WO2013163686A1 - Business system and method for health service recording, billing. processing and rebate claiming - Google Patents

Business system and method for health service recording, billing. processing and rebate claiming

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Publication number
WO2013163686A1
WO2013163686A1 PCT/AU2013/000446 AU2013000446W WO2013163686A1 WO 2013163686 A1 WO2013163686 A1 WO 2013163686A1 AU 2013000446 W AU2013000446 W AU 2013000446W WO 2013163686 A1 WO2013163686 A1 WO 2013163686A1
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WO
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Application
Patent type
Prior art keywords
data
service
patient
health
processing
Prior art date
Application number
PCT/AU2013/000446
Other languages
French (fr)
Inventor
Margaret FAUX
Original Assignee
Margaret Faux Ip Pty Ltd
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

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Classifications

    • GPHYSICS
    • G06COMPUTING; CALCULATING; COUNTING
    • G06QDATA PROCESSING SYSTEMS OR METHODS, SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTING PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTING PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q30/00Commerce, e.g. shopping or e-commerce
    • G06Q30/04Billing or invoicing, e.g. tax processing in connection with a sale
    • GPHYSICS
    • G06COMPUTING; CALCULATING; COUNTING
    • G06FELECTRIC DIGITAL DATA PROCESSING
    • G06F19/00Digital computing or data processing equipment or methods, specially adapted for specific applications
    • G06F19/30Medical informatics, i.e. computer-based analysis or dissemination of patient or disease data
    • G06F19/32Medical data management, e.g. systems or protocols for archival or communication of medical images, computerised patient records or computerised general medical references
    • G06F19/328Health insurance management, e.g. payments or protection against fraud
    • GPHYSICS
    • G06COMPUTING; CALCULATING; COUNTING
    • G06QDATA PROCESSING SYSTEMS OR METHODS, SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTING PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTING PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q50/00Systems or methods specially adapted for specific business sectors, e.g. utilities or tourism
    • G06Q50/10Services
    • G06Q50/22Social work

Abstract

A method for conducting business which allows immediate billing of health service recipient consultations provided by at least one health service provider. The method comprises the steps of; a) providing the health service provider with an electronic device capable of collection of patient and health service consultation billing data; b) performing a health service for one or more patients; c) entering/inputting into the electronic device, new data into a newly established or existing data base of patient data for a potentially unlimited number of patients; d) uploading the collected patient and related health service data via a link to a remote receiving station for processing the data; e) establishing communication between the receiving station and a payment processing body; and f) making a payment to the health service provider from the payment processing body based on the health service provided to the patient by the health service provider.

Description

BUSINESS SYSTEM AND METHOD FOR HEALTH SERVICE RECORDING, BILLING. PROCESSING AND REBATE CLAIMING

BACKGROUND

[0001 ] The present invention relates to methods of doing business and more particularly relates to a business system and method for medical, health, health related and allied medical service billing. The present invention also relates to methods of doing business and to a business system in which a claim for claimable health and health related services can be processed by a practitioner communicating with a payment processing authority for processing and paying a claimable payment once a medical, health, health related or allied medical service is provided. More particularly the business system relates to automated billing to reduce the manual labour and steps in effecting billing during routine medical rounds in hospitals and while providing any claimable health or health related claimable service either inside or outside a hospital environment.

[0002] The present invention further relates to a business system in which a medical practitioner is able to efficiently establish billing of patients according to a system which eliminates or at least reduces the steps involved in the establishment of and transmission of patient billing for medical services.

[0003] The present invention further provides a method of billing patient services initiated at a point of provision of a medical service, using software to reduce manual steps to initiate and establish medical service billing.

PRIOR ART

[0004] Medical service billing is an involved process in public hospitals, private hospitals and in locations where health and health related claimable services are provided as there is a necessary connection health insurers in association with governments which regulate rebates and sets fees for services. When doctors and allied health processionals provide medical services to private patients, there is a providers fee and a scheduled fee set by government for a particular service. As an example, the current health and medical billing process for private hospital consultations with inpatients typically involves the following steps:

a doctor receives a written referral to sec a patient following which the doctor is authorised to consult with the patient in the ward. Typically one doctor will have a large number of patient consultations each day which involves a large amount of paperwork to complete billing for each service.

