“System And Method For Processing Medical Claims Using Biometric Signatures” in Patent Application Approval Process (USPTO 20210350888): Patent Application

2021 NOV 25 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent application by the inventors Arn, Peter (Roxbury, CT, US); Greene, Jonathan (Denver, CO, US); Guaneri, Joseph (Merrick, NY, US); Hacking, S. Adam (Nashua, NH, US); Mason, Steven (Las Vegas, NV, US); Mueller, Micheal (Oil City, PA, US); Para, Wendy (Las Vegas, NV, US); Posnack, Daniel (Fort Lauderdale, FL, US), filed on July 19, 2021, was made available online on November 11, 2021, 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: “Electronic medical record (EMR) systems may be used to generate and maintain an electronic record of health-related information relating to or about individuals within a health care organization. The health-related information may be input by a variety of entities, e.g., the individuals’ health care providers, where such entries may be made by any medically-related entity or its representatives, for example: administrators, nurses, doctors, or other authorized individuals; insurance companies; billing companies; hospitals; testing centers, such as those related to radiologic services, blood and bodily fluid testing services; and psychological service providers, such as psychologists, social workers, addiction and other counselors, and psychiatrists. Each healthcare service may have one or more medical billing codes, for example, Diagnosis-Related Group (DRG) and/or International Classification of Diseases (ICD) codes, e.g., ICD-10, assigned for billing purposes. Some of the individual’s EMRs, including the one or more medical billing codes, may be transferred to a third-party payor, such as an insurance company, for invoicing the individual’s medical claims for the individual’s healthcare services. A medical claim, or a claim, is a medical bill, or bill, submitted to a health insurance carrier, or other party responsible for payment, for services rendered and/or goods provided to patients by health care providers. After a medical claim is submitted to the insurance company, the insurance company determines its financial responsibility for the payment to the healthcare provider (i.e., claim adjudication). The insurance company may have procedures to ensure that no false medical claims are approved for payment, for example, by rejecting payment for medical billing codes inconsistent with the healthcare services provided. As a result of such procedures, the insurance company may decide to pay the medical claim in full, reduce the medical bill, deny the full medical claim, or revise the nature of the claim such that it becomes eligible for full or partial payment.

“Medical billing may present difficulties in claim adjudication when using medical billing codes, often making it difficult for insurance companies to detect whether a particular medical claim is the result of fraud, waste, or abuse. Even if an insurance company has the ability to determine that a medical device has been used, the insurance company may have difficulty in determining whether the use of that medical device was properly billed (e.g., the medical device was not used by or for the patient stated in the medical claim). The use of telemedicine may result in additional risks related to fraud, waste, and abuse, risks which bad actors can exploit. For example, if, at a location other than a healthcare facility, the medical device is being used, a healthcare provider may not oversee the use (e.g., treatment, rehabilitation, or testing), and therefore, the healthcare provider may not be able to easily confirm or validate the accuracy of the medical billing.”

In addition to the background information obtained for this patent application, NewsRx journalists also obtained the inventors’ summary information for this patent application: “In general, the present disclosure provides a system and method for processing medical claims using biometric signatures.

“An aspect of the disclosed embodiments includes a computer-implemented system for processing medical claims. The computer-implemented system includes a medical device configured to be manipulated by a user while the user performs a treatment plan; a patient interface associated with the medical device, the patient interface comprising an output configured to present telemedicine information associated with a telemedicine session; and a processor. The processor is configured to, during the telemedicine session, receive device-generated information from the medical device; generate a first biometric signature; using the device-generated information, generate a second biometric signature; using the first and second biometric signatures, generate a signature comparison; using the signature comparison, generate a signature indicator; and transmit the signature indicator.

“An aspect of the disclosed embodiments includes a system for processing medical claims. The system includes a processor configured to receive device-generated information from a medical device; to generate a first biometric signature; to use the device-generated information to generate a second biometric signature; to use the first biometric signature and the second biometric signature to generate a signature comparison; to use the signature comparison to generate a signature indicator; and to transmit the signature indicator.

“An aspect of the disclosed embodiments includes a method for processing medical claims. The method includes receiving device-generated information from a medical device. The method further includes generating a first biometric signature; using the device-generated information to generate a second biometric signature; using the first biometric signature and the second biometric signature to generate a signature comparison; using the signature comparison to generate a signature indicator; and transmitting the signature indicator.

“An aspect of the disclosed embodiments includes a tangible, non-transitory computer-readable storage medium. The tangible, non-transitory computer-readable storage medium stores instructions that, when executed, cause a processor to receive device-generated information from a medical device. The instructions further cause a processor to generate a first biometric signature; to use the device-generated information to generate a second biometric signature; to use the first biometric signature and the second biometric signature to generate a signature comparison; to use the signature comparison to generate a signature indicator; and to cause the processor to transmit the signature indicator.

“Another aspect of the disclosed embodiments includes a system that includes a processing device and a memory communicatively coupled to the processing device and capable of storing instructions. The processing device executes the instructions to perform any of the methods, operations, or steps described herein.

“Another aspect of the disclosed embodiments includes a tangible, non-transitory computer-readable medium storing instructions that, when executed, cause a processing device to perform any of the methods, operations, or steps disclosed herein.

“Other technical features may be readily apparent to one skilled in the art from the following figures, descriptions, and claims.”

