WO2001027719A3 - Novel method and apparatus for repricing a reimbursement claim against a contract - Google Patents

Novel method and apparatus for repricing a reimbursement claim against a contract Download PDF

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Publication number
WO2001027719A3
WO2001027719A3 PCT/US2000/028455 US0028455W WO0127719A3 WO 2001027719 A3 WO2001027719 A3 WO 2001027719A3 US 0028455 W US0028455 W US 0028455W WO 0127719 A3 WO0127719 A3 WO 0127719A3
Authority
WO
WIPO (PCT)
Prior art keywords
contractual
terms
reimbursement
contract
matching
Prior art date
Application number
PCT/US2000/028455
Other languages
French (fr)
Other versions
WO2001027719A2 (en
WO2001027719B1 (en
Inventor
Dale Hoerle
Mark Lesswing
Original Assignee
Resource Information Man Syste
Dale Hoerle
Mark Lesswing
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Resource Information Man Syste, Dale Hoerle, Mark Lesswing filed Critical Resource Information Man Syste
Priority to AU80225/00A priority Critical patent/AU8022500A/en
Publication of WO2001027719A2 publication Critical patent/WO2001027719A2/en
Publication of WO2001027719A3 publication Critical patent/WO2001027719A3/en
Publication of WO2001027719B1 publication Critical patent/WO2001027719B1/en

Links

Classifications

    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/10—Office automation; Time management
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/04—Trading; Exchange, e.g. stocks, commodities, derivatives or currency exchange
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance

Abstract

A method for repricing a reimbursement claim under at least one contract is provided herein. The method includes converting each contract into a series of contractual terms, where each contractual term contains qualification codes, calculation codes and priority notes. The method then converts a claim into a series of claim lines, containing claim codes, unit numbers and corresponding charges for the claim codes (figure 8, items 104a, 104b) The method then begins to compare each claim code, of the claim, against each qualification code, of each contractual term, of a contract and when a qualification code, of a contractual term, is satisfied by a claim code, of a claim line, the method identifies the contractual term as a matching contractual term associated to the claim line (items 84a, 84b). Upon identifying all matching contractual terms, either to the claim line or the entire claim, the terms, and eliminate any priority conditions associated to the matching contractual terms, and eliminate any matching contractual terms that are excluded by the priority conditions. The method then calculates the reimbursement amount for the claim by determining the reimbursement charges for the non-excluded matching contractual terms. The method may then determine and make any adjustments depending upon any discount terms for the entire reimbursement amount.
PCT/US2000/028455 1999-10-14 2000-10-13 Novel method and apparatus for repricing a reimbursement claim against a contract WO2001027719A2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU80225/00A AU8022500A (en) 1999-10-14 2000-10-13 Novel method and apparatus for repricing a reimbursement claim against a contract

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US15930699P 1999-10-14 1999-10-14
US60/159,306 1999-10-14
US09/577,386 2000-05-23
US09/577,386 US7904317B1 (en) 1999-10-14 2000-05-23 Method and apparatus for repricing a reimbursement claim against a contract

Publications (3)

Publication Number Publication Date
WO2001027719A2 WO2001027719A2 (en) 2001-04-19
WO2001027719A3 true WO2001027719A3 (en) 2001-06-21
WO2001027719B1 WO2001027719B1 (en) 2001-11-08

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2000/028455 WO2001027719A2 (en) 1999-10-14 2000-10-13 Novel method and apparatus for repricing a reimbursement claim against a contract

Country Status (3)

Country Link
US (5) US7904317B1 (en)
AU (1) AU8022500A (en)
WO (1) WO2001027719A2 (en)

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Also Published As

Publication number Publication date
AU8022500A (en) 2001-04-23
US8666787B2 (en) 2014-03-04
US20120130754A1 (en) 2012-05-24
US20140067417A1 (en) 2014-03-06
US8160905B2 (en) 2012-04-17
WO2001027719A2 (en) 2001-04-19
US8407071B2 (en) 2013-03-26
US20130144648A1 (en) 2013-06-06
WO2001027719B1 (en) 2001-11-08
US7904317B1 (en) 2011-03-08
US20110153371A1 (en) 2011-06-23

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