“System And Method For Identification Of An Adequate Healthcare Agreement According To A Given Medical Condition” in Patent Application Approval Process (USPTO 20220084689): Patent Application

2022 MAR 01 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent application by the inventor Kopell, Michael (Kiriat Ata, Il), filed on November 23, 2021, was made available online on March 17, 2022, according to news reporting originating from Washington, D.C., by NewsRx correspondents.

This patent application has not been assigned to a company or institution.

The following quote was obtained by the news editors from the background information supplied by the inventors: “People can have variety of healthcare insurances and healthcare agreements which detail the person’s rights in various circumstances. The healthcare insurances and healthcare agreements are complex and common users cannot extract their rights from standard healthcare insurances and healthcare agreements they have. In many cases, people have multiple insurance agreements, for example from multiple companies or one insurance agreement via an employment agreement and another insurance agreement which is bought by the user. Multiple insurance agreements may result in a situation in which the person pays twice for the same insurance coverage, and wastes his/her money. In addition, many persons who sign the insurance agreements do not fully understand their medical coverage, as there are thousands of medical situations that may be covered by the insurance agreements. Understanding the person’s medical coverage requires much time and energy, in reviewing lengthy insurance agreements and understanding the legal and medical terms which are not clear to the common person.

“Thus, the process of identifying the healthcare coverage a person has requires reviewing multiple documents and agreements. In multiple cases, there is no one place functioning as a focal point for all documents and agreements. Furthermore, even a person could consolidate all the agreements, the documents the signed documents and the memorandums the person has received, identify the coverage the medical treatments, the cost and the required operation, involves with knowledge in multiple areas. Such areas can be law, insurance, and the like. In some cases, the coverage and the optional medical treatments to which the person is entitled is associated with a specific health condition.”

In addition to the background information obtained for this patent application, NewsRx journalists also obtained the inventor’s summary information for this patent application: “The present disclosure discloses a method operable on a computerized system for matching privilege and optional treatment to medical conditions according to healthcare agreements. Such a method comprises multiple steps to match the privileges and the optional treatment to a person. The method disclosed herein can also comprise a step of generating a digital output comprising the medical condition of the person, and the course of actions to which the person is entitled, according to an identified relevant sections in the healthcare agreement portfolio, wherein the healthcare agreement portfolio is associated with the person’s name. Thus, such a method can comprise a step of receiving a medical condition of a person represented as a record of data, wherein the record of data comprises the medical condition thereof, and wherein the medical condition states of one or more aspects of the person’s health.

“The method disclosed herein can also comprise a step of categorizing the record of data representing the medical condition, wherein the categorizing process categorizes terms, and/or phrases, and/or word which appear in the provided record of data representing the medical condition. The categorization process can be followed by a step of identifying a healthcare agreement portfolio associated with the person associated with the provided record of data representing the medical condition. In such cases, wherein the categorization process is completed, the computerized system can also be configured to identify the relevant sections in the healthcare agreement portfolio which are related to the categories identified in the record of data representing the medical condition.

“The method disclosed herein can also comprise a step of identifying the course of actions to which the person is entitled, according to the identified relevant sections in the healthcare agreement portfolio which are related to the categories identified in the record of data representing the medical condition thereof. In case the course of actions which the person is entitled are identified, the computerized system can generate a digital output comprising the person’s name, the categories associated to the medical condition of the person, and the course of actions to which the person is entitled, according to the identified relevant sections in the healthcare agreement portfolio.

“In some cases, computerized system can also be configured to associate the covered cases, corresponding with the identified healthcare agreement portfolio. In such cases, the covered cases are sets of at least one course of action. In some cases, the computerized system can also perform a classifying process to identify classes in the record of data representing the medical condition to classes. In such cases, the classes can be identified sets of terms having some property or attribute in common and differentiated from others by kind, type, or quality.

“The subject matter also discloses receiving personal information from a user of the computerized system and suggesting personal medical insurance coverage to the specific person. The personal medical insurance coverage is calculated according to the personal and medical information inputted by the user into the computerized system. Such personal information may be the person’s age, gender, place of residence, salary and the like the medical information may include smoking habits, nutrition habits, prior surgeons the user had, prior diseases and/or medical conditions the user suffered from, medical drugs consumed regularly by the user and the like. Then, the computerized system compares the person’s medical and personal information to a benchmark which represents the specific person’s medical and personal information. Such benchmark may comprise multiple medical insurance policies and/or coverages of other persons having similar characteristics to the specific person, for example having a similarity of more than 80 percent to the medical information inputted by the user. Then, the computerized system reviews the specific person’s medical insurance coverage and compares it to the benchmark. In case the benchmark has more coverage, the system may suggest the specific person to but the difference between the person’s current coverage and the benchmark coverage. In case the user has more coverage than the benchmark coverage, the system may suggest the person to replace and/or correct his/her medical insurance agreement. In some cases, the specific person may select a level of benchmark, for example basic, normal and high, which indicate a level of medical coverage. For example, a high benchmark will have more coverage for a specific age and gender than the standard benchmark.

“The computerized system may comprise a module in which the users input financial information, such as invoices and/or receipts that indicate payment for medical services, such as appointments, medical diagnosis, medical devices, medical drugs, surgeries and the like. The users may input additional information, such as the date in which the payment was made. The system will then review the users’ medical insurance coverage and issue a request for reimbursement for the relevant entity that is entitled to reimburse the user, such as the insurance company.”

The claims supplied by the inventors are:

“1. A method operable on a computerized system for associating privilege and an optional treatment to medical conditions according to healthcare agreements, comprising: receiving a medical condition of a person represented as a record of data, wherein the record of data comprises the medical condition thereof, wherein the medical condition states one or more aspects of the health of the person; categorizing the record of data representing the medical condition, wherein the categorizing process categorizes terms, and/or phrases, and/or word which appear in the record of data representing the medical condition; identifying a healthcare agreement portfolio associated with the person associated with the record of data representing the medical condition; identifying relevant sections in the healthcare agreement portfolio which are related to categories identified in the record of data representing the medical condition; identifying course of actions to which the person is entitled, according to the identified relevant sections in the healthcare agreement portfolio which are related to the categories identified in the record of data representing the medical condition thereof; generating a digital output comprising the person’s name, the categories associated to the medical condition of the person, and the course of actions to which the person is entitled, according to the identified relevant sections in the healthcare agreement portfolio.

“2. The method of claim 1, wherein generating a digital output further comprises associating the covered cases, corresponding with the identified healthcare agreement portfolio.

“3. The method of claim 2, wherein the covered cases are sets of at least one course of action.

“4. The method of claim 1, wherein the record of data further comprises the name of the person.

“5. The method of claim 1, further comprises a classifying process to identify classes in the record of data representing the medical condition to classes.

“6. The method of claim 5, wherein the classes are identified sets of terms having some property or attribute in common and differentiated from others by kind, type, or quality.”

URL and more information on this patent application, see: Kopell, Michael. System And Method For Identification Of An Adequate Healthcare Agreement According To A Given Medical Condition. Filed November 23, 2021 and posted March 17, 2022. Patent URL: https://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PG01&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.html&r=1&f=G&l=50&s1=%2220220084689%22.PGNR.&OS=DN/20220084689&RS=DN/20220084689

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