Researchers Submit Patent Application, “Data Processing System For Processing Network Data Records Transmitted From Remote, Distributed Terminal Devices”, for Approval (USPTO 20230028535): Patent Application

2023 FEB 09 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- From Washington, D.C., NewsRx journalists report that a patent application by the inventors Moulden, Shelby (Long Beach, CA, US); Osetinsky, Veronica (Belmont, CA, US); Quigley, Patrick (Palos Verdes Estates, CA, US), filed on August 3, 2022, was made available online on January 26, 2023.

No assignee for this patent application has been made.

News editors obtained the following quote from the background information supplied by the inventors: “Computer systems can be used to transmit, receive, and/or process data. For instance, a server computer system can be used to receive and store resources (e.g., payment data), and make the content available to one or more client computer systems. Upon receiving a request for the content from a client computer system, the server computer system can retrieve the requested content, and transmit the content to the client computer system to fulfill the request.”

As a supplement to the background information on this patent application, NewsRx correspondents also obtained the inventors’ summary information for this patent application: “The data processing system allows a consumer to pay a cash rate cost for a health care service. A consumer can purchase a health care service and receive an insurance benefit using a payment card associated with the consumer’s account. The card can include a credit or debit card. This enables a consumer to purchase health care services and receive insurance benefit as if the health care service were any product being purchased with a credit or debit card, where the benefit is applied at the time of purchase at the point of sale device. The health care service provider experiences the purchase as if the purchase were with cash (e.g., cash, credit, or other form of non-insurance payment). The consumer receives the benefit amount according to that consumer’s coverage plan at the time of purchase. Often, purchasing the health care service with cash results in a lower price for the consumer. The data processing system allows the consumer to take advantage of this reduced, cash rate cost while also having insurance benefit pay at least a portion (or substantially all) of the cost.

“The methods of payment and claims by the data processing system provides a simpler alternative to traditional insurance payments and claims processing. In the traditional method, a consumer provides their insurance card at the time of receiving a health care service. After the health care service is received, the health care service provider transmits an invoice, which includes a negotiated cost of the health care service with the particular insurance provider, rather than a cash rate cost. The insurance company remits payment based on a coverage plan for that consumer and sends a bill to the consumer for the remaining balance of the cost which consumer is then responsible for completing payment, often weeks or months after receiving the health care service.

“The data processing system enables the removal of the health insurance company as a middleman between the consumer and the health care service provider for the transaction. Instead, each consumer can pay with a charge card, credit card, or other form of account identifier that identifies the consumer to the point of sale device. Based on the identification of the consumer’s account with the purchase (e.g., because the card or other payment device is linked to the consumer’s insurance account in the data processing system), the data processing system immediately satisfies the cost, and the health care service is paid in full. Because this is preferable to the health care service provider, the health care service provider often offers the health care service at a lower cost if cash is received immediately. The consumer’s account receives the charge, a fixed benefit amount (based on the cash rate cost) is deduced from the cost, and the difference is credited/debited to the consumer’s payment account, either directly or indirectly. If the consumer does not have a direct payment account in the data processing system, the data processing system prompts the consumer to send representation of the bill for the health care service for verification of the cost paid. For example, the consumer can take one or more photos of the receipt from the doctor/medical facility, attach the photo(s) to the expense, and submit the expense to a claims team, all through a user interface. In some implementations, the consumer, having already provided a personal credit card or bank account number when signing up for a plan, is automatically charged for their portion of medical costs. Most payments can be resolved within twenty-four (24) hours.

“A user interface of the data processing system can display various data to the consumer. For example, because the cash rate cost is determined for each health care service, the data processing system is capable of displaying to a consumer exactly how much of a benefit amount is provided for each health care service the consumer uses. In another example, as stated above, through the user interface, the consumer can set a coverage level using an application on a device of the consumer (e.g., during enrollment in an insurance plan). The application shows the consumer, though the user interface, how much each health care service costs, how much coverage costs, and what the benefit is for each health care service.

“Other benefits are also possible. Consumers can use a smartphone application or a web-based application to determine the coverage amount their plan will pay toward a health care service before they see the doctor. They ask the doctor for the cash price of the service, take into consideration the amount their plan will cover, and therefore know the amount they will have to pay out of pocket before obtaining the health care service.