[0005] Usually the doctor will have many patients on the ward under his/her care at any one time and will do regular ward rounds to review all of his/her patients . At the completion of the ward round (whether having reviewed one or twenty patients) the doctor will spend time at the nurses station (or a location dedicated as a central area where patents files can be accessed), to write clinical notes in the patient file. After writing the clinical notes the doctor will take a sticker for each patient, which is usually located on the front of the patient's file. The stickers are also called Bradmar labels or patient labels. Either at home, later or sometimes while still on the ward, the doctor will peel off the backing and place a sticker for each patient, one under the other, down the left side of a piece of A4 paper. Sometimes the doctor's billing service / secretary will provide custom consultation sheets indicating where the stickers should be placed. The doctor then hand writes additional information next to each sticker - all of which is legally required under the relevant legislation to generate a medical claim. The additional information includes; a) The name and provider number of the referring doctor;

b) The referral date;

c) The MBS item numbers corresponding to the service provided. [For

Australia, MBS is the Medicare Benefits Schedule - Federal Government schedule updated 1 November annually with CPI based fee increases.]

d) For anaesthetists, the start and finish times of the anaesthetic;

e) For neonatal paediatricians, the mothers name and contact details; 0 Various other details depending on the nature of the particular services provided and the corresponding rules and regulations for that service.

[0006] The doctor will then provide the completed consultation sheets to the relevant person who will process the claims. The most common methods of passing this information are ordinary mail, fax or email. Email has the disadvantage that it is unencrypted and does not meet health privacy legislation requirements and medical billing records fall within the ambit of that legislation. In the case of outpatients and services provided by allied health professionals the information required by the government and payment processing organisations is essentially the same general content as that required of a medical practitioner. There is a reduction in the number of processing steps when claims are made for services provided outside hospitals.

[0007] Once the consultation details are received by the assigned person who will generate the claims, another process begins. To generate claims electronically it is currently a legal requirement to use Medicare compliant software which doctors and hospitals licence from various approved software vendors. Many practitioners still process their claims manually by creating invoices and posting them to the funds and Medicare and patients. This makes the billing and claim process time consuming and labour intensive for the task.

[0008] In a case where operating software is being used, the process begins with data entry. The minimum data that must be entered is the patients' first name, last name, address, date of birth, Medicare number including the reference number and expiry date, health fund name, health fund membership number, the referring doctors' name and provider number, the referral period and the referral date. [Only the health fund details are not necessary for outpatients. J Then this data goes through an online verification process to check that all details are correct. Incorrect details must be manually fixed before a claim can be generated. Once the patient demographic data is verified correctly the processing person then creates the claim by entering the type of billing (bulk bill, no-gap claim, known-gap claim, direct to patient claim), the date of service and the item numbers. Once all claims have been processed, the processing person will usually cross check the claims against the doctprs' original consultation records before sending. This is a critical step as doctors and other authorised allied health and health related service providers are legally responsible for the item numbers claimed under their name and provider number and there are serious professional consequences and financial penalties for incorrect claiming. Once finalised the claims can be transmitted and / or manually sent.

[0009] In the case of hospital bed consultations by Doctors, the Doctors typically collect patient stickers or collect demographic data in an alternative manual form from the hospitals and pass this information to the person or organisation that will then process the claims and transmit the data to for example the Australian department of Medicare, Veterans Affairs and the Private Health funds. Because existing systems are manual, there are significant human resource requirements and it is therefore expensive. It can be seen from the above processing steps that medical billing is an involved and time consuming process. There is currently no claims and payment system other than the manual system which causes time consuming billing which cannot be done concurrently at time of service.

[0010] Currently there is no business model, apparatus or method which provides efficient medical service billing by removing many of the manual steps described above associated with medical billing. There is a need to address the aforesaid problems in order to increase efficiency of medical billing and to provide an alternative to the known methods and to reduce the time and labour in current billing processing. .

INVENTION

[0011] The present invention provides an alternative to the known largely manual billing systems and more particularly provides a business system for collecting and transmitting patient data for billing and other purposes. The present invention also provides improved methods for health and medical service billing. More particularly the business system provides for automated billing to reduce the manual labour and steps in effecting billing during routine medical rounds both in and outside hospitals and when allied health services are provided to recipients. The present invention further provides a business system in which a medical service practitioner and a wide variety of health service providers authorised to claim payment from a processing authority is able to efficiently establish billing of patients according to a system which eliminates or at least reduces the steps involved in the establishment of and transmission of patient billing for medical, allied health and related services.

