1043results about "Health insurance management" patented technology

A variety of tools and techniques are disclosed for managing, viewing, publishing, searching, clustering, and otherwise manipulating data streams. Data streams such as RSS data feeds may be searched, aggregated, and filtered into a processed feed. The processed feed, along with rules used to process the feed may be shared in a number of ways. A data feed management system may provide an integrated user interface through which a user may manage feeds, including searching for new feeds, managing and filtering current feeds, modifying a user profile, and sharing feeds and feed configuration data with other users. A server may provide a complementary search engine to locate new feeds and to store and / or index items or posts in known feeds. Together, these technologies may provide a richly-functioned feed management system and greater ease of use for individuals in managing large numbers of feeds and large amounts of data in feeds. Additional functional layers may provide for authentication, security, and privacy, metadata creation and management, and social networking features. Using the management tools and additional functionality, a syndicated data stream system may provide a platform for a wide array of useful consumer and business applications.

An informatics system permits data entities from a wide range of data sources to be accessed and evaluated. The sources of the data entities may be simply data sources, such as for articles and other non-patient or population specific information, as well as controllable and prescribable sources, such diagnostic imaging, clinical and other sources forming part of the patient care path. The entities are organized, analyzed in accordance with a domain framework, which may be altered by a user to focus on factors and informational components of interest. Holistic and integrated understanding of such factors are there fore available, and refinement of healthcare processes can be made to provide improved care in a more time and cost effective manner.

There is provided a system for the delivery of medicament comprising a medicament container; a dispensing mechanism for dispensing medicament from the medicament container; an electronic data management system; and a communicator for wireless communication with a network computer system to enable communication of data between the network computer system and the electronic data management system. The electronic data management system comprises a memory for storage of data; a microprocessor for performing operations on the data; and a transmitter for transmitting a signal relating to the data or the outcome of an operation on the data.

Disclosed herein are systems and methods for syndication and management of structured and unstructured data to assist institutional healthcare delivery, healthcare providers' practices, healthcare providers' group practices, collaborative academic research and decision making in healthcare, including through the utilization of medical devices and healthcare pools.

A method and system are provided for consolidating and distributing information. Implementation of system functionalities for both restricted local and unrestricted system-wide uses are permitted. Open standards for hardware, software and firmware components and standardized medical codes, definitions and formats are supported. The preferred embodiment of the invention provides an integrated health care system. The invention can also be used to allow secure access to Social Security, annuity, retirement account, and benefit information, allowing individuals a unified view of their benefit and payment status. A centralized host maintains, consolidates, and redistributes information generated at all networked locations. Information is electronically transferred among the system components to link an individual's local records to those stored remotely. The individual information device, centralized host computer, and any other computers or networks linked to the system can therefore be automatically updated. An individual information device stores a service recipient's insurance information, a emergency records and critical health care histories. This information is accessed by the system for use in managing any aspect of the service recipient's health care. Portable terminals can be used to access the system. A portable terminal can also be used independently from the system to perform health care functions. Unrestricted system-wide, or restricted local uses are supported. Insurance coverage for services and treatments can be determined and the information transmitted directly from the carrier(s) to the service recipient and service provider(s). Supported features include service authorization, messaging, diagnostic services,coverage determination, billing, and electronic payment.

Methods and systems for automatically establishing an enhanced electronic health record (EHR) for a patient include an automatic data collection facility that collects data of a medically related event in proximity to a patient upon occurrence of the event. The collected data may include medication administration data such as medication, time of administration, administration of a dosage of medication, reaction data, and the like. The collected data is communicated to a real-time data integration facility that automatically integrates the data with a patient's electronic health record to establish an enhanced electronic health record.

Method and system for providing a subscription based replenishment transaction of consumable items such as glucose test strips including a data network, a user terminal operatively coupled to the data network, the user terminal configured to receive and transmit data over the data network, and a server terminal operatively coupled to the data network, the server terminal configured to receive from the user terminal a request for establishing an account associated with a consumable item, receive from the user terminal one or more predetermined parameters associated with the account, and generate the account based on the one or more predetermined parameters, where the one or more predetermined parameters include a user specified consumable replenishment level received from the user terminal is disclosed.

