BACKEND BUNDLED HEALTHCARE SERVICES PAYMENT SYSTEMS AND METHODS

    公开(公告)号:US20250005634A1

    公开(公告)日:2025-01-02

    申请号:US18406051

    申请日:2024-01-05

    Abstract: An apparatus for providing a bundled set of individually redeemable healthcare services in a purchase data record, determining a Good Faith Estimate (GFE) for the at least one healthcare service of the bundled set, associating the purchase data record with user debt for purchase of the healthcare services, providing a digital health asset token representing the purchase data record identified by and with a unique confirmation number, said purchase data record comprising the associated user debt of the at least one bundled set of healthcare services, and providing marketplace access to the token to finance the debt. The marketplace may use the token for buying, selling or trading the bundled set of healthcare services to finance the debt. The token and a Good Faith Estimate (GFE) may be provided to an Independent Dispute Resolution (IDR) process for resolving a dispute under the No Surprises Act.

    ADJUDICATION & CLAIM SUBMISSION FOR SELECTIVELY REDEEMABLE BUNDLED HEALTHCARE SERVICES

    公开(公告)号:US20240403931A1

    公开(公告)日:2024-12-05

    申请号:US18536175

    申请日:2023-12-11

    Abstract: Receiving, from a customer, an electronic message comprising at least one healthcare claim for at least one patient, said claim comprising at least one healthcare service; determining, if a selectively redeemable bundled service purchase data record exists for the at least one of the services in the healthcare claim, wherein the selectively redeemable bundled service purchase data record comprises an individual redemption status of each individual bundled service; and upon determining whether the selectively redeemable bundled service purchase data record comprising the at least one service in the healthcare claim exists, sending to the customer the determination of whether the bundled healthcare service purchase data record exists and is available. One implementation generates a shopping cart with a bundled service for purchase and individually disburses payment to respective providers with an EDI X12 835 remittance message. A customer may submit a healthcare claim as an EDI X12 837 claim message.

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