[0012] The present invention further provides a method of billing patient services initiated at a point of provision of a medical service, using software to reduce manual steps to initiate and establish medical service billing.

[0013] In attempting to ameliorate or eliminate the prior art problems identified above, and to provide an alternative to known business systems, the present invention seeks to provide a more efficient method of hospital patient billing by reducing time and labour in making claims following consultations.

[0014] It i:> an object of the present invention to increase the efficiency of payment of health service claims and particularly though not limited to for doctors in hospitals by reducing reliance on manual steps in billing and streamlining the billing process. [0015] In one broadest form the present invention comprises; a business system for billing of hospital patient consultations provided by at least one medical service provider and submitting billing claims; the system comprising the following steps; providing the medical service provider with an electronic device capable of collection of patient and medical consultation billing data; entering/inputting new data into a newly established or existing data base of patient data in the electronic device for a potentially unlimited number of patients; uploading the collected patient and related data to a receiving station for data processing; the receiving station communicating with a payment processing body to render payment for services provided by the medical service provider.

[001 6] According to a preferred embodiment the data processing station is a centralised provider which processes uploaded data and after a checking process uploads the consultation data to a health fund for payment to the originating medical service provider

[0017] According to one embodiment the electronic device for medical service data input is a computer. In an alternative embodiment the electronic device is a mobile phone having an application for processing medical service input data, in a further embodiment the electronic input device is an ipad or mobile tablet.

[0018] According to one embodiment a medical practitioner scans a patient tag at the patient's bedside whereupon the data scanned Is delivered /uploaded to a receiving station which processes the data for uploading to a health insurer or government authority responsible for rebates or payments.

[0019] In another broad form the present invention comprises a business system enabling automated data collection and billing of hospital patient and outpatient consultations provided by at least one medical service provider; the system comprising the following steps; providing the medical service provider with an electronic device capable of receiving scanned data collected at a patient location related to patient consultations; entering/inputting scanned data into a nevvly established or existing data base of patient data via in the electronic device for a potentially unlimited number of patients; uploading the collected patient and related data to a health insurer or payment processing body to process automatic payment for medical services provided by the medical service provider after a verification process.

[0020] In another broad form the present invention comprises: an assembly for collecting and downloading data related to the provision of medical services by a medical service provider at a patient consultation, the assembly comprising; a data input device capable of receiving, processing and storing data related to a patient medical service provider consultation; means associated with the device to upload the medical service and related data to a first data receiving station; means at the first data receiving station to process receive, store and verify accuracy of data particulars and parameters; means at the first receiving station to communicate with a second receiving station for processing fee for service payments to said medical services providers based on a predetermined payment schedule.

[0021 ] The present invention eliminates the prior art systems which are personnel based and use manual steps for patient identification and data input. The invention also provides a portable assembly or kit for use by a health practitioner to initiate billing at the point of patient consultation, thereby eliminating the numerous manual steps in the current process.

[0022] The portable data collection system is user friendly and convenient for a practitioner, eliminates duplication of inputs and allows retention of patient data for access at the point of the consultation in a local area device carried by the practitioner. The portable electronic device minimises the numbers of steps to generate billing data for down line processing and payment and reduces errors by reduction of the number of processing and input steps. The pathway to payment processing is wireless, more accurate, faster and eliminates the prior art bureaucratic steps in setting up of billing data and the multiple hand in manual processing. The electronic portable system allows integration with the relevant national health payment system and its coding databases such as that distributed annually by Medicare Australia. It will be appreciated by persons skilled in the art that the system and enabling apparatus and software is adaptable to the regulatory framework and legislation for a particular jurisdiction. For example in Australia the Medicare regime and its associated regulatory framework sets the schedules and rules for medical billing for Doctors and Hospitals and allied health professionals. The enabling app can be integrated with the national medical billing coding tables of all healthcare systems.

[0023] In another broad form of a method aspect the present invention comprises:

a method for initiating billing for health service consultations, the method comprising the steps of:

a) providing a patient tag at a patient location such as in in a hospital or clinic; b) providing a portable electronic device for use by a health service provider to read, store and process data from said patient tag.

c) uploading data read from said tag to a first receiving station for verification of data and testing for compliance with a predetermined minimum data criteria; d) after verificatic-n of data uploaded to said first processing station, uploading said data to a second processing station;

e) processing automatic payments at the second station after verification of compliance of input data.