Exemplary embodiments of the present invention provide a method of health insurance market risk assessment including receiving first data including demographic and cost data for members of a health insurance plan in a current market, receiving second data including demographic data for the current market, and receiving third data including demographic data for a new market. The first to third data are used to transform a distribution of the plan members to account for differences between the current and new market demographic data and to estimate probabilities of enrollment in the new market. A statistical model is learned to predict risk in the new market using the transformed distribution and the estimated probabilities. The statistical model is used to determine risk of entering the new market.

<heading lvl="0">Abstract of Disclosure< / heading> An integrated suite of services for consumers, service providers and manufacturers in the pharmaceutical industry is disclosed. The present invention utilizes one or more of the NCPDP standard formats and adopts the switch for an integrated system of, for example, instant adjudication of prescriptions, consumer data warehousing and / or incentive rewards for the consumer. A participating consumer with one card, can instantly purchase pharmaceuticals and charge the transaction to a credit card and earn and apply savings dollars redeemable for pharmaceutical purchases. For a participating service provider, instant adjudication and instant validation of consumer eligibility can be performed. Moreover, a service provider may receive messages related to the patient's medications. Significantly, data is recorded for consumers even when consumers make the pharmaceutical purchase with cash. The system includes a unique card issued to participating consumers. The card is adapted to encode conventional credit or debit card information specific to the participating consumer so that the consumer can consummate a transaction for the purchase of pharmaceuticals without possession of an additional credit card. The system further includes a host processor coupled to the point of sale at the service provider through a leased line or public switch network or the like. When a customer performs a pharmaceutical transaction at the point of sale of the service provider, the host processor coordinates any benefits and data with other prescription benefit management systems through messages transmitted and received from any primary or secondary carrier systems. The host processor further is adapted to facilitate real-time adjudication of claims and checks for any dangerous drug-to-drug interactions. The host processor additionally facilitates any financial processing including the accumulation and redemption of any bonus dollars earned by the consumer. Furthermore, since the card used by the consumer can be encoded with credit or debit card information, the host processor determines the desired payment method and performs the actual financial transaction. Even if the transaction at the point of sale is a cash purchase, the consumer may desire to use his unique card for the accrual of bonus dollars. Therefore, data concerning the transaction (i.e., pharmacy number, prescription number, etc.) can be recorded even for transactions conducted with cash.

A patient-centric system and method for accessing personal health records of a patient, stored in relational databases and containing comprehensive records of multiple patients with each patient's records incorporating many different data categories and functions including manual or automated data exchange, consolidation, storage, routing and transmission, consistent with consent directives assigned to authorized users and computer systems of authorized users by the patient or designated representative thereof. The consent directives define privileges of access in each of said data categories and functions within the patients records. The patients records are stored in relational databases hosted by Web servers on a computer network through which the authorized users interact under the control of programming logic consistent with the consent directives assigned by the patient or designated representative thereof.

A personal surgical center embodied as a general purpose computer (e.g. laptop) with wireless technology for monitoring the operation of an independent surgical center and / or handheld instruments. The computer tracks procedures in the operating room and instruments used during those procedures, and accounts for billing, supply management, and payment options. The monitoring of the instruments used during the surgery is conducted by the personal surgical center while actual control of the settings of those instruments is via the independent surgical center or via controls included in the instruments themselves. The monitored information is stored in a log file which is then transmitted to a hospital server for generating reports, inventory control, billing, and the like. Other information generated during the procedure (e.g. doctor notes) is also stored in the log file. The personal surgical center may also access the hospital server or local data storage device for retrieving a surgeon's specific surgery parameters, obtaining patient files, and the like.

