Patent Application Titled “Computing System For Sharing Networks Providing Shared Reserve Features And Related Methods” Published Online (USPTO 20240095696): Patent Application

2024 APR 08 (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 inventor Meggs, Anthony F. (Melbourne, Fl, Us), filed on November 27, 2023, was made available online on March 21, 2024.

No assignee for this patent application has been made.

Reporters obtained the following quote from the background information supplied by the inventors: “In recent years, health care expense sharing has emerged as a “decentralized” approach to financing and reserving for health care costs. As a “non-insurance” alternative, health care sharing is not subject to typical insurance regulations. Individual participants are legally and ultimately responsible for their own medical bills. However, participants in health care sharing networks willingly and consistently share from their own personal funds to pay each other’s medical bills.

“Some health care sharing networks implement a technology framework often called a Virtual Share Exchange (VSE). The VSE may include a collection of virtual account management, billing, and payment technologies that form a comprehensive and transparent health care sharing process. The VSE model enables health care sharing networks to facilitate sharing programs on a P2P (or member-to-member) basis to help provide compliance with applicable safe harbor exemptions to insurance regulations.

“VSE platforms have enabled healthcare sharing networks to rapidly grow and scale similar to institutional computer network models, like health insurance. Modern VSE platforms have become advanced Fintech applications that integrate all the stakeholders and financial processes that are necessary to facilitate member-to-member sharing via computer networking and electronic payment infrastructure.”

In addition to obtaining background information on this patent application, NewsRx editors also obtained the inventor’s summary information for this patent application: “A computing system may include a plurality of different virtual share exchange (VSE) networks. Each VSE network may be configured to maintain member sharing accounts for respective members and electronically transfer funds between the sharing accounts to share payment of member healthcare bills across a plurality of the member sharing accounts based upon a respective set of individual reserve parameters for intra-VSE payment sharing, and to maintain a respective super member account for each of the other VSEs allowing the other VSEs to participate in the intra-VSE payment sharing. The computing system may further include a server comprising a memory and a processor configured to cooperate with the memory to connect the plurality of different VSE networks together in a VSE computing platform, store a database of instructions coded in shared reserve parameters different than the individual reserve parameters for inter-VSE payment sharing across the VSE computing platform, and receive requests from the VSE networks to share payment of extraordinary healthcare bills from their members via respective application programming interfaces (APIs) configured to identify bill submissions having a value exceeding a threshold bill amount across the other VSE networks. The processor may further determine, based upon the instructions coded in the shared reserve parameters, a shared reserve for each VSE network that submits an extraordinary healthcare bill for payment sharing, the shared reserve corresponding to a value of member healthcare bills the VSE network is permitted to share across the other VSE networks, and verify that the VSE network has not exceeded the shared reserve. The processor may also publish, based upon the instructions coded in the shared reserve parameters and via the APIs and super member accounts, each extraordinary healthcare bill for payment sharing across the VSE computing platform to the other VSE networks as a respective member of each VSE network upon verification that the VSE network submitting the extraordinary healthcare bill has not exceeded the shared reserve.

“Each VSE may be further configured to dynamically generate in real time for each inter-VSE payment sharing event a single purpose table in a database on the VSE platform for the given member healthcare bill submitted for payment sharing corresponding to the given healthcare provider, with the single purpose table defining a temporary virtual bill account solely for reconciliation of the respective member healthcare bill, and the temporary virtual bill account being externally addressable through a routing number and a unique account number.

“By way of example, the shared reserve may comprise a submission cap corresponding to a total value of extraordinary healthcare bills submitted to be shared from the VSE network within a time period. In accordance with another example, the shared reserve may comprise a publishing cap corresponding to a total value of extraordinary healthcare bills published and shared from the VSE network within a time period.

“In some embodiments, the processor may be further configured to maintain a database of restricted Current Procedural Terminology (CPT) codes, and restrict publishing of extraordinary healthcare bills for payment sharing to the other VSE networks having the restricted publishing codes. The processor may be further configured to receive all member healthcare bills from each of the VSE networks, and restrict publishing of member healthcare bills for payment sharing across the other VSE networks that do not have a value exceeding the threshold bill amount.

“In an example implementation, the processor may be further configured to determine a distributive reserve of funds held in member sharing accounts for each VSE network that submits an extraordinary healthcare bill for payment sharing, and restrict publishing of extraordinary healthcare bills for payment sharing when the VSE network submitting the extraordinary healthcare bill has a distributive reserve below a distributive reserve threshold. Furthermore, each of the VSE networks may comprise a publishing module in memory to publish member healthcare bills to the VSE network, and the processor may be configured to publish the extraordinary healthcare bill for payment sharing to the other VSE networks through their publishing modules.

