Medical bill analysis and review
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United States of America Patent
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Dec 3, 2013
Issued Date -
N/A
app pub date -
May 9, 2005
filing date -
May 19, 2004
priority date (Note) -
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status (Latency Note)
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Abstract
A method and business technique for reviewing medical service provider bills, recalculating and providing payment recommendation to a paying party for the bills. The method includes analyzing medical bills and determining erroneous and inappropriate charges on bills. The method provides a payment recommendation using multiple databases and sophisticated mathematical modeling that includes one or more of the following: a medical service provider's actual cost of delivering the medical services provided; the average profit-margin of that provider, an average profit margin of comparable medical providers in an area, other industry-specific profit-margin benchmarks; an average acceptable payment by medical service providers in the area for comparable services; payment rates negotiated by large health insurers and managed care organizations; and other industry benchmarks for reasonable payment for comparable services.
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