Patent Application Titled “Systems And Methods For Document Management” Published Online (USPTO 20220309590): Patent Application

2022 OCT 14 (NewsRx) -- By a News Reporter-Staff News Editor at Information Technology Business Daily -- According to news reporting originating from Washington, D.C., by NewsRx journalists, a patent application by the inventors Babu, Suprigya (Redmond, VA, US); Corazao, Peter (Sammamish, WA, US); Huynh, Sang (Auburn, WA, US); Jones, Greg (Suwanee, GA, US); Mukker, Alka (Duluth, GA, US); Patel, Harshit (Cumming, GA, US), filed on March 29, 2021, was made available online on September 29, 2022.

No assignee for this patent application has been made.

Reporters obtained the following quote from the background information supplied by the inventors: “In an example environment, processing payment for medical claims, documents (also referred to herein as “attachments”) supporting the claim are often required by payers. Some, but not all, payers will accept electronic documents. Others will require actual hard copy documents. Thus, submitters/providers cannot or will not all submit attachments required for processing the payment electronically. Approximately 5% of claims may require an attachment. Even at the 5% rate, some 170 million claim attachments are sent manually (mail or fax) each year. That is, approximately 80% of attachments are sent using manual processes like mail and fax. This is costly.

“Handling attachments manually is costly. Providers currently spend an average of $4.50 to send attachments manually. Providers spend an average of 11 minutes per attachment when handled manually vs. 5 minutes when sent via an electronic method. Uncertainty around attachments standards have kept software vendors and payers on the sideline as the manual attachment problem has persisted. Accordingly, there is a need for an attachments solution that is easy to integrate, provides access to nearly any payer and that can evolve with emerging and changing standards.”

In addition to obtaining background information on this patent application, NewsRx editors also obtained the inventors’ summary information for this patent application: “In one embodiment, a document management system is provided that automatically converts documents submitted electronically with or for a claim into a format that is required by a third-party payor. The document management system maintains a list of document format and delivery preferences for each third-party payor. Rather than submit a claim and document directly to the third-party payor, the submitter submits the claim and document to the document management system using a portal that accepts a wide variety of electronic document formats. The document management system then retrieves the format and delivery preferences of the third-party payor and converts the documents into whatever format is required by the third-party payor. The document management system then delivers the converted document to the third-party payor according to the delivery preferences such as email, fax, or regular mail.

“In an embodiment, a method for managing document formats and delivery is provided. The method includes: receiving a document in a first data format of a plurality of formats by a computing device, wherein the document is associated with a matter identifier and a third-party payor; determining document preferences associated with the third-party payor by the computing device, wherein the document preferences identify a second data format of the plurality of formats and one or more document delivery preferences; converting the document to the second data format by the computing device; and providing the document to the third-party in the second data format by the computing device according to the document delivery preferences.

“Embodiments may include some or all of the following features. Receiving the document may include receiving the document through one or more of an application program interface or a portal application. The document may be received in a batch along with a plurality of documents. The document may be received in a 277 document format. The matter identifier may be a claim identifier, and the document may be received in support of an insurance claim for the third-party payor. The method may further include: converting the document from the first data format to a third data format, wherein the third data format is an intermediate data format; and storing the document in the third data format in a datastore, and wherein converting the document to the second data format may further include: retrieving the document from the datastore; and converting the document from the third data format to the second data format. The delivery preferences may include one or more of a preference for mail delivery, a preference for fax delivery, a preference for electronic delivery, a preference for a batch delivery, and a preference for delivery through a portal associated with the third-party payor. The document may be received from a submitter, and the method may further include: receiving a communication associated with the document from the third-party payor, wherein the communication is associated with the matter identifier; based on the matter identifier, determining the submitter that provided the document; and providing the communication to the submitter. The communication may indicate that the document was accepted or rejected by the third-party payor. The third-party payor may be a medical insurance provider.

“The document management system described herein provides many advantages over the prior art. First, by converting documents automatically into document formats that are required by third-party payors, claims submitters are free to use whatever document format they prefer including native document formats. This saves each submitter time as they do not have to convert documents or remember the different formats required by each third-party payor. The system also saves the third-party payors time by reducing the number of rejected or wrongly-formatted documents, and by providing a single entity to deal with when changes are made to a desired format by a third-party payor.

