Patent Application Titled “Backend Bundled Healthcare Services Payment Systems And Methods” Published Online (USPTO 20220398641): Mdsave Shared Services Inc.

2023 JAN 02 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- According to news reporting originating from Washington, D.C., by NewsRx journalists, a patent application by the inventors Ketchel, III, Paul J. (Brentwood, TN, US), filed on August 19, 2022, was made available online on December 15, 2022.

The assignee for this patent application is Mdsave Shared Services Inc. (Brentwood, Tennessee, United States).

Reporters obtained the following quote from the background information supplied by the inventors: “Medical services are services provided to a medical patient. Some medical services may help improve or maintain a patient’s health, based on disease prevention, diagnosis, or treatment. The practice of medicine encompasses medical procedures performed for a patient, which may include both preventive care and treatment. Medical service providers include doctors, hospitals, and health insurers. A provider may offer medical services to patients by provisioning medical resources such as, for example, laboratory, imaging, treatment, or surgical facilities, to provide the services. Some medical services may require specially trained or licensed medical professionals. For example, a medical practice providing diagnosis and treatment for joint pain may provide medical services through the work of an orthopedic specialist. In some scenarios, patient access to a specialized professional or facility may be limited by cost, or availability. Some specialized medical professionals and related facilities may be scarce.

“In addition, the rising cost of healthcare is having a dramatic effect on the U.S. healthcare system. Healthcare costs continue to outpace pace inflationary growth, provider reimbursement rates continue to fall, and the cost of patient insurance premiums are increasing. To lower monthly premium costs, many patients are choosing to purchase (and employers are choosing to offer) high deductible health plans as an alternative to traditional higher premium PPO health plans.

“These high deductible plans require patients to pay cash payments for medical services until the high deductible is satisfied, and once this deductible has been met, the insurance carrier begins to cover medical costs. As a result, many patients are seeing exponential increases in out-of-pocket expenses for medical procedures and services. In addition to more patients selecting high deductible plans, many patients cannot afford increased payments and are becoming uninsured or underinsured. As the number of patients who are uninsured, underinsured, or on high deductible plans grows, the need for a mechanism that allows patients to find discounted medical services increases and an efficient payment system.

“Finally, healthcare services may be necessary even when a patient does not have insurance or funds available to pay for a needed procedure. A patient may need more than one healthcare service in a medical emergency, even though they may not be able to pay. In some scenarios, a patient may accumulate significant financial debt owed to multiple healthcare providers. A person owing significant amounts of money for healthcare services that have already been performed, even though medically necessary, may have substantial difficulty obtaining further medial services due to their unpaid medical bills.”

In addition to obtaining background information on this patent application, NewsRx editors also obtained the inventors’ summary information for this patent application: “Herein disclosed is a method 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.

“The above-described and other features and advantages realized through the techniques of the present disclosure will be better appreciated and understood with reference to the following detailed description, drawings, and appended claims. Additional features and advantages are realized through the techniques of the present invention. Other embodiments and aspects of the invention are described in detail herein and are considered a part of the claimed invention.”

The claims supplied by the inventors are:

“1. A method comprising: receiving a digital indication comprising a selection of a plurality of healthcare services associated with a respective plurality of providers, using a processor; determining a price for the selected plurality of healthcare services based on an information record comprising an individual fee for each provider of the plurality of providers to respectively perform the selected plurality of healthcare services at a service location, using the processor; and distributing payment based on the price allocated among the plurality of providers, using the processor.

“2. The method of claim 1, wherein the price is a bundled price.

“3. The method of claim 1, wherein the selection of the plurality of healthcare services is received via a communication network, using the processor.

“4. The method of claim 1, wherein the selection of the plurality of healthcare services is received from a client application, using the processor.

“5. The method of claim 1, wherein the selection of the plurality of healthcare services is received from a third-party application, using the processor.

“6. The method of claim 1, wherein the method further comprises receiving a digital indication comprising a received payment for the selected plurality of healthcare services, using the processor.

