Patent Issued for System and method for healthcare document management (USPTO 11450417): Rivia Health Inc.

2022 OCT 10 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent by the inventors Burgess, Harlow (Chandler, AZ, US), filed on January 28, 2020, was published online on September 20, 2022, according to news reporting originating from Alexandria, Virginia, by NewsRx correspondents.

Patent number 11450417 is assigned to Rivia Health Inc. (Phoenix, Arizona, United States).

The following quote was obtained by the news editors from the background information supplied by the inventors: “Alongside new medical treatments and diagnostic technologies, modern medicine has spawned a complex ecosystem of service providers and insurers. It is not uncommon for an individual, in the wake of an event such as a car accident, to be receiving bills and other documents not only from their health insurance company, but also hospitals, doctors, specialists, ambulance companies, laboratories, pharmacies, and other parties. Each of these parties has their own timeline and procedure for payment, sometimes even using different terminology to describe the same thing. It is very easy for an individual to be overwhelmed by all of the moving parts that make up the system that is helping them get healthy.

“Juggling the deadlines of multiple bills, making sure promised insurance benefits are being utilized fully, and ensuring no mistakes have been made, would be difficult under the best of circumstances, let alone while one is also recovering. Bills sometimes slip through the cracks or become too much to pay, resulting in accounts going to collections, to the detriment of both the individual and the entity seeking payment.”

In addition to the background information obtained for this patent, NewsRx journalists also obtained the inventors’ summary information for this patent: “According to one aspect, a healthcare document management system includes a document management server communicatively coupled to a database, and further communicatively coupled to a user client device through a network. The document management server is configured to create a user record associated with a user, using information received, at least in part, from the user client device, receive from the user client device an image of a medical document, and convert the image of the medical document into a plurality of text elements using optical character recognition, each text element having a content and an absolute position in the document. The server is also configured to determine if a document type of the medical document is one of a bill and an explanation of benefits by searching the content of each text element for at least one distinguishing string, each distinguishing string being unique to one document type. The server is configured to identify all postal addresses in the medical document by inspecting the content of each text element for a postal address format, validate each postal address, place each postal address in a standardized postal address format, and determine a source of the medical document by comparing each identified postal address with a list of postal addresses unique to known sources. The source is one of a healthcare provider and an insurer. The server is also configured to determine a source of the medical document having postal addresses not found on the list by examining text elements neighboring each postal address that does not match a postal address found on the user record, and retrieve a plurality of data detectors from the database based on the document type. Each data detector is associated with a data type that is anticipated to be in the document, each data detector having at least one identifier that is one of a potential label and a potential format, at least one direction describing a potential relative direction of a text element having a label associated with the data detector, and at least one validation criteria. Each validation criteria describes one of a valid format and a valid range. The server is configured to, for each data detector, order at least one of the identifiers and the directions according to a history stored in the database and associated with the source, identify a table within the document by calculating for each text element of the plurality of text elements a relative position of at least one neighboring text element relative to the text element using the absolute position of the text element, and comparing the relative positions of the plurality of text elements. The server is also configured to locate a header for the table by comparing the content of the text elements within the table with the identifiers of the plurality of data detectors and then identifying the data type of the matching text elements, the header being one of a row and a column. The server is configured to validate, for each identified text element in the header, at least one text element within the other of a row and a column described by the identified text element in the header with the validation criteria of the data detector that identified the identified text element in the header, and associate, for each identified text element in the header, at least one validated text element within the other of the row and the column described by the identified text element in the header with the data detector that identified the identified text element in the header. The server is configured to identify a potential descriptor by comparing the content of each text element not part of the table with the at least one identifier of at least one data detector, determine if the text element pointed to by one of the at least one direction of the data detector used to identify the potential descriptor meets the validation criteria of the data detector, associate the validated text element with the data detector, and send to the user client device, for each text element associated with one data detector of the plurality of data detector, the content of the text element, for verification from the user. The server is also configured to receive a verification message from the user client device, store the verified content in a first document record in the database, the first document record being linked to the user record, and compare the first document record with records associated with other medical documents linked to the user record. The server is configured to notify the user through the user client device that the medical document is a duplicate upon determination that the medical record already exists, pair the first document record, which describes one of an explanation of benefits and a bill, with a second document record which describes the other of an explanation of benefits and a bill, based upon at least a common date, and determine if there is a discrepancy between a patient responsibility according to the first document record and a patient responsibility according to the second document record. The server is configured to notify the user through the user client device of the discrepancy, generate and transmit a billing discrepancy notification to a healthcare provider who is the source of one of the bill associated with one of the first document record and the second document record, in response to receipt by the document management server of permission from the user client device, and generate a list of payments due by collecting payment details from each bill described by one of a plurality of document records linked to the user record. The server is configured do send the list to the user client device, and update, for each data detector, the history associated with the source, according to which identifier of the at least one identifier and which direction of the at least one direction matched the most text elements of the data type described by the data detector in the document.

