Patent Issued for System To Dynamically Adjust Request Values At A Back-End Application Server (USPTO 10,616,373)

2020 APR 17 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- From Alexandria, Virginia, NewsRx journalists report that a patent by the inventors Juan, Stephen (Livermore, CA); Finley, Cynthia D (Lyme, CT); Ternullo, Linda L. (Tolland, CT); Thompson, Jeffrey C. (Meridian, ID); Foti, Brian (Tampa, FL), filed on June 13, 2019, was published online on April 20, 2020.

The patent’s assignee for patent number 10,616,373 is Hartford Fire Insurance Company (Hartford, Connecticut, United States).

News editors obtained the following quote from the background information supplied by the inventors: “In some cases, a back-end application platform may receive a set of manually generated and/or paper (or pdf file) requests, each request including a request value. For example, the sets of requests may be received from different remote third-party administrator platforms throughout a month. Experts at the back-end application platform may review the requests to ensure that each request (and request value) conforms to one of a number of different rules. The experts may change the request values as appropriate in view of those rules and determine an overall amount associated with each third-party administrator platform. Reviewing the sets of requests, however, can be a time consuming and error prone process--especially when there are a substantial number of requests, a substantial number of third-party administrator platforms, and/or wide ranging differences between the rules that need to be used to review the requests. Note that some back-end application platforms might receive sets of requests from tens, or even hundreds, of different third-party administrator platforms (and each platform could be submitting tens of thousands of requests every month).

“It would therefore be desirable to provide systems and methods to facilitate a dynamic, accurate, and transparent adjustment of request values for a back-end application.”

As a supplement to the background information on this patent, NewsRx correspondents also obtained the inventors’ summary information for this patent: “According to some embodiments, systems, methods, apparatus, computer program code and means may receive data streams from remote third-party administrator computer servers. A back-end application computer server may receive a set of requests from a first third-party administrator computer server, each request being associated with a request value. The back-end application server may retrieve a first set of pre-determined rules and automatically apply them to the set of requests, resulting in an adjusted request value and an overall value. The back-end computer server may then automatically transmit a settlement instruction, including the overall value, to an electronic transaction system, and render a transaction activity report display via a remote computer device, associated with the first third-party administrator computer server, including information about the set of requests, the adjusted request value along with an indication of a reason for the adjustment, and the overall value.

“Some embodiments comprise: means for receiving at a communication port a plurality of data streams of electronic messages, each data stream being received from one of a plurality of remote third-party administrator computer servers via a distributed communication network; means for storing information received in the data streams of electronic messages into a data stream computer store; means for accessing a rules computer store storing different sets of pre-determined rules for different third-party administrator computer servers; means for receiving, by a back-end application computer server from the data stream computer store, information associated with a set of requests from a first third-party administrator computer server, each request being associated with a request value; means for retrieving, by the back-end application computer server from the rules computer store, a first set of pre-determined rules for the first third-party administrator computer server; means for automatically applying, by the back-end application computer server, the first set of pre-determined rules to the set of requests from the first third-party administrator computer server, said application resulting in at least one adjusted request value for the set of requests and an overall value based at least in part on the request values and the adjusted request value associated with the set of requests; means for automatically transmitting, by the back-end application computer server, a settlement instruction, including the overall value, to an electronic transaction system; and means for rendering, by the back-end application computer server, a transaction activity report display via a remote computer device, associated with the first third-party administrator computer server, including information about the set of requests, the at least one adjusted request value along with an indication of a reason for the adjustment, and the overall value.

“A technical effect of some embodiments of the invention is an improved and computerized method to facilitate a dynamic, accurate, and transparent adjustment of request values at a back-end application server. With these and other advantages and features that will become hereinafter apparent, a more complete understanding of the nature of the invention can be obtained by referring to the following detailed description and to the drawings appended hereto.”