“In some implementations, to provide a better experience for consumers, the data processing system includes a self-pay data sharing system where users can add cash prices they paid at their medical visit. This method of crowdsourcing data is an efficient way to build a database of true cash prices that other consumers can refer to when choosing a doctor or medical facility.

“The data processing system is able to satisfy the cost of the health care service in response to receiving the transaction data in real time or near real time in order to meet electronic payment timeout requirements (such as with credit or debit card transactions). The data processing system is configured to validate the transaction within this time window, ensuring that the purchase is covered by a consumer’s insurance plan.

“In an aspect, a data processing system is configured for providing a cash payment for a health care service that is at least partly covered by a health insurance provider over a payment processing network. The data processing system receives a request requesting payment for a health care service and a key that uniquely identifies a consumer of health care services; in near real-time with respect to when the request is received, processing, through a payment network, cash payment of the health care service; accessing, from a hardware storage device, a node labeled with the key; and looking-up, in the accessed node, coverage data that specifies an amount of the health care service paid by a health insurance provider of the payment network and an amount paid by the consumer, where the amount paid by the health insurance provider is a specified amount of a determined cash rate cost of the health care service regardless of a source of the health care service.

“In some implementations, the data processing system determines the cash rate cost of the health care service by, for a plurality of requests requesting payment for instances of the health care service, determining a set of total costs including a total cost requested for each instance of the health care service; and applying a weighted average to the set of total costs. In some implementations, the request is received in response to a transaction by a payment card of the consumer. In some implementations, the actions include providing a user interface configured to present the coverage data or the determined cash rate cost for one or more health care services.

“In an aspect, a data processing system is configured to process a payment for a health care service that is at least partly covered by a health insurance provider. The data processing system includes a data storage configured to store cash rate data representing cash rate costs paid for health care services for each of a plurality of transactions processed by point of sale systems of health care providers. The data processing system includes a payment processing engine configured to: receive transaction data indicating a purchase of a health care service at a point of sale system of a health care provider using a payment card identifying a consumer of the health care; in response to receiving the transaction data, access a profile of the consumer, the profile specifying a payment source for the purchase of the health care; retrieve co-pay data from the payment source, the co-pay data specifying a portion of a cost of the health care being paid by the payment source; cause, within a threshold time of receiving the transaction data, the portion of the cost to be satisfied from the payment source and a remaining portion of the cost to be satisfied from a coverage account; access the data storage to receive the cash rate data associated with the health care; determine a benefit amount of the cost of the health care, the benefit amount of the cost being based on the cash rate costs paid for the health care; determine a credit or a debit to apply to the payment source by comparing the benefit amount of the cost to the remaining portion of the cost satisfied by the coverage account; generate a notice of the credit or the debit; and cause transmission of the notice to a computing device associated with the consumer.

“In some implementations, the payment processing engine is further configured to update the cash rate data associated with the health care in response to receiving the transaction data. In some implementations, the cash rate data comprises, for each health care, a weighted average of a cost for each instance of purchasing the health care in the plurality of transactions. In some implementations, the data storage comprises different cash rate data for each geographic region of a plurality of geographic regions associated with the plurality of transactions.”

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

The claims supplied by the inventors are:

“1-20. (canceled)

“21. A data processing system, configured to process a payment for a health care service that is at least partly covered by a health insurance provider, the data processing system comprising: a payment processing engine comprising one or more processors, the payment processing engine configured to determine cash rate costs paid for health care services from each of a plurality of health care providers by performing operations comprising: receiving transaction data indicating a purchase of a health care service at a point of sale system of a health care provider, the transaction data associated with a key value, the transaction data specifying an amount paid for the health care service; in response to receiving the transaction data, accessing, from a hardware storage device, a node labeled with the key value; looking-up, in the accessed node, a geographic region associated with the purchase of the health care service; and updating, for the geographic region, based on the amount paid for the health care service specified by the transaction data, cash rate data specifying a cash rate for purchasing the health care service in the geographic region; and causing, at a user device based on the cash rate data, presentation of the cash rate for purchasing the health care service in the geographic region; and a data storage configured to: store the cash rate data specifying the cash rate for purchasing the health care service in the geographic region.