“In some embodiments, the processor may be further configured to calculate a respective contribution amount for payment sharing for each of the other VSE networks based upon a number of members in each VSE network, and publish each extraordinary healthcare bill for payment sharing to the other VSE networks in accordance with their respective contribution amounts. In an example embodiment, each of the VSE networks may comprise an allocation module in memory to match member sharing accounts with published member healthcare bills, and the processor may be configured to receive shared payment for the extraordinary healthcare bill from the VSE networks, and distribute the shared payment to the VSE network requesting payment sharing of the extraordinary healthcare bill via its allocation module.

“A related method may include using a server to connect a plurality of different virtual share exchange (VSE) networks, such as those described briefly above, together in a VSE computing platform. The method may further include storing at the server a database of instructions coded in shared reserve parameters different than the individual reserve parameters for inter-VSE payment sharing across the VSE computing platform, and receiving requests at the server from the VSE networks to share payment of extraordinary healthcare bills from their members via respective application programming interfaces (APIs) configured to identify bill submissions having a value exceeding a threshold bill amount across the other VSE networks. The method may also include determining, at the server and based upon the instructions coded in the shared reserve parameters, a shared reserve for each VSE network that submits an extraordinary healthcare bill for payment sharing, with the shared reserve corresponding to a value of member healthcare bills the VSE network is permitted to share across the other VSE networks, and verifying that the VSE network has not exceeded the shared reserve. The method may further include publishing, using the server and based upon the instructions coded in the shared reserve parameters and via the APIs and super member accounts, each extraordinary healthcare bill for payment sharing across the VSE computing platform to the other VSE networks as a respective member of each VSE network upon verification that the VSE network submitting the extraordinary healthcare bill has not exceeded the shared reserve.”

The claims supplied by the inventors are:

“1. A computing system comprising: a plurality of different virtual share exchange (VSE) networks, each VSE network being configured to maintain member sharing accounts for respective members and electronically transfer funds between the sharing accounts to share payment of member healthcare bills across a plurality of the member sharing accounts based upon a respective set of individual reserve parameters for intra-VSE payment sharing, and to maintain a respective super member account for each of the other VSEs allowing the other VSEs to participate in the intra-VSE payment sharing; and a server comprising a memory and a processor configured to cooperate with the memory to connect the plurality of different VSE networks together in a VSE computing platform, store a database of instructions coded in shared reserve parameters different than the individual reserve parameters for inter-VSE payment sharing across the VSE computing platform, receive requests from the VSE networks to share payment of extraordinary healthcare bills from their members via respective application programming interfaces (APIs) configured to identify bill submissions having a value exceeding a threshold bill amount across the other VSE networks, determine, based upon the instructions coded in the shared reserve parameters, a shared reserve for each VSE network that submits an extraordinary healthcare bill for payment sharing, the shared reserve corresponding to a value of member healthcare bills the VSE network is permitted to share across the other VSE networks, and verify that the VSE network has not exceeded the shared reserve, and publish, based upon the instructions coded in the shared reserve parameters and via the APIs and super member accounts, each extraordinary healthcare bill for payment sharing across the VSE computing platform to the other VSE networks as a respective member of each VSE network upon verification that the VSE network submitting the extraordinary healthcare bill has not exceeded the shared reserve.

“2. The computing system of claim 1 wherein each VSE is further configured to dynamically generate in real time for each inter-VSE payment sharing event a single purpose table in a database on the VSE platform for the given member healthcare bill submitted for payment sharing corresponding to the given healthcare provider, the single purpose table defining a temporary virtual bill account solely for reconciliation of the respective member healthcare bill, the temporary virtual bill account being externally addressable through a routing number and a unique account number.

“3. The computing system of claim 1 wherein the shared reserve comprises a submission cap corresponding to a total value of extraordinary healthcare bills submitted to be shared from the VSE network within a time period.

“4. The computing system of claim 1 wherein the shared reserve comprises a publishing cap corresponding to a total value of extraordinary healthcare bills published and shared from the VSE network within a time period.

“5. The computing system of claim 1 wherein the processor is further configured to maintain a database of restricted Current Procedural Terminology (CPT) codes, and restrict publishing of extraordinary healthcare bills for payment sharing to the other VSE networks having the restricted publishing codes.

“6. The computing system of claim 1 wherein the processor is further configured to receive all member healthcare bills from each of the VSE networks, and restrict publishing of member healthcare bills for payment sharing across the other VSE networks that do not have a value exceeding the threshold bill amount.