[0024] In another broad form the present invention comprises:

a method for conducting business which allows immediate billing of patient consultations provided by at least one health service provider; the method comprising the steps of; a) providing the health service provider with an electronic device capable of collection of patient and health service consultation and/or billing data; b) performing a claimable health service for one or more patients; c) entering/inputting into the electronic device, new data into a, newly established or existing data base of patient data for a potentially unlimited number of patients; d) uploading the collected patient and related health service data via a link to a remote receiving station for processing the data; e) establishing communication between the receiving station and a payment processing body; and f) making a payment to the health service provider from the payment processing body based on the claimable service provided to the patient by the medical service provider.

[0025] In another broad form according to an apparatus aspect, the present invention comprises;

a computer software application in a portable electronic device for use in remote billing of a health service provided to or for a hospital patient, outpatient or other recipient of a claimable health service; the application in the electronic device capable of receiving, storing, processing, altering, updating, amending data input, regarding patient health and account status and particulars, wherein the application allows a provider to input data into the application preloaded into an electronic device such as a phone, ipad, computer, television or tablet; the application allowing received data to be uploaded to a first processing station for data processing including data verification and checking, uploading the verified data to a second processing station, the second processing station enabling payment of the practitioner for said health service according to a predetermined payment schedule.

[0026] The present invention provides an alternative to the known prior art and the shortcomings identified. The foregoing and other objects and advantages will appear from the description to follow. In the description reference is made to the accompanying representations, which forms a part hereof, and in which is shown by way of illustration specific embodiments in which the invention may be practiced. These embodiments will be described in sufficient detail to enable those skilled in the art to practice the invention, and it is to be understood that other embodiments may be utilised and that structural changes may be made without departing from the scope of the invention. The following detailed description is, therefore, not to be taken in a limiting sense, and the scope of the present invention is best defined by the appended claims.

DETAILED DESCRIPTION

[0027] The present invention will now be described in more detail according to a preferred but non limiting embodiment and with reference to the accompanying illustration wherein;

Figure 1 shows a schematic layout of the system steps at the point of local data capture according to a preferred embodiment, s [0028] Throughout the specification a reference to billing can be taken to man a reference to invoicing and charging a fee for performing a service. A medical service can be taken to mean a surgical, pathological, medical or diagnostic service performed on a patient. A claimable health service is one that entitles a service provider to receive a payment based on a claim for providing a service included on a specified schedule associated with the payment processing authority (private or government) from which the payment is claimed and then paid. Throughout the specification a reference to the term app can be taken to mean a reference to software whether proprietary or specific for the purpose of initiating billing upon provision of a health service. The term medical practitioner or Doctor can be taken to mean and person who provides a medical or related service which allows billing through a fee processing body such as a health fund or government health department. The term health service provider can be taken to mean any person qualified or otherwise who provides a health service including a claimable service drawn from the health service areas of: A non who provider health services drawn fro the following non exhaustive list of health services and who can apply the app to their particular filed of claimable healthcare practice including: physiotherapists, dietitions, nurse practitioners, psychologists, social workers, occupational therapists, aboriginal health workers, exercise physiologists, speech pathologists, podiatrists, mid wives, dentists, veterinary scientists, pharmacists, general practitioners. Payment processing authorities include health funds, dental benefits schemes, veterinary insurance schemes, governments backed health rebate schemes such as Medicare in Australia according to its current or future modified form. Medicare for instance has stopped the use of bulk bill vouchers. This system acts as a replacement which can be supported by medicare who itself desires to reduce the high cots of processing manual claims. The present invention described herein accommodates objective which aim to reduce paperwork, manual handling and administrative processing. [0029] The examples referred to herein are illustrative and are not to be regarded as limiting the scope of the invention. While various embodiments of the invention have been described herein, it will be appreciated that these are capable of modification, and therefore the disclosures herein arc not to be construed as limiting of the precise details set forth, but to avail such changes and alterations as fall within the purview of the description. Although the method and apparatus aspects of the invention will be described with reference to their application to medical consultation billing, it will be appreciated that the invention has alternative applications. Although the invention and non limiting embodiments are described herein with particular reference to a medical practitioner (doctor) providing a service to a patient in a hospital (followed by invoicing to a payment authority and subsequent payment) the system and associated computer application can be adapted for use by a variety of allied health service practitioners, including veterinary practitioners, in a variety of locations who are able to provide a claimable health or health related service.

