Patent Issued for Healthcare debit card linked to healthcare-related and non-healthcare-related financial accounts (USPTO 11797933): Alegeus Technologies LLC
2023 NOV 10 (NewsRx) -- By a
The patent’s inventors are Dibiasi, John P. (
This patent was filed on
From the background information supplied by the inventors, news correspondents obtained the following quote:
“Field of the Invention
“The present invention relates generally to healthcare financial payment systems and methods, and more particularly to a novel system and method in which a healthcare debit card used by a cardholder to pay for medical products and services is linked with a healthcare-related financial account associated with the cardholder as well as with a non-healthcare-related financial account belonging to the cardholder.
“With the widespread use of medical insurance has come the necessity of establishing that a particular individual has medical insurance coverage and arranging for the payment of medical products and services which are provided to the individual. At physicians’ offices, hospitals, and pharmacies, the established policy has become that unless proof of coverage is provided at the time of provision of medical services or purchase of medical products, the consumer must pay, or make arrangements to pay, for the cost of the medical products or services at the time of their delivery. At physicians’ offices at the time of service, consumers having medical insurance are typically required to present a card evidencing proof of the consumer’s medical insurance plan and information regarding the plan including the copay amount required for an office visit, and pay the copay amount.
“At hospitals, consumers having medical insurance typically present the card evidencing proof of the consumer’s medical insurance plan and information regarding the plan prior to delivery of medical services (other than in the case of an emergency). At pharmacies, consumers having medical insurance are required to present the card evidencing proof of the consumer’s medical insurance plan and information regarding the plan including the copay amount required for the prescription(s) being obtained, and pay the copay amount. In each of these situations, the consumer is required to either pay a copay amount prior to the delivery of medical services or a prescription, or, in the case of a hospital, to agree to pay the hospital for the amount which is not covered by the consumer’s medical insurance.
“This system of payment for medical services and products operated as described above until federal laws were passed to allow a participant and eligible dependents to save a considerable amount of money in taxes through a Flexible Spending Arrangement (“FSA”). FSA programs allow participants to deduct a predetermined amount of money from the participant’s before-tax income. This predetermined amount of money is set aside in the participant’s healthcare-related financial account, which is sometimes referred to as a flexible spending account or a flex account. The money then can be used toward paying for expenses incurred for certain eligible products and services specified by the
“A Health Savings Account (“HSA”) is a tax-advantaged trust or custodial healthcare-related financial account created for the benefit of an individual (not limited to employees) who is covered under a high deductible health plan (“HDHP”). The HSA provider need not require proof of HDHP coverage but may desire to do so for purposes of its recordkeeping and reporting. If an employer sets up an HSA for an employee, however, the employer must verify that the employee is enrolled in an HDHP offered by the employer. Contributions may be made by an employer, the individual, or a family member (subject to the gift tax). Contributions are deductible if made by an individual and are excludable from income and wages if they are made by an employer. Earnings grow tax-free and distributions for qualified medical expenses are tax-free. Nonqualified withdrawals are subject to income and penalty taxes, and excess contributions are subject to a six percent excise tax. Like an IRA, the HSA is owned by the individual and is portable.
“A health reimbursement arrangement (“HRA”) is an arrangement funded solely by an employer. An HRA may be offered to employees or former employees. Amounts in the HRA healthcare-related financial account must be used for qualified medical expenses, and balances may be carried forward. Depending upon the terms of the HRA, coverage may (or may not) continue if the employee terminates service. An HRA is not portable.
“The operation of a healthcare provider in conjunction with such healthcare-related financial accounts (any of an FSA, an HSA, or an HRA) typically involves three entities which each have a predefined function. The first of these entities is a cardholder administrator that enrolls employees or other cardholders serviced by a particular healthcare program. The cardholder administrator, in the process of enrolling employees or cardholders, obtains information from the employees or cardholders and their dependants and provides that information to the second and third entities.
