Systems And Methods For Health Insurance Claim Processing
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United States of America Patent
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app pub date -
Jul 28, 2011
filing date -
Jul 28, 2010
priority date (Note) -
Abandoned
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Abstract
A method of processing health insurance claims includes receiving, within a claim receiver, a claim submission from a client, the claim submission identifying a policy of the client and details of the health insurance claim. The claim receiver converts, within the claim receiver, the claim submission into a claim charge to facilitate automated processing of the health insurance claim. The claim charge is validated against one or more validation rules to the identify zero, one, or more claim validation exceptions. The validation exceptions are resolved and the claim submission is settled if the validated claim charge and any remaining validation exceptions conform to settlement control data.
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