Patent Issued for Backend bundled healthcare services payment systems and methods (USPTO 11915287): Mdsave Shared Services Inc.

2024 MAR 18 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent by the inventors Ketchel, III, Paul J. (Brentwood, TN, US), filed on August 19, 2022, was published online on February 27, 2024, according to news reporting originating from Alexandria, Virginia, by NewsRx correspondents.

Patent number 11915287 is assigned to Mdsave Shared Services Inc. (Brentwood, Tennessee, United States).

The following quote was obtained by the news editors 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 the background information obtained for this patent, NewsRx journalists 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. A method comprising: receiving from a user a digital indication comprising a selection of a plurality of healthcare services associated with a plurality of providers, using a processor; providing the user a price for the selected plurality of healthcare services based on an individual fee for each provider of the plurality of providers to perform at least one healthcare service of the selected plurality of healthcare services, using the processor; generating an electronic health record comprising an information record with an indication of each healthcare service of the selected plurality of healthcare services, using the processor; configuring the information record with an individual redemption status indication for each healthcare service of the selected plurality of healthcare services and machine-readable information uniquely identifying the information record, using the processor; presetting the individual redemption status indication for at least two healthcare services of the selected plurality of healthcare services as unredeemed in the information record, wherein the at least two healthcare services of the selected plurality of healthcare services are selectively redeemable individually as a function of the machine-readable information, using the processor; providing at least one provider of the plurality of providers with access to the machine-readable information, using the processor; and in response to receiving the machine-readable information with an indication at least one selectively redeemable healthcare service has been performed, distributing payment to at least one provider of 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 one or more of 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 a 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 1, wherein the method further comprises providing the user access to the machine-readable information to receive one or more of the at least two selectively redeemable healthcare services individually, using the processor.

“21. The method of claim 1, wherein the at least two healthcare services of the selected plurality of healthcare services that are selectively redeemable individually further comprises at least one secondary service associated with at least one primary service.

“22. The method of claim 1, wherein the method further comprises configuring the information record with an indication at least one healthcare service of the selected plurality of healthcare services that are selectively redeemable individually is required to be performed at an outside facility, using the processor.

“23. The method of claim 1, wherein the information record is the electronic health record.

“24. The method of claim 1, 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 providers, using the processor.

“25. The method of claim 1, wherein the method further comprises configuring the information record with an individual redemption date indication for each healthcare service of the selected plurality of healthcare services; and in response to receiving the machine-readable information with the indication at least one selectively redeemable healthcare service has been performed: updating the individual redemption status indication in the information record to indicate that particular healthcare service has been redeemed and updating the redemption date in the information record for that particular service, using the processor.

“26. The method of claim 1, wherein the information record persists in a data store operably coupled with the processor and wherein the at least two healthcare services of the selected plurality of healthcare services are selectively redeemable individually, using the processor, at least until all of the selectively redeemable healthcare services are redeemed.

“27. The method of claim 1, wherein the method further comprises presenting to the user the plurality of healthcare services, using the processor.

“28. The method of claim 1, wherein the method further comprises receiving a request for redemption of at least one selectively redeemable healthcare service and using the information record and the machine-readable information uniquely identifying the information record to selectively determine the redemption status of the at least one selectively redeemable healthcare service, using the processor.

“29. The method of claim 1, wherein the method further comprises updating the redemption status of at least one selectively redeemable healthcare service in the information record to indicate the at least one selectively redeemable healthcare service has been redeemed, using the processor.

“30. The method of claim 1, wherein the machine-readable information, further comprises one or more of a confirmation number, a bar code, a QR code, an email, SMS message, graphic display element, an electronic message, a network packet, telephone number, email address, URL link or a digital token.”

URL and more information on this patent, see: Ketchel, III, Paul J. Backend bundled healthcare services payment systems and methods. U.S. Patent Number 11915287, filed August 19, 2022, and published online on February 27, 2024. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(11915287)&db=USPAT&type=ids

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