The claims supplied by the inventors are:

“1. A computer-implemented system for processing medical claims, comprising: a medical device configured to be manipulated by a user while the user performs a treatment plan; a patient interface associated with the medical device, the patient interface comprising an output configured to present telemedicine information associated with a telemedicine session; and a processor configured to: during the telemedicine session, receive device-generated information from the medical device; generate a first biometric signature; using the device-generated information, generate a second biometric signature; using the first and second biometric signatures, generate a signature comparison; using the signature comparison, generate a signature indicator; and transmit the signature indicator.

“2. The computer-implemented system of claim 1, wherein: the device-generated information is generated by the medical device; using the device-generated information, the processor is further configured to determine device-based medical coding information; and generating the second biometric signature uses the device-based medical coding information.

“3. The computer-implemented system of claim 1, wherein the processor is further configured to receive reviewed medical coding information; and wherein generating the first biometric signature uses the reviewed medical coding information.

“4. The computer-implemented system of claim 1, wherein the processor is further configured to receive electronic medical records pertaining to the user of the medical device; and wherein generating the first biometric signature uses the electronic medical records.

“5. The computer-implemented system of claim 1, wherein the processor is further configured to: using the second biometric signature and an emergency biometric signature, generate an emergency comparison; using the emergency comparison, generate an emergency indicator; and transmit the emergency indicator.

“6. A system for processing medical claims, comprising: a processor configured to: receive device-generated information from a medical device; generate a first biometric signature; using the device-generated information, generate a second biometric signature; using the first and second biometric signatures, generate a signature comparison; using the signature comparison, generate a signature indicator; and transmit the signature indicator.

“7. The system of claim 6, wherein the device-generated information is generated by the medical device.

“8. The system of claim 6, wherein, using the device-generated information, the processor is further configured to determine device-based medical coding information; and wherein generating the second biometric signature uses the device-based medical coding information.

“9. The system of claim 8, wherein the processor is further configured to generate the emergency biometric signature.

“10. The system of claim 6, wherein the device-generated information includes at least one of vital sign information, images, and medical device use information.

“11. The system of claim 6, wherein the device-generated information includes performance information; and wherein generating the second biometric signature uses the performance information.

“12. The system of claim 6, wherein generating the first biometric signature uses historical performance information.

“13. The system of claim 6, wherein the first biometric signature includes a first kinesiological signature; and wherein the second biometric signature includes a second kinesiological signature.

“14. A method for processing medical claims, comprising: receiving device-generated information from a medical device; generating a first biometric signature; using the device-generated information, generating a second biometric signature; using the first biometric signature and the second biometric signature, generating a signature comparison; using the signature comparison, generating a signature indicator; and transmitting the signature indicator.

“15. The method of claim 14, wherein the device-generated information is generated by the medical device.

“16. The method of claim 14, further comprising using the device-generated information to determine device-based medical coding information; wherein generating the second biometric signature uses the device-based medical coding information.

“17. The method of claim 14, further comprising receiving reviewed medical coding information; wherein generating the first biometric signature uses the reviewed medical coding information.

“18. The method of claim 14, further comprising receiving electronic medical records pertaining to a user of the medical device; wherein generating the first biometric signature uses the electronic medical records.

“19. The method of claim 14, further comprising: using the second biometric signature and an emergency biometric signature to generate an emergency comparison; using the emergency comparison to generate an emergency indicator; and transmitting the emergency indicator.

“20. The method of claim 19, further comprising generating the emergency biometric signature.

“21. The method of claim 14, wherein the device-generated information includes at least one of vital sign information, images, and medical device use information.

“22. The method of claim 14, wherein the device-generated information includes performance information; and wherein generating the second biometric signature uses the performance information.

“23. The method of claim 14, wherein generating the first biometric signature uses historical performance information.

“24. The method of claim 14, wherein the first biometric signature includes a first kinesiological signature; and wherein the second biometric signature includes a second kinesiological signature.

“25. A tangible, non-transitory computer-readable storage medium storing instructions that, when executed, cause a processor to: receive device-generated information from a medical device; generate a first biometric signature; using the device-generated information, generate a second biometric signature; using the first biometric signature and the second biometric signature, generate a signature comparison; using the signature comparison, generate a signature indicator; and transmit the signature indicator.

“26. The tangible, non-transitory computer-readable storage medium of claim 25, wherein the instructions further cause the processor to receive electronic medical records pertaining to a user of the medical device; and wherein generating the first biometric signature uses the electronic medical records.

“27. The tangible, non-transitory computer-readable storage medium of claim 25, wherein the instructions further cause the processor to: using the second biometric signature and an emergency biometric signature, generate an emergency comparison; using the emergency comparison, generate an emergency indicator; and transmit the emergency indicator.

“28. The tangible, non-transitory computer-readable storage medium of claim 25, wherein the device-generated information includes performance information; and wherein generating the second biometric signature uses the performance information.

“29. The tangible, non-transitory computer-readable storage medium of claim 25, wherein the device-generated information includes performance information; and wherein generating the second biometric signature uses the performance information.

“30. The tangible, non-transitory computer-readable storage medium of claim 25, wherein generating the first biometric signature uses historical performance information.”

URL and more information on this patent application, see: Arn, Peter; Greene, Jonathan; Guaneri, Joseph; Hacking, S. Adam; Mason, Steven; Mueller, Micheal; Para, Wendy; Posnack, Daniel. System And Method For Processing Medical Claims Using Biometric Signatures. Filed July 19, 2021 and posted November 11, 2021. 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=%2220210350888%22.PGNR.&OS=DN/20210350888&RS=DN/20210350888

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