“The second entity is a medical insurance program administrator that administers the claims of cardholders under the medical insurance of the healthcare program. The medical insurance program administrator typically establishes payment schedules and deductibles for medical products and services and informs providers of such medical products and services of the amounts which will they be paid by the medical insurance portion of the healthcare program. The medical insurance program administrator also typically provides healthcare cards to the employees or cardholders, which they can present to providers of medical products and services as proof of enrollment in the medical insurance program.
“The third entity is a healthcare-related financial account administrator, which administers the healthcare-related financial accounts which are owned by the employees or cardholders. The healthcare-related financial account administrator reviews the eligibility of medical products and services which are submitted by employees or cardholders in order to determine whether the medical products and services are eligible for payment from the healthcare-related financial accounts. If the medical products and services are eligible, the healthcare-related financial account administrator then determines whether the cardholders have sufficient funds left in their healthcare-related financial accounts. If the medical product or services in question are eligible, and if there are sufficient funds, the healthcare-related financial account administrator sends payment, typically to the employee or cardholder.
“In all healthcare systems involving medical insurance, whether or not the employees or cardholders have healthcare-related financial accounts, the cardholders generally complete each transaction involving obtaining medical products or services by paying a remaining amount directly to the medical product or service providers. Additionally, in many healthcare systems there is uncertainty about the final cost to the employee or cardholder since the approval and payment systems do not operate in real time. Finally, since there is no central coordination of the various aspects of the healthcare program, each of the entities often operates without any interaction with the other entities.
“It is accordingly the primary objective of the present invention that it provide a system and method for linking a healthcare debit card to both a healthcare-related financial account and a non-healthcare-related financial account in addition to linking the healthcare debit card to a medical insurance program. It is a related objective of the present invention that the healthcare debit card contain sufficient information, either in printed form or in electronic form, or in both forms, to enable medical product and service providers to ascertain that the healthcare debit card provides for payment from the three sources. It is another related objective of the present invention that it be capable of working which any of a plurality of different healthcare-related financial accounts, including FSA, HSA, and HRA healthcare-related financial accounts.
“It is an additional objective of the present invention that it provide coordination between the submissions for payment of medical products and services to a medical insurance provider, the healthcare-related financial account, and the non-healthcare-related financial account to ensure that the submissions to these three entities are made quickly and in the proper sequence. It is a related objective that the system and method of the present invention be capable of operation in real time or in near-real time, thereby enabling complete resolution of payment for the medical products and services at the time of delivery. It is a further objective that the healthcare debit card used in the system and method of the present invention may optionally be used as a conventional credit or debit card for use in purchasing non-medical products and services.
“The system and method of the present invention must also be flexible of design and robust in operation, and once established it should require little or no effort to maintain it other than to keep the employee or cardholder data current. In order to enhance the market appeal of the system of the present invention, it should also be relatively inexpensive to implement and to operate to thereby give it a high perceived value-to-cost ratio to afford it the broadest possible market. Finally, it is also an objective that all of the aforesaid advantages and objectives of the system and method of the present invention be achieved without incurring any substantial relative disadvantage.”
Supplementing the background information on this patent, NewsRx reporters also obtained the inventors’ summary information for this patent: “The disadvantages and limitations of the background art discussed above are overcome by the present invention. With this invention, a healthcare debit card is provided which has the cardholder’s name, a healthcare debit card number, and healthcare plan information typically including deductible amounts printed thereon. The healthcare debit card also has a magnetic stripe used to store data including information about the card, the cardholder, a healthcare plan, and financial account information on the back side of the healthcare debit card. Alternately, the healthcare debit card may instead be a standard size card which contains an electronic chip which may be used to store the same type of information. Such cards, commonly referred to as “smartcards,” have a built-in microprocessor and memory used for identification and/or financial transactions.
“The system of the present invention is used to link the healthcare debit card to a medical insurance provider and to a healthcare-related financial account, as well as to a non-healthcare-related financial account. The healthcare-related financial account may be a Flexible Spending Arrangement (FSA), a Health Savings Account (HSA), or a Health Reimbursement Arrangement (HRA). The non-healthcare-related financial account may be a bank checking or savings account or a credit card, or any other type of non-healthcare-related financial account.
