公开(公告)号：US20140006061A1

公开(公告)日：2014-01-02

申请号：US13715809

申请日：2012-12-14

申请人： Advance Response, LLC

发明人： Timothy Watanabe ,  Kenneth Poray ,  Craig So

IPC分类号： G06Q40/08

CPC分类号： G06Q40/08 ,  G06Q10/10

摘要： Methods and apparatus for automated insurance claims and eligibility/benefits communication, audit, and research are described. This application relates to methods and apparatus for automated insurance claims and eligibility/benefits communication, audit, and research. These methods include processing an insurance claim, comprising creating a claim for payment of medical services for a patient from a medical provider, submitting the payment claim to an insurance carrier, adjudicating the claim; and submitting the payment to the medical provider, wherein during the process of adjudicating the claim, data is collected about the efficiency of the payment process and it is reported back to the medical provider and used to improve the information used to create the claim. Other embodiments are described.

摘要翻译： 描述了自动保险索赔和资格/福利交流，审计和研究的方法和设备。 本申请涉及自动保险索赔和资格/福利交流，审计和研究的方法和设备。 这些方法包括处理保险索赔，包括从医疗提供者创建向患者支付医疗服务的索赔，向保险公司提交付款申请，裁定索赔; 并向医疗提供者提交付款，其中在审理索赔的过程中收集关于支付过程的效率的数据，并将其报告给医疗提供者并用于改进用于创建权利要求的信息。 描述其他实施例。

公开(公告)号：US08793311B2

公开(公告)日：2014-07-29

申请号：US12546271

申请日：2009-08-24

申请人： Timothy Watanabe ,  Kenneth Poray ,  Craig So ,  Ryan Menda

发明人： Timothy Watanabe ,  Kenneth Poray ,  Craig So ,  Ryan Menda

IPC分类号： G06F15/16

CPC分类号： H04L69/24 ,  G06Q10/10 ,  G06Q30/04 ,  G10L13/00 ,  G10L15/26 ,  H04L51/00 ,  H04L67/28 ,  H04L67/2823 ,  H04L67/30 ,  H04M3/42

摘要： Methods and systems that allow multiple channels of communication between multiple users via a platform that automatically integrates and synchronizes the resources of each user during the communication are described. The systems comprise a platform capable of handling multiple types of communications with multiple users and systems. The platform contains a browser, one or more servers for handling communications between the platform and user devices that are external to the platform, a speech engine for converting text to speech and vice versa, a chat server, an email server, a text server, a data warehouse, a scheduler, a workflow/rules engine, a reports server, and integration APIs that can be integrated with 3rd party systems and allow those systems to be integrated with the platform. The platform is linked to multiple users (and their devices or systems) through a communications network. Each user can select a preferred communication mode that includes the device, software, and desired communication channel. The platform is able to match the preferred communication mode between multiple users, allowing the users to communicate with each other using their preferred mechanism as well as their preferred communication mode. With such a configuration, the methods for communicating between multiple users are more efficient, effective, and reliable, with increased visibility and accountability between the users. Other embodiments are described.

摘要翻译： 描述允许在多个用户之间通过在通信期间自动整合和同步每个用户的资源的平台的多个通信通道的方法和系统。 该系统包括能够处理与多个用户和系统的多种类型的通信的平台。 该平台包含一个浏览器，一个或多个用于处理平台与平台外部的用户设备之间的通信的服务器，用于将文本转换为语音的语音引擎，反之亦然的聊天服务器，电子邮件服务器，文本服务器， 数据仓库，调度程序，工作流/规则引擎，报表服务器和集成API，可以与第三方系统集成，并允许这些系统与平台集成。 该平台通过通信网络与多个用户（及其设备或系统）相连。 每个用户可以选择包括设备，软件和期望的通信信道的优选通信模式。 该平台能够匹配多个用户之间的优选通信模式，允许用户使用其优选机制以及其优选的通信模式彼此通信。 通过这种配置，用户之间进行通信的方法更有效率，有效性和可靠性，从而增加用户之间的可见性和问责性。 描述其他实施例。

公开(公告)号：US20140200928A1

公开(公告)日：2014-07-17

申请号：US14216008

申请日：2014-03-17

申请人： Advance Response, LLC.

发明人： Timothy Watanabe ,  Kenneth Poray ,  Craig So ,  Tiffany Eastley ,  Vince Uyeda ,  Mark Tsutsui ,  James Han

IPC分类号： G06Q40/08 ,  G06Q50/22

CPC分类号： G06Q40/08 ,  G06Q10/10 ,  G06Q50/22

摘要： Methods and apparatus for automating the process for researching medical claims and/or eligibility, as well as standardizing and analyzing the resulting data are. These methods include automated processes for researching an insurance claim, comprising steps of interactively and recursively querying search fields in a web portal(s) and/or phone system(s), aggregating the information from multiple sources into a standardized format in a database table(s). This data can be used to generate analytics, predictive analysis and reports for the medical provider and/or payers. This application also sets forth multiple communication standards for exchanging data over a phone or computer system. Other embodiments are described.

摘要翻译： 自动化用于研究医疗索赔和/或资格的过程的方法和装置，以及标准化和分析所得数据。 这些方法包括用于研究保险索赔的自动化过程，包括交互地和递归地查询网络门户和/或电话系统中的搜索字段的步骤，将来自多个源的信息聚合成数据库表中的标准化格式 （s）。 该数据可用于为医疗提供者和/或付款人生成分析，预测分析和报告。 该应用还阐述了通过电话或计算机系统交换数据的多种通信标准。 描述其他实施例。

公开(公告)号：US08645303B2

公开(公告)日：2014-02-04

申请号：US12476017

申请日：2009-06-01

申请人： Tim Watanabe ,  Kenneth Poray ,  Craig So ,  Ryan Menda ,  Brian Eastley

发明人： Tim Watanabe ,  Kenneth Poray ,  Craig So ,  Ryan Menda ,  Brian Eastley

IPC分类号： G06F17/00 ,  G06N5/02

CPC分类号： G06Q30/02 ,  G06Q30/06 ,  H04L12/4625 ,  H04L67/02 ,  H04M3/4938

摘要： Methods and systems for creating, accessing, and communicating content are described. The systems comprise a single platform that allows multiple coordinated communication channels with a single user device (or user system) or multiple user devices (or user systems) at the same time. The platforms contains a browser for communicating with a communications network, multiple types of servers for handling different communications between the platform and a user device external to the platform, a database for storing content, a speech engine for converting text to speech, for converting speech to text, or both, and a configuration engine for configuring the applications that users will use during interaction with the platform. The platform can accordingly communicate with a user (or a user system) using any desired number (or combination) of communication channels. Other embodiments are described.

摘要翻译： 描述用于创建，访问和传达内容的方法和系统。 该系统包括单个平台，其允许与单个用户设备（或用户系统）或多个用户设备（或用户系统）同时进行多个协调的通信信道。 平台包含用于与通信网络通信的浏览器，用于处理平台与平台外部的用户设备之间的不同通信的多种类型的服务器，用于存储内容的数据库，用于将文本转换为语音的语音引擎，用于转换语音 文本或两者，以及用于配置用户在与平台交互期间将使用的应用的配置引擎。 平台可以相应地使用任何所需数量（或组合的）通信信道与用户（或用户系统）进行通信。 描述其他实施例。