Internet (INTERNET) des demandes de remboursement destinées à un agent payeur (PAYERS' WEB SITES / sites web des agents payeurs). Le système réunit trois composantes principales. La première composante est une application logicielle qui est installée sur le système informatique local du fournisseur de service, qui extrait des informations de facturation stockées sur ce système et qui crée des fichiers de données convenant à l'établissement de demandes de remboursement correctement rédigées auprès des sites web des agents payeurs. La deuxième composante est un portail web qui interagit non seulement avec la première composante, mais également avec les sites web des agents payeurs de façon à se tenir à jour concernant les normes de présentation des différents agents payeurs, et de faciliter l'établissement électronique des demandes de remboursement. La troisième composante permet à la première composante de communiquer via l'Internet avec des agents payeurs non Internet.

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