Importance

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Abstract

A system (200) and method (400) for automatically handling health care claim status requests (228) and responses (232). The system includes a health care software application (246) that provides patient invoice functionality relating to health care claims submitted to various payers (216), e.g., insurance companies. A claim status transaction software module (258) includes a routing software sub-module (282) that intelligently routes responses received from payers within the system so that a variety of follow-up activities may be performed. The routing software sub-module routes the responses as a function of information contained in the responses. The system also includes a pre-checking software sub-module (272) that performs a variety of checks on each claim status request prior to the system sending that request. If a request fails a pre-check, the response can be automatically placed onto a follow-up list (296) for follow up.

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First Claim