“7. The computing system of claim 1 wherein the processor is further configured to determine a distributive reserve of funds held in member sharing accounts for each VSE network that submits an extraordinary healthcare bill for payment sharing, and restrict publishing of extraordinary healthcare bills for payment sharing when the VSE network submitting the extraordinary healthcare bill has a distributive reserve below a distributive reserve threshold.

“8. The computing system of claim 1 wherein each of the VSE networks comprises a publishing module in memory to publish member healthcare bills to the VSE network, and wherein the processor is configured to publish the extraordinary healthcare bill for payment sharing to the other VSE networks through their publishing modules.

“9. The computing system of claim 1 wherein the processor is further configured to calculate a respective contribution amount for payment sharing for each of the other VSE networks based upon a number of members in each VSE network, and publish each extraordinary healthcare bill for payment sharing to the other VSE networks in accordance with their respective contribution amounts.

“10. The computing system of claim 1 wherein each of the VSE networks comprises an allocation module in memory to match member sharing accounts with published member healthcare bills; and wherein the processor is configured to receive shared payment for the extraordinary healthcare bill from the VSE networks, and distribute the shared payment to the VSE network requesting payment sharing of the extraordinary healthcare bill via its allocation module.

“11. A method comprising: using a server to connect a plurality of different virtual share exchange (VSE) networks together in a VSE computing platform, each VSE network being configured to maintain member sharing accounts for respective members and electronically transfer funds between the sharing accounts to share payment of member healthcare bills across a plurality of the member sharing accounts based upon a respective set of individual reserve parameters for intra-VSE payment sharing, and to maintain a respective super member account for each of the other VSEs allowing the other VSEs to participate in the intra-VSE payment sharing; storing at the server a database of instructions coded in shared reserve parameters different than the individual reserve parameters for inter-VSE payment sharing across the VSE computing platform; receiving requests at the server from the VSE networks to share payment of extraordinary healthcare bills from their members via respective application programming interfaces (APIs) configured to identify bill submissions having a value exceeding a threshold bill amount across the other VSE networks; determining, at the server and based upon the instructions coded in the shared reserve parameters, a shared reserve for each VSE network that submits an extraordinary healthcare bill for payment sharing, the shared reserve corresponding to a value of member healthcare bills the VSE network is permitted to share across the other VSE networks, and verifying that the VSE network has not exceeded the shared reserve; and publishing, using the server and based upon the instructions coded in the shared reserve parameters and via the APIs and super member accounts, each extraordinary healthcare bill for payment sharing across the VSE computing platform to the other VSE networks as a respective member of each VSE network upon verification that the VSE network submitting the extraordinary healthcare bill has not exceeded the shared reserve.

“12. The method of claim 11 further comprising, at each VSE, dynamically generating in real time for each inter-VSE payment sharing event a single purpose table in a database for the given member healthcare bill submitted for payment sharing corresponding to the given healthcare provider, the single purpose table defining a temporary virtual bill account solely for reconciliation of the respective member healthcare bill, the temporary virtual bill account being externally addressable through a routing number and a unique account number.

“13. The method of claim 11 wherein the shared reserve comprises a submission cap corresponding to a total value of extraordinary healthcare bills submitted to be shared from the VSE network within a time period.

“14. The method of claim 11 wherein the shared reserve comprises a publishing cap corresponding to a total value of extraordinary healthcare bills published and shared from the VSE network within a time period.

“15. The method of claim 11 further comprising, at the server, maintaining a database of restricted Current Procedural Terminology (CPT) codes and restricting publishing of extraordinary healthcare bills for payment sharing to the other VSE networks having the restricted publishing codes.

“16. The method of claim 11 further comprising, at the server, receiving all member healthcare bills from each of the VSE networks and restricting publishing of member healthcare bills for payment sharing across the other VSEs that do not have a value exceeding the threshold bill amount.

“17. The method of claim 11 further comprising, at the server, determining a distributive reserve of funds held in member sharing accounts for each VSE network that submits an extraordinary healthcare bill for payment sharing and restricting publishing of extraordinary healthcare bills for payment sharing when the VSE network submitting the extraordinary healthcare bill has a distributive reserve below a distributive reserve threshold.

“18. The method of claim 11 further comprising, at the server, calculating a respective contribution amount for payment sharing for each of the other VSE networks based upon a number of members in each VSE network; and wherein publishing further comprises publishing each extraordinary healthcare bill for payment sharing to the other VSE networks in accordance with their respective contribution amounts.”

For more information, see this patent application: Meggs, Anthony F. Computing System For Sharing Networks Providing Shared Reserve Features And Related Methods. U.S. Patent Application Number 20240095696, filed November 27, 2023 and posted March 21, 2024. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20240095696)&db=US-PGPUB&type=ids

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