“Second, by automatically providing the documents to the third-party payors using desired delivery methods, claims submitters save enormous amounts of time by avoiding having to print, fax, or mail documents. Many submitters almost exclusively deal with electronic documents and electronic document formats making printing and mailing a document a costly and time consuming interruption to their workflows.

“Additional advantages of the invention will be set forth in part in the description which follows, and in part will be obvious from the description, or may be learned by practice of the invention. The advantages of the invention will be realized and attained by means of the elements and combinations particularly pointed out in the appended claims. It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention, as claimed.”

The claims supplied by the inventors are:

“1. A method for managing document formats and delivery comprising: receiving a document in a first data format of a plurality of formats by a computing device, wherein the document is associated with a matter identifier and a third-party payor; determining document preferences associated with the third-party payor by the computing device, wherein the document preferences identify a second data format of the plurality of formats and one or more document delivery preferences; converting the document to the second data format by the computing device; and providing the document to the third-party in the second data format by the computing device according to the document delivery preferences.

“2. The method of claim 1, wherein receiving the document comprises receiving the document through one or more of an application program interface or a portal application.

“3. The method of claim 1, wherein the document is received in a batch along with a plurality of documents.

“4. The method of claim 1, wherein the document is received in a 277 document format.

“5. The method of claim 1, wherein the matter identifier is a claim identifier, and the document is received in support of an insurance claim for the third-party payor.

“6. The method of claim 1, further comprising: converting the document from the first data format to a third data format, wherein the third data format is an intermediate data format; and storing the document in the third data format in a datastore, and wherein converting the document to the second data format comprises: retrieving the document from the datastore; and converting the document from the third data format to the second data format.

“7. The method of claim 1, wherein the delivery preferences comprise one or more of a preference for mail delivery, a preference for fax delivery, a preference for electronic delivery, a preference for a batch delivery, and a preference for delivery through a portal associated with the third-party payor.

“8. The method of claim 1, wherein the document is received from a submitter, and further comprising: receiving a communication associated with the document from the third-party payor, wherein the communication is associated with the matter identifier; based on the matter identifier, determining the submitter that provided the document; and providing the communication to the submitter.

“9. The method of claim 8, wherein the communication indicates that the document was accepted or rejected by the third-party payor.

“10. The method of claim 1, wherein the third-party payor is a medical insurance provider.

“11. The method of claim 1, wherein the document preferences are received from the third-party payor.

“12. A system for managing documents and document providers, the system comprising: at least one computing device; and a memory storing computer-executable instructions that when executed by the at least one computing device cause the at least one computing device to: receive a document in a first data format of a plurality of formats, wherein the document is associated with a matter identifier and a third-party payor; determine document preferences associated with the third-party payor, wherein the document preferences identify a second data format of the plurality of formats and one or more document delivery preferences; convert the document to the second data format; and provide the document to the third-party in the second data format according to the document delivery preferences.

“13. The system of claim 12, wherein receiving the document comprises receiving the document through one or more of an application program interface or a portal application.

“14. The system of claim 12, wherein the document is received in a batch along with a plurality of documents.

“15. The system of claim 12, wherein the document is received in a 277 document format.

“16. The system of claim 12, wherein the matter identifier is a claim identifier, and the document is received as part of an insurance claim for the third-party payor.

“17. The system of claim 12, further comprising: converting the document from the first data format to a third data format, wherein the third data format is an intermediate data format; and storing the document in the third data format in a datastore, and wherein converting the document to the second data format comprises: retrieving the document from the datastore; and converting the document from the third data format to the second data format.

“18. The system of claim 17, wherein the delivery preferences comprise one or more of a preference for mail delivery, a preference for fax delivery, a preference for electronic delivery, a preference for a batch delivery, and a preference for delivery through a portal associated with the third-party payor.

“19. The system of claim 12, wherein the document is received from a submitter, and further comprising: receiving a communication associated with the document from the third-party payor, wherein the communication is associated with the matter identifier; based on the matter identifier, determining the submitter that provided the document; and providing the communication to the submitter.

“20. The system of claim 19, wherein the communication indicates that the document was accepted or rejected by the third-party payor.”

For more information, see this patent application: Babu, Suprigya; Corazao, Peter; Huynh, Sang; Jones, Greg; Mukker, Alka; Patel, Harshit. Systems And Methods For Document Management. Filed March 29, 2021 and posted September 29, 2022. Patent URL: https://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PG01&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.html&r=1&f=G&l=50&s1=%2220220309590%22.PGNR.&OS=DN/20220309590&RS=DN/20220309590

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