“Particular embodiments may comprise one or more of the following features. The document management server may be further configured to determine if the document type of the medical document is an insurance card through at least one of comparing a size of the text elements relative to a size of the medical document and searching the content of each text element for at least one distinguishing string unique to insurance cards. The server may be configured to retrieve a second plurality of data detectors from the database. Each data detector may be associated with a data type that is anticipated to be in the insurance card. The server may be configured to store the verified content in the user record if the document type is insurance card. The document management server may be further configured to receive, from the user client device, a query made by the user in natural language, parse the query, search the database for data associated to the parsed query, and/or send data associated to the parsed query to the user client device. The server may be configured to escalate the query to a human agent, in response to a lack of data associated to the parsed query in the database, by sending the query to an agent client communicatively coupled to the document management server. The data associated to the parsed query may be retrieved, in part, from the user record, and may be specific to the user. The document management server may be communicatively coupled to at least one of a healthcare provider server and an insurer server through the network. The document management server may be further configured to receive an external document record directly from one of the healthcare server and the insurer server.”

There is additional summary information. Please visit full patent to read further.

The claims supplied by the inventors are:

“1. A healthcare document management system, comprising: a document management server communicatively coupled to a database, and further communicatively coupled to a user client device through a network, the document management server configured to: create a user record associated with a user, using information received, at least in part, from the user client device; store the user record in the database; receive from the user client device an image of a medical document; convert the image of the medical document into a plurality of text elements using optical character recognition, each text element having a content and an absolute position in the document; determine if a document type of the medical document is one of a bill and an explanation of benefits by searching the content of each text element for at least one distinguishing string, each distinguishing string being unique to one document type; identify all postal addresses in the medical document by inspecting the content of each text element for a postal address format; validate each postal address; place each postal address in a standardized postal address format; determine a source of the medical document by comparing each identified postal address with a list of postal addresses unique to known sources, wherein the source is one of a healthcare provider and an insurer; determine a source of the medical document having postal addresses not found on the list by examining text elements neighboring each postal address that does not match a postal address found on the user record; retrieve a plurality of data detectors from the database based on the document type, each data detector associated with a data type that is anticipated to be in the document, each data detector comprising at least one identifier that is one of a potential label and a potential format, at least one direction describing a potential relative direction of a text element having a label associated with the data detector, and at least one validation criteria, wherein each validation criteria describes one of a valid format and a valid range; for each data detector, order at least one of the identifiers and the directions according to a history stored in the database and associated with the source; identify a table within the document by calculating for each text element of the plurality of text elements a relative position of at least one neighboring text element relative to the text element using the absolute position of the text element, and comparing the relative positions of the plurality of text elements; locate a header for the table by comparing the content of the text elements within the table with the identifiers of the plurality of data detectors and then identifying the data type of the matching text elements, the header being one of a row and a column; validate, for each identified text element in the header, at least one text element within the other of a row and a column described by the identified text element in the header with the validation criteria of the data detector that identified the identified text element in the header; associate, for each identified text element in the header, at least one validated text element within the other of the row and the column described by the identified text element in the header with the data detector that identified the identified text element in the header; identify a potential descriptor by comparing the content of each text element not part of the table with the at least one identifier of at least one data detector; determine if the text element pointed to by one of the at least one direction of the data detector used to identify the potential descriptor meets the validation criteria of the data detector; associate the validated text element with the data detector; send to the user client device, for each text element associated with one data detector of the plurality of data detector, the content of the text element, for verification from the user; receive a verification message from the user client device; store the verified content in a first document record in the database, the first document record being linked to the user record; compare the first document record with records associated with other medical documents linked to the user record; notify the user through the user client device that the medical document is a duplicate upon determination that the medical record already exists; pair the first document record, which describes one of an explanation of benefits and a bill, with a second document record which describes the other of an explanation of benefits and a bill, based upon at least a common date; determine if there is a discrepancy between a patient responsibility according to the first document record and a patient responsibility according to the second document record; notify the user through the user client device of the discrepancy; generate and transmit a billing discrepancy notification to a healthcare provider who is the source of one of the bill associated with one of the first document record and the second document record, in response to receipt by the document management server of permission from the user client device; generate a list of payments due by collecting payment details from each bill described by one of a plurality of document records linked to the user record; send the list to the user client device; and update, for each data detector, the history associated with the source, according to which identifier of the at least one identifier and which direction of the at least one direction matched the most text elements of the data type described by the data detector in the document.