[0030] Referring to figure 1 there is shown a typical hospital room setting 1 in which a patient 2 lies on a bed 3 and is surrounded by health professionals 4, 5 who perform services on behalf of the patient 2. Each medical service provider 4, 5 are provided with an electronic device 6, 7 respectively capable of collection and/or storage of and/or processing of and/or uploading of patient data related to the provision of medical services and including patient data related to medical consultation and service billing. Typically practitioner 4 will provide a service for patient 2 . Once a medical service has been provided to patient 2, medical practitioner 4 ( or his assistant) inputs patient data into electronic device 7. As shown in figure 1 electronic device 7 may be an ipad 8, computer terminal 9, iphone 10 or table 1 1 .

[0031 ] An app may be downloaded to devices which accommodate apps such as the ipad 8 and iphone 10 and tablet 1 1. Where computer terminal 9 is used for input the computer will also have enabling data processing software. A readable tag 12 including patient data may also be located at the patient bed 3 to facilitate input of patient identity data or other patient related data. Data can be added to tag 12 or the tag can be scanned to upload patient data. Tag 12 may have existing data or may be programmed with new patient data as required. Data from a potentially unlimited number of patients may be entered into the electronic device. Tag 12 may have its own barcode which relates to a The data con be new data or newly established or augmenting existing data bases of patient data. Once collected by manual input, reading or scanning, it is uploaded via a link 1 3 to a remote receiving station 14 for data processing. Receiving station may be located in a hospital or remote from the setting 1 at which billable services are performed. A link is established between remote receiving station 14 and a payment processing body 15 located remotely. Payment processing body 15 is an organisation such as a health liind or government authority responsible for payment of medical practitioner claims. Payment processing body 15 makes a payment to the medical service provider 16 once processing of the claim is completed. In this way payments can be effected almost instantaneously in real time but even if there is a delay, payment will be made automatically when processed. Receiving station 14 performs the step of checking and verifying uploaded patient and medical service data. Link 17 enables remote receiving station 14 which is either at a hospital or at a remote location to communicate back to the service provider in the event for instance that inaccurate information has been uploaded from setting I .

[0032] Station 14 may be accessed by the electronic device 7 via a wireless or adsl router . Λ plurality of servers like station Ϊ 4 may be used on site at the hospital or at a location remote from the hospital. Alternatively the processing servicer station may be accessed via cloud technology accessible by user ID and password.

[0033] According to a preferred embodiment the system is integrated with an application (computer app) which facilitates expedient establishment of records, recall of existing records and processing of billing and submission of billing claims. A consumer obtains an app which can be provided free as part of the business package. The app may include data such as, but not limited to, billing coding, medical benefits schedule of fees and integrated listing of health funds. When a computer app is used it allows interactive communications between the processing station 14 and the payment authority 1 5.

[0034] An initial screen invites a user to enter new data related to a patient consultation and other data such as a photo of the patient, the referring doctor, ancillary material such as patient status, treatment and requirements. If a patient has already been established in the data base the screen will invite input of the patient identity and show the patient profile including past billing history, date of provision of services and referring doctor. The current invoicing cycle for the current consultation is added to the patient data.

[0035] The associated app allows a user to import doctor and patient listings and adds to the data base list each time a new patient is consulted, new doctors and new patients to an existing list.

[0036] An advantage of the present invention is that a medical practitioner or other allied health service provider can initiate billing at a time of service so as to minimise errors or omissions and increase their remuneration through better efficiency and reduced billing leakage. A further advantage is that the costs of processing are minimised so that will allow medical billing companies and agents to keep costs to a minimum and to enhance profits. This will reduce the costs to public hospital revenue departments who employ staff to perform those manual tasks. A further advantage is that the system makes the passage of payments to doctors and allied health professionals more efficient thereby improving cash flow, minimising interest charges and the costs of credit for doctors. A further advantage of the present invention is that it reduces errors which currently cost the health budget millions each year as the electronic apparatus allows reduced human contact with the data collection and processing, hence a reduced error rate. As a result, the less people touching the data means less errors and reduced human resource costs. A further advantage of the system is that it protects privacy and acts as an aide memoire to assist doctors to see all patients that require attention or are currently under their care.

