Patent Issued for CPT code search engine for backend bundling of healthcare services and a virtual payment system (USPTO 11341556): Mdsave Shared Services Inc.

2022 JUN 15 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent by the inventors Ketchel, Paul J. (Nashville, TN, US), filed on September 15, 2021, was published online on May 24, 2022, according to news reporting originating from Alexandria, Virginia, by NewsRx correspondents.

Patent number 11341556 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: “A current procedural terminology code, (“CPT-Code”) search engine for backend bundling of healthcare services and a virtual payment system. Various implementations provide a CPT Code-based search engine for backend bundling by an aggregate billing source to transact and pay debt owed for healthcare services on behalf of consumers of varied healthcare services from diverse providers and facilities. Various implementations provide a predetermined bundled set of healthcare services defined by CPT and related codes producing search results in an easy-to-understand consumer-friendly format. Also presented is an apparatus and associated methods for bundling the debt of a plurality of healthcare services downstream from a healthcare service provider based on collecting a single payment from a consumer that has already received the healthcare services and distributing payment to a plurality of providers and facilities for at least one of the healthcare services. Some backend bundled services and debt may be converted to tradeable health assets.

“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 configured to be operably coupled to 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 to bundle user debt of 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 predetermined bundled set of healthcare services; 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 user debt of the selected plurality 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 facilitate payment for the plurality of healthcare services.

“2. The apparatus of claim 1, wherein the operations performed by the processor further comprise receiving a single payment for the at least one bundled set of healthcare services.

“3. The apparatus of claim 2, wherein the operations performed by the processor further comprise disbursing a plurality of payments allocated from the received payment, wherein the plurality of disbursed payments is disbursed to a respective plurality of providers of the at least one bundled set of a plurality of selectively redeemable healthcare services.

“4. The apparatus of claim 2, wherein the payment is in an amount of a bundle price based on a location associated with at least one selectively redeemable healthcare service of the at least one bundled set of healthcare services.

“5. The apparatus of claim 2, wherein the bundled set of healthcare services was already provided separately by respective providers before receiving payment.

“6. The apparatus of claim 2, wherein the bundled set of healthcare services was offered to be provided separately by respective providers after receiving payment.

“7. The apparatus of claim 2, wherein the received payment further comprises real currency.

“8. The apparatus of claim 2, wherein the received payment further comprises virtual funds.

“9. The apparatus of claim 2, wherein the received payment further comprises authorization to finance the bundled debt of a plurality of healthcare services.

“10. The apparatus of claim 1, wherein associate the selected plurality of healthcare services with at least one predetermined bundled set of healthcare services further comprises mapping one or more service code related to the plurality of healthcare services to the at least one predetermined bundled set of healthcare services.

“11. The apparatus of claim 10, wherein the operations performed by the processor further comprise comparing the one or more service code to one or more predetermined bundled set that comprises at least one service associated with the one or more service code.

“12. The apparatus of claim 10, wherein the operations performed by the processor further comprise in response to determining one or more service code of the plurality of healthcare services does map to at least one predetermined bundled set of healthcare services, adding the at least one predetermined bundled set of healthcare services to a group of predetermined bundled sets that cover the one or more service code.

“13. The apparatus of claim 10, wherein the operations performed by the processor further comprise in response to determining one or more service code of the plurality of healthcare services does not map to at least one predetermined bundled set of healthcare services, adding the one or more service code to a group of service codes not covered by a predetermined bundled set.

“14. The apparatus of claim 13, wherein the operations performed by the processor further comprise creating a new bundled set comprising the one or more service code not covered by a predetermined bundled set.

“15. The apparatus of claim 10, wherein the operations performed by the processor further comprise extracting the one or more service code from data received by a web service or the user interface.

“16. The apparatus of claim 1, wherein the operations performed by the processor further comprise determining and indicating a minimal group of bundled sets and discrete services that cover care of the received selection of the plurality of healthcare services.

“17. The apparatus of claim 16, wherein the operations performed by the processor further comprise indicating the minimal group of bundled sets and discrete services via a web service.

“18. The apparatus of claim 16, wherein determining the minimal group of bundled sets and discrete services further comprises removing duplicate services from the received selection of the plurality of healthcare services.

“19. The apparatus of claim 16, wherein determining the minimal group of bundled sets and discrete services further comprises removing a bundled set that is a subset of another bundled set from a group of bundled sets that covers care of the received selection of the plurality of healthcare services.

“20. The apparatus of claim 16, wherein determining the minimal group of bundled sets and discrete services further comprises removing services common to a plurality of predetermined bundled sets.

“21. The apparatus of claim 16, wherein the operations performed by the processor further comprise determining a bundle price as a function of the minimal group of bundled sets and discrete services that cover care of the received selection of the plurality of healthcare services.

“22. The apparatus of claim 16, wherein the operations performed by the processor further comprise receiving a single payment in an amount of a bundle price for the minimal group of bundled sets and discrete services.

“23. The apparatus of claim 1, wherein the operations performed by the processor further comprise determining a marketplace user’s propensity to pay a bundle price.

“24. The apparatus of claim 23, wherein the operations performed by the processor further comprise automatically adjusting the plurality of services comprising a bundled set based on the marketplace user’s propensity to pay.

“25. The apparatus of claim 24, wherein automatically adjusting the plurality of services further comprises adding, removing, or substituting at least one service of the bundled set.

“26. The apparatus of claim 1, wherein the operations performed by the processor further comprise aggregating the debt for the bundled set of healthcare services and sending the aggregated debt to a billing provider.

“27. The apparatus of claim 26, wherein the operations performed by the processor further comprise receiving at least one payment for the bundled set of healthcare services from the billing provider.

“28. The apparatus of claim 1, wherein the operations performed by the processor further comprise receiving at least one payment for the bundled set of healthcare services from a marketplace user that selected the plurality of healthcare services.

“29. The apparatus of claim 1, wherein the operations performed by the processor further comprise provide user access to the confirmation number for the user to receive each healthcare service of the bundled set of healthcare services.

“30. The apparatus of claim 1, wherein the operations performed by the processor further comprise send the digital health asset token to an asset exchange trading platform wherein a bundle price is adjusted based on trading the digital health asset on the exchange trading platform.”

URL and more information on this patent, see: Ketchel, Paul J. CPT code search engine for backend bundling of healthcare services and a virtual payment system. U.S. Patent Number 11341556, filed September 15, 2021, and published online on May 24, 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=11341556.PN.&OS=PN/11341556RS=PN/11341556

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