“2. The system of claim 1, wherein the document management server is further configured to: determine if the document type of the medical document is an insurance card through at least one of comparing a size of the text elements relative to a size of the medical document and searching the content of each text element for at least one distinguishing string unique to insurance cards; retrieve a second plurality of data detectors from the database, each data detector associated with a data type that is anticipated to be in the insurance card; and store the verified content in the user record if the document type is insurance card.

“3. The system of claim 1, wherein the document management server is further configured to: receive, from the user client device, a query made by the user in natural language; parse the query; search the database for data associated to the parsed query; send data associated to the parsed query to the user client device; and escalate the query to a human agent, in response to a lack of data associated to the parsed query in the database, by sending the query to an agent client communicatively coupled to the document management server; wherein the data associated to the parsed query is retrieved, in part, from the user record, and is specific to the user.

“4. The system of claim 1, wherein the document management server is communicatively coupled to at least one of a healthcare provider server and an insurer server through the network, and wherein the document management server is further configured to receive an external document record directly from one of the healthcare server and the insurer server.

“5. A healthcare document management system, comprising: a document management server communicatively coupled to a database, and further communicatively coupled to a user client device through a network, the document management server configured to: create a user record associated with a user, using information received, at least in part, from the user client device; store the user record in the database; receive from the user client device an image of a medical document; convert the image of the medical document into a plurality of text elements using optical character recognition, each text element having a content and an absolute position in the document; identify all postal addresses in the medical document by inspecting the content of each text element for a postal address format; validate each postal address; place each postal address in a standardized postal address format; determine a source of the medical document by comparing each identified postal address with a list of postal addresses unique to known sources, wherein the source is one of a healthcare provider and an insurer; determine a source of the medical document having postal addresses not found on the list by examining text elements neighboring each postal address that does not match a postal address found on the user record; retrieve a plurality of data detectors from the database, each data detector associated with a data type that is anticipated to be in the document, each data detector comprising at least one identifier that is one of a potential label and a potential format, at least one direction describing a potential relative direction of a text element having a label associated with the data detector, and at least one validation criteria, wherein each validation criteria describes one of a valid format and a valid range; identify a potential descriptor by comparing the content of each text element with the at least one identifier of at least one data detector; determine if the text element pointed to by one of the at least one direction of the data detector used to identify the potential descriptor meets the validation criteria of the data detector; associate the validated text element with the data detector; send to the user client device, for each text element associated with one data detector of the plurality of data detector, the content of the text element, for verification from the user; receive a verification message from the user client device; and store the verified content in a first document record in the database, the first document record being linked to the user record.”

There are additional claims. Please visit full patent to read further.

URL and more information on this patent, see: Burgess, Harlow. System and method for healthcare document management. U.S. Patent Number 11450417, filed January 28, 2020, and published online on September 20, 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=11450417.PN.&OS=PN/11450417RS=PN/11450417

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