WO2017075207A1 - Système et procédé d'assurance pour animaux de compagnie - Google Patents

Système et procédé d'assurance pour animaux de compagnie Download PDF

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Publication number
WO2017075207A1
WO2017075207A1 PCT/US2016/059095 US2016059095W WO2017075207A1 WO 2017075207 A1 WO2017075207 A1 WO 2017075207A1 US 2016059095 W US2016059095 W US 2016059095W WO 2017075207 A1 WO2017075207 A1 WO 2017075207A1
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WIPO (PCT)
Prior art keywords
component
insurance
pet
backend
veterinary practice
Prior art date
Application number
PCT/US2016/059095
Other languages
English (en)
Inventor
DVM Kerri E. MARSHALL
Darryl Rawlings
Kathryn Plowman
Chris Cappelletti
Original Assignee
Trupanion Inc.
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
Priority claimed from US14/924,606 external-priority patent/US10013530B2/en
Application filed by Trupanion Inc. filed Critical Trupanion Inc.
Publication of WO2017075207A1 publication Critical patent/WO2017075207A1/fr

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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
    • G06Q40/08—Insurance
    • 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
    • G06Q50/00—Information and communication technology [ICT] specially adapted for implementation of business processes of specific business sectors, e.g. utilities or tourism
    • G06Q50/02—Agriculture; Fishing; Forestry; Mining

