Invented by Paul J. KETCHEL, III, Ryan AIPPERSPACH, Karen Martirosyan, Ani OSBORNE, Mark Kaufman, Michael Bischoff, Daniel Schmidt, MDSave Shared Services Inc
The MDSave Shared Services Inc invention works as followsThe invention relates to the following: presenting services that include at least a bundled group of healthcare service to be performed by respective providers separately, determining the bundle price of the at-least one bundled healthcare set, and, in response to payment of an amount equal to the bundle price, creating a persistent data record redeemable for each of the at-least one bundled healthcare set, and assigning the unique confirmation number for the data record. Payment received may be virtual funds. Discounts may be applied to the bundle price. The bundle price could be determined by the time or location at which a minimum of one service is performed. The bundle price can be determined by the remaining deductible of the user’s health insurance. Payment can be made to several providers of the bundle of healthcare services. Payments can be made in virtual funds.
Background for Prepaid healthcare bundles with discrete virtual payment distribution
Medical services are any services that are provided to a patient. Some medical services can help maintain or improve a patient?s health based on diagnosis, prevention or treatment of disease. Medical procedures are included in the practice of medicine, including both treatment and preventive care. Doctors, hospitals and health insurers are all medical service providers. Medical service providers may provide medical services by providing medical resources, such as laboratory, imaging or treatment facilities, or surgical equipment, in order to offer the services. Certain medical services require medical professionals who are specially licensed or trained. A medical practice that provides diagnosis and treatment of joint pain, for example, may offer medical services by utilizing the expertise of an orthopedic expert. In certain scenarios, the cost or availability of a professional or facility that is specialized may limit patient access. There may be a shortage of specialized medical professionals or facilities.
A medical practice can also limit the procedures that are offered to patients depending on the availability and location of professionals or facilities who have specialized training at a particular time. This is becoming more common with the COVID-19 Pandemic. The services provided to a patient can be determined by allocating surgeons at different surgical facilities during specific times. Even when the demand for medical services at a particular location or time exceeds the supply, patients can be restricted to only those medical professionals and facilities that are allocated. Medical practices that provide many different types of services can spend significant resources to adapt their services in response to changes in demand and cost. “Some medical practices may not capture revenue potential lost when resources to deliver medical services are underutilized in relation to medical service demand.
The price of healthcare services can vary depending on the specialty, procedure and practice of physicians. Many patients in the United States do not have easy access to compare prices for common medical procedures. The US’s current managed-care-based payor system often determines the cost of treatments.
These managed care organizations have formularies of drugs and treatments that are tailored to the individual health plans of patients, and which limit what drugs and treatments patients can access. These price lists and formularies have been unavailable to patients for many years. They also had few tools available to help them compare health care services and predetermine the cost. Patients who want to compare the cost of medical procedures are currently forced to do extensive and often time-consuming research.
The rising cost of healthcare has a dramatic impact on the U.S. Healthcare System. The cost of healthcare continues to rise, while inflationary growth is slowing down. Provider reimbursement rates are also falling, and patient insurance premiums continue to increase. Many patients and employers choose high-deductible health plans to lower their monthly premiums.
These high-deductible plans require that patients pay cash for medical services up until the deductible amount is met. Once the deductible has reached, the insurance company begins to cover the medical costs. Many patients have seen their out-of pocket expenses for medical services and procedures increase exponentially. Many patients are unable to pay for the increased costs and become uninsured. “As the number of uninsured or underinsured patients, as well as those on high-deductible plans, increases, there is a need for an efficient payment system and a mechanism to allow patients to get discounted medical services.
Here is a device and methods for providing users with a choice of at least one bundle of healthcare services that are provided discretely or individually by multiple providers. The method also includes determining the bundle price of the healthcare services and receiving payment. or ?voucher data record? The voucher is redeemable by the customer to receive the bundle of healthcare services. Payments are distributed to each provider according to the payment received. The bundle price can be determined by the user’s deductible for health insurance, as well as location and/or timing of the services.
The following detailed description and drawings along with the appended claims will help you better understand and appreciate the above-described features and benefits, as well as other features and benefits, realized by the techniques of this disclosure. The techniques of the invention enable the realization of additional features and benefits. “This document describes in detail other embodiments and aspects that are included as part of the claimed patent.
While the specification ends with claims that define the features of invention that are considered novel, we believe that the invention can be better understood by a combination of drawings and descriptions of exemplary embodiments. The embodiments described in this document are only exemplary and can take on many different forms. The specific structural and functionality details disclosed with respect to the exemplary examples described herein should not be interpreted as restrictive, but rather as a basis to teach one skilled in art how to employ the invention in variously in any suitable form. It will be obvious to those skilled that the invention can be practiced even without these specific details. The terms and phrases used in this document are not meant to limit but to describe the invention.