The claims supplied by the inventors are:

“What is claimed is:

“1. A system to improve an accuracy of information generated by a back-end application computer server, comprising: (a) a communication port to facilitate receipt of a plurality of data streams of electronic messages, each data stream being received from one of a plurality of remote third-party administrator computer servers via a distributed communication network; (b) a rules computer store to store different sets of pre-determined rules for different third-party administrator computer servers; © the back-end application computer server, coupled to the communication port, the data stream computer store, and the rules computer store, programmed to: (i) determine information associated with a set of requests from a first third-party administrator computer server, each request being associated with a request value, (ii) retrieve from the rules computer store a first set of pre-determined rules for the first third-party administrator computer server, (iii) automatically apply the first set of pre-determined rules to the set of requests from the first third-party administrator computer server, said application resulting in at least one adjusted request value for the set of requests and an overall value based at least in part on the request values and the adjusted request value associated with the set of requests, (iv) automatically transmit a settlement instruction, including the overall value, to an electronic transaction system, and (v) as a result of application of the first set of pre-determined rules, automatically transmit a flag to an electronic messaging communication server; (d) the electronic transaction system to receive the settlement instruction and to execute a settlement transaction in accordance with the overall value; and (e) the electronic messaging communication server to receive said flag, and as a result of receiving said flag, trigger an electronic notification from the electronic messaging communication server to the remote computer device associated with the first third-party administrator computer server.

“2. The system of claim 1, wherein the communication port further provides at least one of: (i) security features for the distributed communication network, and (ii) load balancing functionality.

“3. The system of claim 1, wherein the back-end application computer server is to process multiple data streams from the first third-party administrator computer server, each data stream being associated with a different client and different set of pre-determined rules for that client.

“4. The system of claim 1, wherein said automatic application of the first set of pre-determined rules by the back-end application server is performed on a periodic basis associated with at one of: (i) a monthly basis, (ii) a bi-weekly basis, or (iii) a weekly basis.

“5. The system of claim 1, wherein the first set of pre-determined rules includes at least one of: (i) an aggregate request value amount, and (ii) a rule based on a geographic location associated with a request.

“6. The system of claim 1, wherein a transaction activity report display is rendered via a spreadsheet application.

“7. The system of claim 1, wherein a transaction activity report display can be customized, by a user at the remote computer device, to cover a time period from a start date to an end date for the report.

“8. A computerized method to improve an accuracy of information generated by a back-end application computer server, comprising: receiving at a communication port a plurality of data streams of electronic messages, each data stream being received from one of a plurality of remote third-party administrator computer servers via a distributed communication network; accessing a rules computer store storing different sets of pre-determined rules for different third-party administrator computer servers; determining information associated with a set of requests from a first third-party administrator computer server, each request being associated with a request value; retrieving, by the back-end application computer server from the rules computer store, a first set of pre-determined rules for the first third-party administrator computer server; automatically applying, by the back-end application computer server, the first set of pre-determined rules to the set of requests from the first third-party administrator computer server, said application resulting in at least one adjusted request value for the set of requests and an overall value based at least in part on the request values and the adjusted request value associated with the set of requests; as a result of applying the first set of pre-determined rules, automatically transmitting, by the back-end application computer server, a flag to an electronic messaging communication server; automatically transmitting, by the back-end application computer server, a settlement instruction, including the overall value, to an electronic transaction system; receiving, by the electronic transaction system, the settlement instruction and executing a settlement transaction in accordance with the overall value; and receiving, by the electronic messaging communication server, said flag and as a result of receiving said flag, triggering an electronic notification from the electronic messaging communication server to the remote computer device associated with the first third-party administrator computer server.

“9. The method of claim 8, further comprising: providing security features for the distributed communication network; and providing load balancing functionality.

“10. The method of claim 9, wherein the back-end application computer server is to process multiple data streams from the first third-party administrator computer server, each data stream being associated with a different client and different set of pre-determined rules for that client.

“11. The method of claim 8, wherein said automatic application of the first set of pre-determined rules by the back-end application server is performed on a periodic basis associated with at one of: (i) a monthly basis, (ii) a bi-weekly basis, or (iii) a weekly basis.

“12. The method of claim 8, wherein the first set of pre-determined rules includes at least one of: (i) an aggregate request value amount, and (ii) a rule based on a geographic location associated with a request.

