Patent Issued for Backend bundled healthcare services payment systems and methods (USPTO 11475499): Mdsave Shared Services Inc.

2022 NOV 09 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- From Alexandria, Virginia, NewsRx journalists report that a patent by the inventors Ketchel, III, Paul J. (Nashville, TN, US), filed on April 12, 2022, was published online on October 18, 2022.

The patent’s assignee for patent number 11475499 is Mdsave Shared Services Inc. (Brentwood, Tennessee, United States).

News editors 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.”

As a supplement to the background information on this patent, NewsRx correspondents also obtained the inventors’ summary information for this patent: “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. An apparatus comprising: a processor; a user interface, operably coupled with the processor; and a memory operably coupled with the processor, wherein the memory encodes processor executable program instructions and data to program and configure the processor to cause the apparatus to perform operations comprising: receiving an electronic message comprising a selection of a plurality of healthcare services separately associated with respective providers, wherein the selection comprises an indication of user debt for the selected plurality of healthcare services; and in response to receiving the electronic message comprising the selection of the plurality of healthcare services, associate the selected plurality of healthcare services with at least one bundled set of healthcare services; associate the at least one bundled set of healthcare services with the user debt; generate in the memory a digital health asset token representing a 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; preset an initial individual redemption status in the purchase data record for each healthcare service of the at least one bundled set of healthcare services as unredeemed; and provide marketplace access to the digital health asset token representing the user debt to finance the user debt associated with the at least one bundled set of healthcare services.

“2. The apparatus of claim 1, wherein the operations performed by the apparatus further comprise receiving payment in an amount of the user debt for each of the at least one bundled set of healthcare services.

“3. The apparatus of claim 2, wherein the operations performed by the apparatus further comprise creating at least one debt bundle comprising the amount of the user debt for each of the at least one bundled set of healthcare services.

“4. The apparatus of claim 1, wherein the marketplace uses the digital health asset token to buy, sell or trade the at least one bundled set of healthcare services to finance the user debt.

“5. The apparatus of claim 4, wherein provide marketplace access further comprises sending the digital health asset token to a marketplace trading platform.

“6. The apparatus of claim 5, wherein a rate of return for the digital health asset token is adjusted based on buying, selling, or trading the digital health asset token using the marketplace trading platform.

“7. The apparatus of claim 6, wherein the rate of return for the digital health asset token is further adjusted based on a GFE for at least one healthcare service of the at least one bundled set.

“8. The apparatus of claim 6, wherein the rate of return for the digital health asset token is further adjusted based on marketplace activity.

“9. The apparatus of claim 6, wherein the digital health asset token comprises a begin rate of return when adjustments begin and an end rate of return when adjustments end.

“10. The apparatus of claim 9, wherein the operations performed by the apparatus further comprise receiving from the marketplace trading platform an electronic message comprising an end rate of return distinct from the begin rate of return for the digital health asset token.

“11. The apparatus of claim 1, wherein the marketplace comprises a plurality of computer-implemented marketplace systems configured to implement buying, selling, or trading the digital health asset token to finance the user debt.

“12. The apparatus of claim 11, wherein the operations performed by the apparatus further comprise sending an electronic message comprising the digital health asset token to at least one computer-implemented marketplace system, wherein a rate of return for the digital health asset token is adjusted from a begin rate of return when adjustments begin to an end rate of return when adjustments end, based on marketplace activity.

“13. The apparatus of claim 12, wherein the operations performed by the apparatus further comprise receiving from at least one computer-implemented marketplace system, an electronic message comprising an end rate of return distinct from the begin rate of return.

“14. The apparatus of claim 12, wherein the marketplace further comprises an asset exchange trading platform.

“15. The apparatus of claim 14, wherein the operations performed by the apparatus further comprise sending an electronic message comprising the digital health asset token to the asset exchange trading platform.

“16. The apparatus of claim 14, wherein operations performed by the apparatus further comprise sending an electronic message configured to cause the asset exchange trading platform to adjust a bundle price based on buying, selling or trading the digital health asset token.

“17. The apparatus of claim 14, wherein the operations performed by the apparatus further comprise receiving from the asset exchange trading platform an adjusted bundle price for the at least one bundled set of healthcare services.

“18. The apparatus of claim 1, wherein the operations performed by the apparatus further comprise determining a Good Faith Estimate (GFE) for at least one healthcare service of the at least one bundled set.

“19. The apparatus of claim 18, wherein the GFE for the at least one healthcare service of the at least one bundled set is a GFE for the digital health asset token.

“20. The apparatus of claim 19, wherein provide marketplace access further comprises sending the GFE to a marketplace trading platform.

“21. The apparatus of claim 18, wherein the operations performed by the apparatus further comprise adjusting the GFE based on patient acuity determined as a function of patient medical data encoded by an electronic health record.

“22. The apparatus of claim 1, wherein the user debt comprises a plurality of bundled sets of healthcare services.

“23. The apparatus of claim 22, wherein the purchase data record further comprises an individual redemption status for each healthcare service in the plurality of bundled sets of healthcare services.

“24. The apparatus of claim 23, wherein the operations performed by the apparatus further comprise preset the initial individual redemption status in the purchase data record for each healthcare service in the plurality of bundled sets of healthcare services as unredeemed.

“25. The apparatus of claim 1, wherein the at least one bundled set of healthcare services are predetermined bundles.

“26. The apparatus of claim 1, wherein the at least one bundled set of healthcare services are new bundles formed from at least one predetermined bundle and at least one discrete procedure, and wherein the operations performed by the apparatus further comprise forming at least one new bundle from the at least one predetermined bundle and the at least one discrete procedure.

“27. The apparatus of claim 1, wherein finance further comprises sending a plurality of electronic messages comprising a plurality of requests to finance the user debt, and wherein the operations performed by the apparatus further comprise sending the plurality of electronic messages comprising a plurality of requests to finance the user debt.

“28. The apparatus of claim 27, wherein the operations performed by the apparatus further comprise: receiving at least one electronic message comprising an indication of financed payment for the user debt; and disbursing at least one payment allocated from the financed payment to at least one provider.

“29. The apparatus of claim 1, wherein the operations performed by the apparatus further comprise: providing access to a computer-implemented Independent Dispute Resolution (IDR) process to use the digital health asset token and the marketplace for resolving a dispute using a GFE; and receiving an electronic message from the IDR process comprising a resolution of the dispute.

“30. The apparatus of claim 1, wherein the operations performed by the apparatus further comprise accept payment for a bundle price adjusted to within $400 of a GFE for the at least one bundled set of healthcare services.”

For additional information on this patent, see: Ketchel, III, Paul J. Backend bundled healthcare services payment systems and methods. U.S. Patent Number 11475499, filed April 12, 2022, and published online on October 18, 2022. Patent URL: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=11475499.PN.&OS=PN/11475499RS=PN/11475499

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