“The system of the present invention links together a number of entities which each have a predefined function in the operation of the system. The first entity is a cardholder administrator that enrolls employees or other cardholders serviced by a particular healthcare program. The function of the cardholder administrator is to provide information regarding cardholders to the system, typically by entering that information into a computer terminal. The second entity is a medical insurance program administrator that administers the claims of cardholders under the medical insurance of the healthcare program. These two entities have existed historically, and the medical insurance program administrator has informed providers of medical products and services of the amounts which will be paid by the medical insurance of the healthcare program.
“A third entity is a healthcare-related financial account administrator, which administers healthcare-related financial accounts which are owned by cardholders. The healthcare-related financial account can be any one of a Flexible Spending Arrangement (FSA), a Health Savings Account (HSA), or a Health Reimbursement Arrangement (HRA). This entity has also existed historically, and the healthcare-related financial account administrator has reviewed the eligibility of medical products and services which are submitted by cardholders in order to determine whether the medical products and services are eligible for payment from the healthcare-related financial accounts. If they are eligible, the healthcare-related financial account administrator then pays for them if the cardholders have sufficient funds left in their healthcare-related financial accounts.
“The system and method of the present invention adds two additional entities, and also provides a mechanism for medical product and service providers to obtain essentially instant payment for all medical products and services. The first additional entity may be a financial institution in which a cardholder has a financial account, which may for example be any of a conventional checking or savings account or a credit card. The second additional entity is a system administrator, which serves to coordinate the operations performed under the system and method of the present invention between all of the other entities.”
The claims supplied by the inventors are:
“1. A system, comprising: a data processing system located remote from a terminal device, the data processing system comprising a system interface, memory, and one or more processors to: receive, via a network from the terminal device, an indication to process an electronic transaction as a single electronic transaction at the terminal device corresponding to a series of electronic transactions performed by the data processing system via: i) one or more links established with a plurality of remote devices comprising at least one of a cardholder administrator device, a medical insurance program administrator device, a healthcare financial account administrator device, or a financial institution device; and ii) data including at least one of healthcare financial account information, non-healthcare-related financial account information, or insurance provider information; determine, responsive to the indication to process the electronic transaction, that the electronic transaction is authorized using an insurance policy associated with the insurance provider information corresponding to the electronic transaction; cause, responsive to the determination that the electronic transaction is authorized using the insurance policy, a transfer of funds corresponding to the insurance policy of the insurance provider information from the data; determine that the electronic transaction is at least partially authorized using a healthcare-related policy provided by the healthcare financial account information; generate, responsive to the determination that the electronic transaction is at least partially authorized using the healthcare-related policy and the insurance policy, a first request to access funds from a healthcare financial account corresponding to the healthcare financial account information from the data; determine that an amount of funds in the healthcare financial account is below a threshold; transmit, via the one or more links established to process the electronic transaction as the single electronic transaction corresponding to the series of electronic transactions and responsive to the determination that the amount of funds is below the threshold, a second request to access a remaining portion of funds from a non-healthcare-related financial account corresponding to the non-healthcare-related financial account information; and provide, via the network responsive to execution of the electronic transaction as the series of electronic transactions comprising the first request and the second request, an indication of completion of the electronic transaction.
“2. The system of claim 1, comprising: the data processing system to establish, via the network, the one or more links with the plurality of remote devices.
“3. The system of claim 1, comprising: the data processing system to split, responsive to the determination that the amount of funds is below the threshold, the electronic transaction into the series of electronic transactions comprising the first request and the second request.
“4. The system of claim 3, comprising: the data processing system to reduce, based on the insurance policy or the healthcare-related policy and prior to the split of the electronic transaction into the first request and the second request, an amount of the electronic transaction.
“5. The system of claim 1, comprising: the data processing system to provide the indication of the completion of the electronic transaction to the terminal device via the network.
“6. The system of claim 1, comprising: the data processing system to receive, from the terminal device, an indication to process the electronic transaction as the series of electronic transactions at the data processing system using the data.