[0037] As an example, typically a doctor will attend a patient in a hospital and perform a service for a scheduled fee which must ultimately be recovered. It collects patient data and medical billing data, which is essential to the 1 processing of private practice claims for both individual medical practitioners and hospitals. The practitioners fill in a datasheet on their phone, portable computer, ipad, tablet or like device and send it electronically to synapse who process it so the doctors can get paid for their work by insurers and Medicare. This replaces the current manual entry systems used by doctors and hospitals. The practitioner can input data into the electronic device by manual input or scanning a patient tag including patient data. Once the data is in the electronic data storage device, the data is delivered directly to an online provider which can check and as required further process the data for uploading to in the case of the Australian system a health insurer or direct to Medicare. The aforesaid process avoids the short comings of the prior art processing which involves multiple personnel and weeks and even months of processing. This removes the current use of unsecure emailing, manual inputs and processing, faxing or ordinary mailing of claims.

[0038] The system allows the doctors to receive and store have portable data regarding their current patients and their attendances, financial data relating to their attendances and details regarding the patients' basic demographics. The enabling app allows billing to be done at time of service make it more efficient accurate, cost effective and versatile. The pathway to payment processing is wireless, more accurate, faster and eliminates the prior ait bureaucratic steps in setting up of billing data and the multiple hand in manual processing. [0039] The present invention streamlines and fully integrates a data process that is critical to the operation of all private medical and allied health care practice globally. This relates to both the private practice of individual doctors as well as private patients being seen in public hospitals and for whom the hospital will collect the relevant private revenue and allied health service providers. The cost saving to the national health expenditure as a result of the system according to the invention is substantial.

[0040] A major advantage is the time saving and portability of the data and equipment used to process data. Use of electronic data input removes the need to carry bundles of papers, stickers and forms and removes the need for after hours processing of manually recorded data for later submission for billing. Accurate data input removes billing leakage and captures all items which can be legitimately billed which avoid unwanted omissions to bill some services performed. This ensures that doctors, allied health professionals and other professions are paid for all services provided and that none are lost in a cumbersome manual system prone to error. Also the risk of making servicing errors are minimised so that the practitioner is less likely to come to the attention of regulatory bodies for errors in billings.

[004 ] J It should be understood that various changes and modifications to the presently preferred embodiments described herein will be apparent to those skilled in the art. Such changes and modifications can be made without departing from the spirit and scope of the present subject matter and without diminishing its intended advantages. It is therefore intended that such changes and modifications be covered by the appended claims.