“22. The data processing system of claim 21, wherein updating the cash rate data specifying a cash rate for purchasing the health care service in the geographic region comprises: determining an identity of a health care service provider for the health care service; and updating the cash rate data based on the identity of the health care service provider.

“23. The data processing system of claim 21, wherein the cash rate data comprises, for each health care service, a weighted average of a cost for each instance of purchasing the health care service for a plurality of transactions in the geographic region.

“24. The data processing system of claim 21, wherein the data storage comprises different cash rate data for each geographic region of a plurality of geographic regions including the geographic region.

“25. The data processing system of claim 21, wherein presentation of the cash rate for purchasing the health care service in the geographic region comprises a presentation of a benefit amount corresponding to the cash rate.

“26. The data processing system of claim 25, wherein the presentation comprises a push notification or alert.

“27. The data processing system of claim 25, wherein the presentation comprises a representation of an estimate of whether a provider of the health care service is more expensive than the cash rate for purchasing the health care service in the geographic region, near in cost to the cash rate for purchasing the health care service in the geographic region, or less expensive than the cash rate for purchasing the health care service in the geographic region.

“28. The data processing system of claim 25, wherein the presentation is configured to be searchable based on the benefit amount.

“29. The data processing system of claim 25, wherein the payment processing engine is configured to generate additional cost data representing a projected cost or credit associated with a transactions, the projected cost or credit being a function of the cash rate data for the transaction; and wherein the presentation comprises a representation of the additional cost data.

“30. A method for processing a payment for a health care service that is at least partly covered by a health insurance provider, the method comprising: determining, by a payment processing engine, cash rate costs paid for health care services from each of a plurality of health care providers by performing operations comprising: receiving transaction data indicating a purchase of a health care service at a point of sale system of a health care provider, the transaction data associated with a key value, the transaction data specifying an amount paid for the health care service; in response to receiving the transaction data, accessing, from a hardware storage device, a node labeled with the key value; looking-up, in the accessed node, a geographic region associated with the purchase of the health care service; and updating, for the geographic region, based on the amount paid for the health care service specified by the transaction data, cash rate data specifying a cash rate for purchasing the health care service in the geographic region; and causing, at a user device based on the cash rate data, presentation of the cash rate for purchasing the health care service in the geographic region; and storing, at a data storage, the cash rate data specifying the cash rate for purchasing the health care service in the geographic region.

“31. The method of claim 30, wherein updating the cash rate data specifying a cash rate for purchasing the health care service in the geographic region comprises: determining an identity of a health care service provider for the health care service; and updating the cash rate data based on the identity of the health care service provider.

“32. The method of claim 30, wherein the cash rate data comprises, for each health care service, a weighted average of a cost for each instance of purchasing the health care service for a plurality of transactions in the geographic region.

“33. The method of claim 30, wherein the data storage comprises different cash rate data for each geographic region of a plurality of geographic regions including the geographic region.

“34. The method of claim 30, wherein presentation of the cash rate for purchasing the health care service in the geographic region comprises a presentation of a benefit amount corresponding to the cash rate.

“35. The method of claim 34, wherein the presentation comprises a push notification or alert.

“36. The method of claim 34, wherein the presentation comprises a representation of an estimate of whether a provider of the health care service is more expensive than the cash rate for purchasing the health care service in the geographic region, near in cost to the cash rate for purchasing the health care service in the geographic region, or less expensive than the cash rate for purchasing the health care service in the geographic region.

“37. The method of claim 34, wherein the presentation is configured to be searchable based on the benefit amount.

“38. The method of claim 35, wherein the payment processing engine is configured to generate additional cost data representing a projected cost or credit associated with a transactions, the projected cost or credit being a function of the cash rate data for the transaction; and wherein the presentation comprises a representation of the additional cost data.”

For additional information on this patent application, see: Moulden, Shelby; Osetinsky, Veronica; Quigley, Patrick. Data Processing System For Processing Network Data Records Transmitted From Remote, Distributed Terminal Devices. U.S. Patent Application Number 20230028535, filed August 3, 2022 and posted January 26, 2023. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20230028535)&db=US-PGPUB&type=ids

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