A system and method for processing patient data permits physicians and other medical staff personnel to record, accurately and precisely, historical patient care information. An objective measure of a physician's rendered level of care, as described by a clinical status code, is automatically generated. Data elements used in the determination of the generated clinical status code include a level of history of the patient, a level of examination of the patient, a decision-making process of the physician treating the patient, and a "time influence factor." The quantity and quality of care information for a particular patient is enhanced allowing future care decisions for that patient to be based on a more complete medical history. Enhanced care information can be used in outcome studies to track the efficacy of specific treatment protocols. Archiving of patient information is done in a manner which allows reconstruction of the qualitative aspects of provided medical services. The medical care data can be recorded, saved, and transferred from a portable system to a larger stationary information or database system. Considerable physician and staff time are saved and precision and accuracy are significantly enhanced, by generating these clinical status codes automatically (at the point of service by the care-provider without any intermediary steps) from information recorded simultaneously with the provision of services.

An information management system for restricting access to personal data in compliance with law or regulation includes a database having restricted records stored therein, at least one of the records including an identification of a client or group of clients about whom said record concerns. A computer system under the control of a trusted information broker is configured to receive via a communication medium a request initiated by a requester for access to at least one of the restricted records in the database, the request including an identification of the requester. The computer system is further configured to transmit a request for consent to the client and receive an indication from the client that the client consents or does not consent to access to the restricted record by the requestor. The computer system grants or denies access to the restricted records based upon the indication from the client.

An integrated pharmacy system receives prescription information, creates a substitution reference list identifying the requested medical item and a plurality of equivalent medical items, automatically selects one of the items identified on the substitution reference list, fills the prescription, checks the accuracy of the filled prescription, facilitates the sales exchange, and creates an archive of the transaction, although not all steps need to be performed for every application. The integrated pharmacy system can also prevent unauthorized users from performing improper functions such as, for example, attempting to dispense an item which is not a proper substitute for the requested item. The present invention, by automatically substituting equivalent medical items for a requested medical item and by automatically archiving each prescription transaction, simplifies the prescription filling and record keeping requirements for the pharmacy technician and pharmacist.

A computer-implemented method, including processing, with a processor, a request by a person or entity to access, obtain, change, alter, or modify, an individual's or patient's healthcare record or file which contains healthcare information or healthcare-related information personal to the individual or patient, generating a message containing information regarding the person or entity and / or identification information regarding the person or entity, and containing an actual change, alteration, or modification, sought to be made or made to the individual's or patient's healthcare record or file, and transmitting the message to a communication device of the individual or patient during, concurrently with, at a same time as, or prior to a completion of, an accessing, obtaining, changing, altering, or modifying, of the individual's or patient's healthcare record or file or a processing of the request.

A security mediator, comprising an input configured to receive a user information request; an automated index, stored in a memory, configured to store information for determining which of a plurality of remote databases stores information responsive to the request; an automated security rule base, stored in a memory, containing rules applicable to information responsive to the request stored in the plurality of remote databases; a communication port configured to communicate to a plurality of remote databases which store information responsive to the request: security information, a query corresponding to the request and associated rules applicable to the information responsive to the request at the respective remote database; and at least one processor being configured to apply at least one security rule responsive to the query of the automated security rule base, and index information derived from a plurality of the remote databases, in a manner which permits application of the rules and which restricts insecure use of the index.

A system and method for displaying a health status of hospitalized patients. Patient data associated with hospitalized patients is selected according to display rules. A display module selects selected patient data, applies display rules to the selected patient data, and displays the selected patient data. A smart alert module generates and applies patient specific rules to other selected patient data elements. If a patient-specific rule for a hospitalized patient has been contravened, an alert is issued from the remote command center. Graphical attributes may be assigned to patients for whom an alert has been issued and to selected patient data elements that fall outside of an acceptable range. The graphical attributes determine how selected patient data appear on a display screen.

A system and methods is described for providing unified and secure centralizing information management to permit interoperability of disparate stakeholders in the healthcare industry access and update information under a common scheme thereby creating a more efficient delivery system for all the stakeholders such as patients, doctors, clinics, hospitals, insurance companies, pharmacies and related healthcare entities.

