US 12,217,874 B2
System and method for suggesting insurance eligible genetic efficacy tests
Rob Todd, Doylestown, PA (US); Jerry Wrobel, Aurora, OH (US); and John Pigott, Slyvania, OH (US)
Assigned to Xact Laboratories, LLC, Twinsburg, OH (US)
Filed by Xact Laboratories, LLC, Twinsburg, OH (US)
Filed on Apr. 14, 2020, as Appl. No. 16/848,504.
Application 16/848,504 is a continuation in part of application No. 16/674,189, filed on Nov. 5, 2019, granted, now 11,380,424.
Application 16/674,189 is a continuation in part of application No. 16/441,597, filed on Jun. 14, 2019, granted, now 11,527,331.
Claims priority of provisional application 62/773,424, filed on Nov. 30, 2018.
Claims priority of provisional application 62/685,479, filed on Jun. 15, 2018.
Prior Publication US 2020/0243201 A1, Jul. 30, 2020
Int. Cl. G16H 50/70 (2018.01); G06Q 40/08 (2012.01); G16B 30/00 (2019.01); G16H 10/40 (2018.01); G16H 10/60 (2018.01); G16H 40/20 (2018.01); G16H 50/20 (2018.01); G16H 70/20 (2018.01); G16H 70/40 (2018.01)
CPC G16H 50/70 (2018.01) [G06Q 40/08 (2013.01); G16B 30/00 (2019.02); G16H 10/40 (2018.01); G16H 10/60 (2018.01); G16H 40/20 (2018.01); G16H 50/20 (2018.01); G16H 70/20 (2018.01); G16H 70/40 (2018.01)] 16 Claims
OG exemplary drawing
 
1. A system for suggesting insurance eligible genetic efficacy tests to a healthcare provider, carrying out ordered one or ones of the suggested tests, and providing results therefrom, the system comprising:
an electronic health record (“EHR”) system associated with a healthcare provider office;
a laboratory information system (“LIS”) associated with a laboratory and in electronic communication with the EHR system, wherein said LIS comprises one or more electronic storage devices and one or more processors;
a database comprising insurance eligibility rules;
one or more robots in electronic communication with the LIS and comprising one or more electronic storage devices comprising software instructions, which when executed, configure one or more processors of the one or more robots to, following receipt of instructions from the LIS to perform ordered genetic testing, assemble a testing device to add, remove, block, and/or unblock wells of the testing device in accordance with the instructions received from the LIS; and
a genetic sequencing machine in electronic communication with the LIS and comprising one or more electronic storage devices comprising software instructions, which when executed, configure one or more processors of the genetic sequencing machine to, following receipt of the instructions from the LIS to perform ordered genetic testing, perform the ordered genetic testing in an automated fashion with the testing device in accordance with the instructions received from the LIS;
wherein the one or more electronic storage devices of the LIS comprise software instructions, which when executed, configure the one or more processors of the LIS to:
query the EHR system to retrieve insurance information, an active medication, and a diagnosis associated with a particular patient;
query the database to retrieve insurance eligibly rules for a particular insurance policy of a particular insurance provider based on the retrieved insurance information;
determine one or more genetic efficacy tests which are eligible for coverage under the particular policy of the particular insurance provider by applying the retrieved insurance eligibility rules to the retrieved active medication and diagnosis;
cause, by electronic transmission of data from the LIS, generation, at the EHR system, of an electronic notification indicating eligibility for genetic efficacy testing and a proposed order form for each of the one or more eligible genetic tests which is electronically selectable at the EHR system;
receive, from the EHR system, data indicating an agreed order for at least one of the one or more eligible genetic efficacy tests of the proposed order form as indicated by electronic selection at the proposed order form at the EHR system;
generate electronic, machine-readable instructions to perform the ordered genetic testing;
transmit said electronic, machine-readable instructions to the genetic sequencing machine for the ordered genetic testing; and
receive data indicating genetic testing results for the ordered genetic testing from the genetic sequencing machine, the genetic testing results comprising genetic markers for the particular patient.