“7. The method of claim 6, wherein the received payment is pre-paid in an amount of the price.

“8. The method of claim 6, wherein the received payment further comprises real currency, virtual funds or promotional credit.

“9. The method of claim 6, wherein the received payment further comprises a virtual card payment.

“10. The method of claim 1, wherein the method further comprises providing a marketplace access to the price to finance the selected plurality of healthcare services, using the processor.

“11. The method of claim 1, wherein the method further comprises adjusting the individual fee for at least one provider of the plurality of providers, using the processor.

“12. The method of claim 11, wherein the method further comprises adjusting the individual fee based on a geographic zone corresponding to the service location, using the processor.

“13. The method of claim 11, wherein the method further comprises adjusting the individual fee based on a relative value unit (RVU) measure for malpractice by at least one provider of at least one healthcare service of the selected plurality of healthcare services, using the processor.

“14. The method of claim 1, wherein distributing payment further comprises at least one payment allocated to at least one provider of the plurality of providers, wherein the allocated payment is in an amount determined as a function of an insurance deductible, using the processor.

“15. The method of claim 1, wherein distributing payment further comprises allocating a real currency payment or a virtual funds payment to at least one provider, using the processor.

“16. The method of claim 1, wherein distributing payment further comprises allocating funds from a virtual card to at least one provider of the plurality of providers, using the processor.

“17. The method of claim 1, wherein distributing payment further comprises allocating funds deposited to a virtual account of at least one provider or user, using the processor.

“18. The method of claim 1, wherein at least one healthcare service of the selected plurality of healthcare services further comprises a medical service.

“19. The method of claim 1, wherein at least one healthcare service of the selected plurality of healthcare services further comprises prescribing a drug.

“20. The method of claim 6, wherein in response to receiving the digital indication comprising the received payment the method further comprises: generating an electronic health record comprising a purchase information record identified by and with a unique confirmation number, using the processor; presetting an initial individual redemption status in the purchase information record for each service of the selected plurality of healthcare services as a purchased and unredeemed bundled set of healthcare services, using the processor; and providing a user access to the purchase information record to selectively receive each healthcare service of the selected plurality of healthcare services, using the processor.

“21. The method of claim 20, wherein the purchase information record further comprises a digital voucher.

“22. The method of claim 21, wherein the digital voucher is selectively redeemable, using the processor, for each healthcare service individually.

“23. The method of claim 20, wherein the purchase information record is the electronic health record.

“24. The method of claim 20, wherein the method further comprises: storing the electronic health record in a memory operably coupled with the processor, using the processor; and sending the electronic health record to at least one provider of the plurality of respective providers, using the processor.

“25. The method of claim 20, wherein the method further comprises sending the unique confirmation number to a user, using the processor.

“26. The method of claim 20, wherein the purchase information record persists in a data store operably coupled with the processor and wherein the purchase information record is redeemable, using the processor, at least until each of the selected plurality of healthcare services in the bundled set is redeemed.

“27. The method of claim 20, wherein the method further comprises presenting to the user a plurality of healthcare services comprising at least one bundled set of healthcare services to be performed separately by the plurality of respective providers, using the processor.

“28. The method of claim 20, wherein the method further comprises receiving a request for redemption of at least one healthcare service of the selected plurality of healthcare services and using the purchase information record confirmation number to selectively determine the redemption status of the at least one healthcare service, using the processor.

“29. The method of claim 20, wherein the method further comprises updating the redemption status of the purchase information record to indicate redemption of at least one of the selected plurality of healthcare services, using the processor.

“30. The method of claim 29, wherein the purchase information record further comprises a transaction information record of the selected plurality of healthcare services, and wherein updating the redemption status further comprises updating in a data store operably coupled with the processor the transaction information record of the selected plurality of healthcare services, using the processor.”

For more information, see this patent application: Ketchel, III, Paul J. Backend Bundled Healthcare Services Payment Systems And Methods. U.S. Patent Application Number 20220398641, filed August 19, 2022 and posted December 15, 2022. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20220398641)&db=US-PGPUB&type=ids

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