A method of using a dictionary of message codes related to health care information is provided. The message codes in the dictionary have corresponding message values. The method includes receiving at least one message value at a first device. The first device then generates at least one message code related to health care information from the at least one message value using corresponding message values from the dictionary. The method also includes transmitting the at least one message code over a payment processing network.

An integrated medical software system with embedded transcription functionality, and a method of using that system, is disclosed. The system includes a clinical software module that is configured to be executed by a processor to create an electronic document and to capture clinical data for a patient in the electronic document during an encounter with the patient. The system also includes a transcription software application that is configured to be executed by the processor to select predefined clinical data that will appear within the electronic document in response to speech commands and to automatically transcribe dictated clinical data that will appear within the electronic document in response to dictation, wherein the predefined clinical data being previously linked to at least one of a diagnosis code and a procedure code and the dictated clinical data being automatically linked to at least one of a diagnosis code and a procedure code as it is transcribed. And the system includes an account management software module that is configured to be executed by the processor to automatically generate at least one of a bill, a claim, or a statement for the patient using the at least one of a diagnosis code and a procedure code linked to at least one of the predefined clinical data and the dictated clinical data.

Current health parameters for a user are monitored at a personal health monitoring system. Current health parameters include multiple monitored physical parameters and multiple monitored environmental parameters. The current health parameters are compared with health allowances for the user. A control signal for transmission to a health control device that controls at least one parameter from among the multiple physical parameters and multiple environmental parameters is determined in response to determining that at least one of the current health parameters exceeds at least one of the health allowances, such that the at least one current health parameter that exceeds the at least one of the health allowances is adjusted by the health control device according to the control signal in order to balance the comprehensive health of the user.

A method for using a digital electrical apparatus to electrically process signals in generating output for insurance documentation, the method including the steps of: in a digital electrical computer apparatus comprising a digital computer having a processor, the processor electrically connected to a memory device for storing and retrieving operations including machine-readable signals in the memory device, to an input device for receiving input data and converting the input data into input electrical data, to a visual display unit for converting output electrical data into output having a visual presentation, to a printer for converting the output electrical data into printed documentation, wherein the processor is programmed to control the apparatus to receive the input data and to produce the output data by steps including: defining a plurality of patient categories; and for each of the categories, determining a periodic duration-specific insurance benefit amount for long-term care patients; the method further including the step of inserting the periodic duration-specific insurance benefit amounts in a long-term care insurance policy.

A software-based, integrated member decision support system provides a method for corporations, insurance carriers, health maintenance organizations, physicians, physician groups, or other clients to efficiently provide medical, pharmaceutical, and health benefit advice and information for an enrolled population. The system contains one or more databases which include member profiles, clinical information and guidelines, pharmaceutical information and guidelines, health benefit information, and optional additional information. A caller establishes communication with the system, which directs the caller to an operator who provides the caller with medical, pharmaceutical, and / or health benefit advice based on an inquiry from the caller and the information stored on the system. The system may automatically alert the caller or the operator of important medical or pharmaceutical information. At the conclusion of the call, the system or the system with the operator's input, may update the caller's member profile, request written materials, generate referrals, order prescriptions, or generate reports.

A method of verifying health insurance coverage eligibility for a patient includes receiving at a host computer system a message from a provider. The message includes a request for an eligibility and coverage information packet. The message identifies at least the patient and the provider. The method also includes using at least a portion of the information in the request to locate a payer associated with the patient and sending a message to a computing system of the payer. The message comprises a request to return to the host computer system the eligibility and coverage information packet. The method also includes receiving the eligibility and coverage information packet from the computing system of the payer and sending the packet to the provider.

A method for providing insurance coverage to a subscriber comprises offering an insurance policy to said subscriber wherein said insurance policy comprises providing allowances to pay for one or more expenses covered by said insurance policy and providing monetary credits to said subscriber for any unused portion of a given allowance where said monetary credits can be used to cover the cost of a subsequent allowed expense. The insurance policy may be a pharmacy benefits plan. The covered expenses may be pharmacy expenses. The allowed expenses may be medical expenses which qualify under section 213 of the US Internal Revenue code for payment by an employer without said subscriber having to declare said payment as taxable income.