“13. A system to improve an accuracy of information generated by an insurance enterprise computer server, comprising: (a) a communication port to receive a plurality of insurance claim data streams, each insurance claim data stream being received from one of a plurality of remote third-party administrator devices via the Internet; (b) an insurance policy database to store different sets of pre-determined deductible amounts and exception rules for different third-party administrators; © the insurance enterprise server, coupled to the communication port, the insurance claim data stream database, and the insurance policy database, programmed to: (i) determine information associated with a set of claims from a first third-party administrator, each claim being associated with a claim value, (ii) retrieve from the insurance policy database a first pre-determined deductible amount and exception rule for the first third-party administrator, (iii) automatically apply the first pre-determined deductible amount and exception rule to the set of claims from the first third-party administrator, said application resulting in at least one adjusted claim value for the set of claims and an overall settlement value based at least in part on the claim values and the adjusted claim value associated with the set of claims, (iv) automatically transmit an automated clearinghouse payment instruction, including the overall settlement value, to an electronic banking system, and (v) as a result of application of the first pre-determined deductible amount and exception rule, automatically transmit a flag to an electronic messing communication server; (d) the electronic banking system to receive the automated clearinghouse payment instruction and to execute a settlement in accordance with the overall settlement value; and (e) the electronic messaging communication server to receive said flag, and as a result of receiving said flag, trigger an electronic notification from the electronic messaging communication server to the remote computer device associated with the first third-party administrator device.

“14. The system of claim 13, wherein the insurance policy is associated with at least one of: (i) a medical insurance policy, and (ii) a workers’ compensation insurance policy.

“15. The system of claim 13, wherein the deductible amount is associated with at least one of: (i) a standard deductible amount, (ii) a loss limit, (iii) a retention amount, (iv) a cap amount, (v) a step amount, (vi) an escrow account, (vii) an insurance basket, (viii) a corridor deductible, (ix) a crash deductible, and (x) a date associated with an insurance claim.

“16. The system of claim 13, wherein the exception rule is associated with at least one of: (i) a type of insurance claim, (ii) a geographic location associated with an insurance claim, and (iii) a specific provision of an insurance policy.

“17. The system of claim 13, wherein the insurance enterprise server is further to generate at least one of: (i) a reconciliation message, and (ii) an excess calculation report.

“18. The system of claim 17, wherein the excess calculation report includes at least one of: (i) an exception identifier, (ii) an exception state, and (iii) an exception amount.

“19. The system of claim 13, wherein a transaction activity spreadsheet report includes at least five of: (i) a claim level payable amount, (ii) a transactions total amount, (iii) a cumulative total paid, (iv) a claimant, (v) a claim number, (vi) an insurer claim number, (vii) a date of loss, (viii) a transaction amount, (ix) a payment description, (x) a draft or check number, (xi) a draft date, (xii) an account name, (xiii) a product name, (xix) an insurance policy number, (xx) a deductible/loss limit/retention amount, (xxi) a policy inception date, (xxii) a policy expiration date, (xxiii) a third-party administrator identifier, (xxiv) a third-party administrator name, (xxv) an organization identifier, (xxvi) a valuation date, (xxvii) a payable document number, (xxviii) a line of business, (xxix) an entry code, (xxx) a loss event branch, (xxxi) a loss event identifier, and (xxxii) a loss event claim counter.

“20. The system of claim 13, wherein: a transaction activity spreadsheet report further includes a display of: (i) a current month payable amount, (ii) a current policy period payment amount, and (iii) a date associated with a claim; and an excess calculation report includes a display of a geographic location exception indication.”

For additional information on this patent, see: Juan, Stephen; Finley, Cynthia D; Ternullo, Linda L.; Thompson, Jeffrey C.; Foti, Brian. System To Dynamically Adjust Request Values At A Back-End Application Server. U.S. Patent Number 10,616,373, filed June 13, 2019, and published online on April 20, 2020. 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=10,616,373.PN.&OS=PN/10,616,373RS=PN/10,616,373

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