“7. The system of claim 1, wherein the terminal device connects to an electronic card reader device configured to interface with at least one of a magnetic stripe configured by a printer or a radio frequency communication device to receive, from at least one of the magnetic stripe configured by the printer or the radio frequency communication device, the healthcare financial account information, the non-healthcare-related financial account information, and the insurance provider information.
“8. The system of claim 7, wherein at least one of the magnetic stripe configured by the printer or the radio frequency communication device comprises information about at least one of a card number, cardholder information, the insurance provider information, or information regarding copay amounts.
“9. The system of claim 1, comprising the data processing system to: identify, for the electronic transaction, the insurance policy or the healthcare-related policy comprising at least one of an authorization process, validation process, or a resource availability process; determine, based on the insurance policy or the healthcare-related policy, that a first portion of the electronic transaction is authorized and a second portion of the electronic transaction fails authorization; and split the electronic transaction into a third request for the second portion that fails authorization.
“10. The system of claim 9, comprising: the data processing system to transmit the third request to at least one of the terminal device or a third-party server remote from the data processing system.
“11. A method, comprising: receiving, by a data processing system comprising a system interface, memory, and one or more processors, via a network from a terminal device located remote from the data processing system, an indication to process an electronic transaction as a single electronic transaction at the terminal device corresponding to a series of electronic transactions performed by the data processing system via: i) one or more links established with a plurality of remote devices comprising at least one of a cardholder administrator device, a medical insurance program administrator device, a healthcare financial account administrator device, or a financial institution device; and ii) data including at least one of healthcare financial account information, non-healthcare-related financial account information, or insurance provider information; determining, by the data processing system responsive to the indication to process the electronic transaction, that the electronic transaction is authorized using an insurance policy associated with the insurance provider information corresponding to the electronic transaction; causing, by the data processing system responsive to the determination that the electronic transaction is authorized using the insurance policy, a transfer of funds corresponding to the insurance policy of the insurance provider information from the data; determining, by the data processing system, that the electronic transaction is at least partially authorized using a healthcare-related policy provided by the healthcare financial account information; generating, by the data processing system responsive to the determination that the electronic transaction is at least partially authorized using the healthcare-related policy and the insurance policy, a first request to access funds from a healthcare financial account corresponding to the healthcare financial account information from the data; determining, by the data processing system, that an amount of funds in the healthcare financial account is below a threshold; transmitting, by the data processing system via the one or more links established to process the electronic transaction as the single electronic transaction corresponding to the series of electronic transactions and responsive to the determination that the amount of funds is below the threshold, a second request to access a remaining portion of funds from a non-healthcare-related financial account corresponding to the non-healthcare-related financial account information; and providing, by the data processing system via the network responsive to execution of the electronic transaction as the series of electronic transactions comprising the first request and the second request, an indication of completion of the electronic transaction.
“12. The method of claim 11, comprising: establishing, by the data processing system via the network, the one or more links with the plurality of remote devices.
“13. The method of claim 11, comprising: splitting, by the data processing system responsive to the determination that the amount of funds is below the threshold, the electronic transaction into the series of electronic transactions comprising the first request and the second request.
“14. The method of claim 13, comprising: reducing, by the data processing system based on the insurance policy or the healthcare-related policy and prior to the split of the electronic transaction into the first request and the second request, an amount of the electronic transaction.
“15. The method of claim 11, comprising: providing, by the data processing system, the indication of the completion of the electronic transaction to the terminal device via the network.
“16. The method of claim 11, comprising: receiving, by the data processing system from the terminal device, an indication to process the electronic transaction as the series of electronic transactions at the data processing system using the data.
“17. The method of claim 11, wherein the terminal device connects to an electronic card reader device configured to interface with at least one of a magnetic stripe configured by a printer or a radio frequency communication device to receive, from at least one of the magnetic stripe configured by the printer or the radio frequency communication device, the healthcare financial account information, the non-healthcare-related financial account information, and the insurance provider information.”
There are additional claims. Please visit full patent to read further.
For the URL and additional information on this patent, see: Dibiasi,
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