Claims

THE CLA IMS DEFINING THE INVENTION ARE AS FOLLOWS
I . A method for conducting business which allows immediate billing of patient consultations provided by at least one health service provider; the method comprising the steps of; a) providing the health service provider with an electronic device capable of collection of patient and health service consultation and/or billing data; b) performing a claimable health service for one or more patients; c) entering/inputting into the electronic device, new data into a newly established or existing data base of patient data for a potentially unlimited number of patients; d) uploading the collected patient and related health service data via a link to a remote receiving station for processing the data; e) establishing communication between the receiving station and a payment processing body; and f) making a payment to the health service provider from the payment processing body based on the claimable service provided to the patient by the medical service provider.
2. A method according to claim I wherein the remote receiving station for processing said uploaded data is a centralised provider
3. A method according to claim 2 wherein the centralised provider performs the step of checking the uploaded data
4. A method according to claim 3 wherein after said checking step the centralised provider uploads the service data to the processing body.
5. A method according to claim 4 wherein said health fund provides payment to the medical service provider.
6. A method according to claim 5 wherein said payment to said medical service provider takes place in real time.
7. A method according to claim 6 comprising the further step of providing a readable patient tag containing patient data.
8. A method according to claim 7 comprising the further step of scanning the patient tag at the patient's location to enable transmission of patient data to the receiving station.
9. A method according to claim 8 wherein the payment body receives data from the data tag related to a patient to enable payment of a fee for service provided by the health service provider.
10. A method according to claim 9 wherein the payment body is a health insurer or government authority responsible for rebates or payments to health service providers.
1 1. A method according to claim 10 wherein said payment to said provider is effected within the same day as the service is provided.
12. A method according to claim 1 1 comprising the further step prior to performing the health service to the patient, of loading enabling software into said electronic device to facilitate said data processing between the health service provider and the payment body.
13. A method according to claim 12 wherein the enabling software is contained in a downloadable application.
14. A method according to claim 13 wherein the electronic device enables direct interaction in real time between the health service provider and the payment authority once the claimable service has been provided to a patient.
15. A method according to claim 14 wherein the electronic device which receives and uploads patient consultation data comprises a computer.
16. A method according to claim 14 wherein the electronic device which receives and uploads patient consultation data comprises a mobile phone.
17. A method according to claim 14 wherein the electronic device which receives and uploads patient consultation data comprises an iphone.
18. A method according to claim 14 wherein the electronic device which receives and uploads patient consultation data comprises a smart phone
19. A method according to claim 14 wherein the electronic device which receives and uploads patient consultation data comprises an ipad
20. Λ method according to claim 14 wherein the electronic device which receives and uploads patient consultation data comprises a mobile tablet.
21 . A method according to claim 14 wherein the health service provided is selected from one or more of the following health service areas: medicine, surgery, physiotherapy, dietitions, nurse practitioners, psychology social works, occupational therapy, aboriginal health work, exercise physiology, speech pathology, diagnostics, podiatrists, mid wifery, dentistry, veterinary science, pharmacy, general practitioners, hospital patients and outpatients.
22. A method according to claim 14 wherein the payment processing authority is a health fund, dental benefits body, veterinary insurance body, government.
23. A method according to claim 14 wherein the software application is capable of receiving, storing, processing, altering, updating, amending data input regarding patient health status and particular
24. A method of conducting business in which there is provided automated data collection and billing of patient consultations and health care services provided by at least one health service provider; the method comprising the following steps; a) providing the health service provider with an electronic device capable of receiving scanned data collected at a patient location related to patient consultations and services provided; b) providing an enabling computer software program on the electronic device to enable interactive communications between the medical service provider and a payment processing body; c) entering/inputting scanned data into a newly established or existing data base of patient data via the electronic device for a potentially unlimited number of patients; d) uploading the collected patient and related data to a health insurer or the payment processing body to process automatic payment for claimable medical, health and allied health services provided by the service provider after a verification process. λ
25. A method according to claim 24 wherein the portable data collection device allows local area communications and eliminates duplication of inputs and allows retention of patient data lor access at the point of the patient consultation.
26. A method according to claim 25 wherein the electronic portable device al lows integration with the payment processing body and interactive identification of a service provider.
27. A method according to claim 26 wherein an enabling software app allows said integration with national health service billing coding tables of all healthcare systems.
28. A method according to claim 27 wherein the software application is capable of receiving, storing, processing, altering, updating, amending data input regarding patient health status and particular.
29. A method according to claim 28 wherein communications between the medical service provider and the payment processing health authority is wireless.
30. A method for initiating billing for health service consultations, the method comprising the steps of:
a) providing a patient tag at a patient location in a hospital or clinic; b) providing a portable electronic device for use by a health service provider to read, store and process data from said patient tag. c) uploading data read from said tag to a first receiving station for verification of data and testing for compliance with a predetermined minimum data criteria;
d) after verification of data uploaded to said first processing station, uploading said data to a second processing station;
e) processing automatic payments at the second station after verification of compliance of input data.
31. A method according to claim 30 comprising the further step after veri fication of input data, of making a payment according to a predetermined payment schedule to the health service provider.
32. A system for collecting and uploading data related to the provision of medical services by a medical service provider at a patient consultation location, the system comprising; an electronic data input device operable by a health practitioner at a patient location and capable of receiving, processing and storing data related to a patient medical service provider consultation; the device enabling transmission of input data related to the medical service and related billing data to a first data receiving station; the receiving station allowing processing of said patient data for storing and accuracy verification of data received by the receiving station; a communication link between said receiving and processing station to enable communication with a second receiving station for processing fee for service payments to said medical services providers based on a predetermined payment schedule.
33. A system according to claim 32 further comprising a readable electronic tag at the location of the patient to enable input from said tag of patient data.
34. A system according to claim 33 wherein the electronic device is selected from a computer, ipad, iphone, or tablet.
35. A computer software application in a portable electronic device for use in remote billing of a health service provided to or for a hospital patient, outpatient or other recipient of a claimable health serv ice; the application in the electronic device capable of receiving, storing, processing, altering, updating, amending data input regarding patient health and account status and particulars, wherein the application allows a provider to input data into the application preloaded into an electronic device such as a phone, ipad, computer, television or tablet; the application allowing received data to be uploaded to a first processing station for data processing including data verification and checking, uploading the verified data to a second processing station, the second processing station enabling payment of the practitioner for said health service according to a predetermined payment schedule.
PCT/AU2013/000446 2012-05-01 2013-05-01 Business system and method for health service recording, billing. processing and rebate claiming WO2013163686A1 (en)

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