US 11,990,217 B2
Healthcare coverage matching and verification
Eric Hallemeier, Dallas, TX (US); Deb Grier, Delanson, NY (US); Gopi Kolla, Irving, TX (US); Anand Padmanaban, Lewisville, TX (US); Chris Lolo, McKinney, TX (US); Karthik Sundaram, Little Elm, TX (US); and Kevin Nyaribo, Irving, TX (US)
Assigned to Health Management Systems, Inc., Irving, TX (US)
Filed by Health Management Systems, Inc., Irving, TX (US)
Filed on Apr. 26, 2021, as Appl. No. 17/240,600.
Application 17/240,600 is a continuation of application No. 16/181,778, filed on Nov. 6, 2018, granted, now 10,991,457.
Claims priority of provisional application 62/582,255, filed on Nov. 6, 2017.
Prior Publication US 2021/0391045 A1, Dec. 16, 2021
This patent is subject to a terminal disclaimer.
Int. Cl. G16H 70/20 (2018.01); G06Q 40/08 (2012.01); G16H 10/60 (2018.01); G16H 15/00 (2018.01)
CPC G16H 15/00 (2018.01) [G06Q 40/08 (2013.01); G16H 10/60 (2018.01)] 25 Claims
OG exemplary drawing
 
1. A system for facilitating processing of medical information, comprising:
a user interface to receive a healthcare claim comprising client demographics associated with a client;
a first processor communicatively coupled to the user interface; and
a second processor communicatively coupled to the user interface,
wherein a matching component is implemented in the first processor, wherein the first processor executes instructions to process the client demographics in the healthcare claim, access a matching database and determine a matching database record that corresponds to the healthcare claim,
wherein a verification component is implemented in the second processor, wherein the second processor executes instructions to communicate with one or more coverage providers, identify coverage information that corresponds to the matching database record, and verify the coverage information in a verification database,
wherein the system is configured to perform a coordination of benefits operation between the one or more coverage providers upon a determination that the coverage information comprises an indication that the client has coverage from at least two coverage providers,
wherein the matching component and the verification component are implemented as separate and independently configurable components to enable their separate and concurrent usage, and are communicatively connected to the user interface in a parallel configuration,
wherein the second processor executes the instructions to process a first healthcare claim at substantially same time as the first processor executes the instructions to process a second healthcare claim that is subsequent to the first healthcare claim,
wherein the second processor executes the instructions to communicate with the one or more coverage providers using transactions with a predetermined format.