As stated above, an apparatus and methods are presented for presenting users with a choice of at least one bundle set of healthcare service provided discretely or individually by a plurality respective providers, determining the bundle price for the selected bundled services, receiving payment, generating vouchers that the user can redeem to selectively receive each of bundled healthcare services included in the set, transmitting the unique confirmation number for the voucher so the user can track the redemption of the voucher, and disbursing the payment from the received payment to each
A bundle set can include a variety of products or services. Services or products can include, for instance, healthcare services and drugs, secondary services related to primary services or primary services. A bundled set can be a group of healthcare services that are to be performed by different providers. In the present disclosure, the term “separately” is used. In the present disclosure, the term?separately? or ?discretely.? Pre-paid bundles may be available at a discounted price. The bundle price can be discounted. The bundle price can be discounted depending on the time, location or facility at which the service will be performed. A discount may be applied to the price based on an individual’s health insurance deductible. A portion of the payment received may be applied towards the health insurance deductible. The bundle price can be calculated based on how much of the user’s health insurance deductible is left. The pre-paid bundle can be paid in virtual funds. In some implementations, payment may be disbursed to the providers of services or products included in the bundle set. Payment can be disbursed to a doctor, a group of doctors, a hospital or an insurance company. A disbursed payment can be a number of payments that are allocated from a payment received, and these payments may then be disbursed among a variety of providers.
An implementation according to the present disclosure can use a processor in order to generate a unique number of confirmation for the pre-paid bundle set of healthcare services purchased, store the number into a voucher record, and then transmit the number to the user. The voucher data record can be stored in memory or in a data storage that is operably coupled to the processor. The voucher data record can represent a voucher that the user can redeem to receive at least one of the healthcare services of the bundle set of healthcare. The voucher data record can include the unique confirmation number of the purchased bundled healthcare services. The voucher data record can also include a voucher redemption state for each service in the bundle of healthcare services. This allows for the creation of vouchers that are redeemable for healthcare services purchased pre-paid, or even better, for individual services within the bundle of healthcare services. The voucher data record that is associated with the unique confirmation code is persistent, and allows an individual bundle set from a group, or individual services within a bundle set, to be selectedly redeemed.
The voucher can be used for more than one service redemption at different locations and times. The disclosed persistent voucher creation for selective redemption provides a solution to the problem of tracking and updating redemption status of each service in a bundle of services that is to be performed individually, while the individual services are being selectively redeemed.
The drawings will be used to describe “Exemplary Embodiments of a Transactional Marketplace System in accordance with this invention.” The present invention can be used to implement exemplary embodiments that allow healthcare providers and pharmacies to offer discounted healthcare products and services to prospective patients in exchange for prepayments.
In this regard, exemplary implementations may be implemented to provide prospective patient with a mechanism for remotely searching, comparing, and making pre-paid purchase of such healthcare products and services offered by local medical service provider and pharmacies through a networked device configured to access a network-based application. In addition, exemplary embodiments can be implemented to allow healthcare service providers to offer prospective patients a bundle of healthcare services performed by different providers through a network-based system. The patient would then have the option to purchase the services in one transaction.
Exemplary implementations may be further implemented to provide an electronic payment system that facilitates and accounts for the exchange of payments for services and goods purchased (or offered) by patients and healthcare providers through the transactional market system, in which each participant is assigned a respective virtual account to track and manage the process of exchanging currency or credits to pay for transactions using virtual funds created in the virtual payment system.
The virtual money accounts may be used by third-party payers and entities that provide the transactional market system. Participants to the transactions in the virtual payment systems may also include patients, healthcare providers or other entities designated for receiving payment for services or goods offered through the marketplace.
Exemplary embodiments” may be implemented in order to allow various types of healthcare providers (individual physicians, practice groups and hospital systems) to form affiliations through a network-based system and to offer various options to the service providers that will enable them to remotely provide healthcare services associated with these affiliations.
It should be noted that the various aspects of exemplary implementations of this invention described herein may not be limited to products and services in healthcare (also known as procedures herein) but may, instead, be implemented for any classes or types of products and services that are offered by any classes or types of service providers.
Referring to FIG. 1 is a schematic diagram that illustrates an example network architecture of a healthcare marketplace 100, which can be configured in order to implement exemplary embodiments. It is important to note that FIG. FIG. “Figure 1 should not be viewed as limiting in terms of environments where exemplary embodiments can be implemented.
In the example shown in FIG. The healthcare marketplace system is implemented in a client/server architecture. It includes a central system 110, which is accessed by all users of the system using any of a number of client systems 140 connected to the central system via a communications network 150. Central server system 110 also includes a database 112 coupled to a store 114, an application server and a data server 116. Each client system 140 is either a terminal or another client device that runs a client application 142 to access services provided by a network-based service (also called a “network service” herein) implemented by the application server 116.Click here to view the patent on Google Patents.