Definitions

  • Veterinary hospitals provide many medical services during the course of caring for a patient.
  • Pet insurance is one of these many services.
  • patients have health problems that require veterinary care above and beyond what a pet owner is prepared to pay out-of-pocket at the time services are provided, even when they have pet insurance coverage.
  • the pet owner files a claim after leaving the veterinary practice and receives notice of coverage, eligibility and payment, if applicable, from the insurance company.
  • Figure 1 is a diagram of an implementation of a pet medical insurance system
  • FIG. 1 illustrates more details of the pet medical insurance system
  • Figure 3 illustrates an example of a user interface of the pet medical insurance system
  • Figure 4 illustrates a method of interacting with hospital appointment information and providing insurance action options
  • Figure 5 illustrates an example of a user interface of appointment data and insurance interaction
  • Figure 6 illustrates a method for offering insurance, tracking insurance offers, and providing insurance coverage and eligibility details
  • Figure 7 illustrates an example of a user interface for offering pet insurance coverage to a pet owner
  • Figures 8 A and 8B illustrate an example of a user interface for tracking insurance offers
  • Figure 9 illustrates an example of a user interface displaying the status of a particular pet's medical insurance coverage and eligibility
  • Figure 10 illustrates a method for requesting and receiving medical record information
  • Figures 11 A and 1 IB illustrates an example of a user interface for medical records requests
  • Figures 12A and 12B illustrates an example of a user interface for completing medical records requests
  • Figure 13 illustrates a method for submitting and processing a claim in the pet insurance system
  • Figures 14A and 14B illustrate an example of a user interface for submitting claims in the pet insurance system
  • Figure 15 illustrates an example of a user interface indicating claims outcomes
  • Figure 16 illustrates an example of a user interface for claims submission and payment tracking.
  • the disclosure is particularly applicable to a cloud computing architecture pet insurance system and it is in this context that the disclosure will be described. It will be appreciated, however, that the system and method has greater utility.
  • a pet owner is a guardian of the pet and could be the pet owner, pet sitter, or similar pet guardian.
  • a patient refers to an animal being treated by a veterinary practice.
  • a patient also may be referred to as "pet”.
  • a veterinary practice refers to a hospital, clinic or similar where services are provided for an animal.
  • FIG 1 is a diagram of an implementation of pet insurance system (100).
  • the implementation in Figure 1 is cloud computing architecture.
  • the system may be implemented in a client/server architecture, a mainframe architecture, a software as a service model and the like, all of which are within the scope of this disclosure.
  • the system may include one or more computing devices (102) and each computing device may be used by a pet owner to connect to and interact with the pet insurance backend component (106) over a communication path (108).
  • the system may also have one or more computing devices (104), such as 104A, 104N and each computing device may be used by (or integrated into) a veterinary practice and allow the veterinary practice to interact with a pet insurance backend component (106) or the communications path (108).
  • Each computing device (102, 104) may be a processor based device with storage, memory, a display and wireless or wired connectivity circuits that allow the computing device (102, 104) to interact with the backend component (106).
  • each computing device may be a smartphone device, such as a device operating using the iOS, Android or Symbian operating systems, a personal computer, a client server system, a terminal, a tablet computer, a cellular phone and any other device that would be capable of interacting with the backend component (106).
  • each of the computing device 104 may have a data integration agent (200) and a client (201) that interacts with the backend component (106).
  • the data integration agent (200) and the client (201) may be a plurality of lines of code executed by the processor of the computing device.
  • each of the computing device 102, 104 may have a browser that interacts with the backend component (106), displays web pages and allows the user to enter information into forms.
  • the browser may be a plurality of lines of computer code executed by the processor of the computing device 102, 104.
  • the communication path (108) may be a wired or wireless network that may be unsecure or secure and uses typical protocols for the exchange of data between the computing devices 102, 104 and the backend component (106).
  • the communication path 108 may be an Ethernet network, the Internet, a wireless cellular network, a wireless digital data network and the like or any combination thereof and the system is not limited to any particular communication path 108.
  • the communication path 108 may use the known HTTP or HTTPS protocol for data
  • the backend component 106 may be implemented as one or more computing resources or hardware devices.
  • the backend component 106 may be one or more server computers, one or more cloud computing resources and the like and each resource has one or more processors, memory, persistent storage and the like.
  • the backend component 106 may further comprise a web server (106 A), online services (106B), a pet insurance management component (106C), and data storage and processing (106D) that are coupled together as shown in Figure 1.
  • the web server (106 A) that may be implemented as a hardware web server or a software implemented web server, may generate and exchange web pages with each computing device 102, 104 that is using a browser.
  • TCS Trupanion Central Services
  • the management component (106B) may be implemented as a plurality of lines of computer code that are stored in the computing resources and then executed by the processor(s) of the computing resources to implement the pet insurance management functions that are described below in more detail.
  • the data processing and storage device (106D) may be a hardware storage device or a software implemented storage device, such as a database, that stores user and veterinary practice information for the system, stores information about each insurance offer, stores information about each pet that is enrolled in the pet insurance system, and stores the information about each pet insurance claim in the system.
  • Figure 2 illustrates more details of the pet insurance system and in particular the components in each veterinary practice computing device 104 and the backend component 106 and the interactions between the two.
  • the veterinary practice may have one or more browsers/clients (201), a hospital practice information management system (300), and a data integration agent (200).
  • data from the hospital practice information management system (300) flows into the data integration agent (200) and the data integration agent (200) connects to and communicates with the backend component (106).
  • the data integration agent (200) also connects to and communicates with one or more client/browsers (201) in the computing devices 104.
  • each of the components of the veterinary practice computing device 104 may be a plurality of lines of computer code that are executed by a processor of the computing device 104.
  • the Hospital Practice Information Management System is an existing system used by a veterinary practice that use database and visualization technologies (user interface) with the aim to support various hospital/patient management and administration tasks.
  • PIMS Hospital Practice Information Management System
  • Different PIMS manufacturers include different modules that allow for many common hospital technology requirements that may include inventory tracking, procedure codes, connection to diagnostic equipment and service providers, connection to a variety of radiology modalities and services, and invoice generation.
  • the data integration agent (200) may be provided by the pet insurance backend system (106) and may be installed in the computing device 104 of the veterinary practice.
  • the data integration agent (200) is a system which integrates with these varied systems to provide added value and operational simplicity for employees of the veterinary practice and pet owners.
  • the data integration agent is responsible for retrieving and mapping data from the PIMS (300), sending communications to and receiving information from Trupanion Central Services (106B) about claim, insurance offers, and enrollments, and communication with the Trupanion Express clients/browsers (201).
  • the data integration agent (200) employs various technological mechanisms to limit traffic between Trupanion Central Services (106B) and Trupanion Express clients/browsers (201), as well as the PIMS (300), creating efficient correspondence between all systems.
  • the data integration agent (200) may include an abstracted engine that allows communication with various PIMS systems on the market today, as well as the ability to integrate with additional in the future in a plug-and-play fashion.
  • the client/browser 200 is the user interface for Trupanion Express. It communicates with the data integration agent (200) and the web UI (106 A) with the aim to exchange information between the hospital and the backend component (106).
  • the client/browser allows submitting claims, issuing insurance offers, searching PIMS data for clients, appointments, mapping clients between systems, and displaying all of the information for these activities in a digestible way for veterinary practice employees— resulting in improved patient care.
  • the backend component (106) may further comprise a services component (106B), that may be known as Trupanion Central Services, a data storage and processing component (106D), and a pet insurance system(s) (106C), that may be comprised of enrollment and claims systems that are coupled together as shown in Figure 2.
  • a services component 106B
  • 106D data storage and processing component
  • 106C pet insurance system(s)
  • each of the components of the backend (106) may be a plurality of lines of computer code that are executed by a processor of the computing device 106.
  • the services component (106B) integrates with data storage and processing (106D).
  • the enrollment processing system and claims processing system— pet insurance systems 106C— may interact with the data storage and processing systems (106D) allowing insurance offers to be issued and activated and claims to be processed.
  • the services component (106B) is a service inside
  • Trupanion' s network and processes requests from and sends information to the data integration agent (200) and passes appropriately formed requests to the data storage & processing systems (106D).
  • the data storage and processing system (106D) is any location where transactional data for Trupanion' s various IT systems is processed and/or stored.
  • the pet insurance system (106C) is comprised of the enrollment processing system, the system that issues insurance offers to pet owners, and the claims processing system, the system that catalogs the collection of medical records that enables claims adjudicators to manage and process pet owner claims.
  • the pet insurance system (100) is revolutionary in that it enables claims to be adjudicated very quickly - allowing the pet owner to not pay out-of-pocket expenses at the veterinary practice.
  • the pet insurance system (100) allows Trupanion to pay the veterinary hospital directly with the invoice while the customer is waiting to checkout, similar to the concept of "co-pay" in human health care.
  • the pet insurance system (100) allows for near real-time claims submission and claims processing, enabling claim adjudication at point-of-sale at the veterinary practice.
  • a typical system uses typical channels such as fax or mail that support a delayed reimbursement model for veterinary practices and/or pet owners.
  • Figure 3 illustrates an example of a user interface 500 of the pet insurance system.
  • the user interface may include a navigation portion (501) that allows the user to navigate around to various parts of the pet insurance system user interface.
  • the user interface may include a status (502) for each pet to indicate the current coverage of that pet.
  • the user interface may further include an action button (503) allowing the user to submit claims or issue an insurance offer to a selected pet.
  • the user interface may have status indicators for current claims transactions (504).
  • the user interface may also have status indicators for current offers of insurance (505).
  • Figure 4 illustrates a method (600) for determining the current pet insurance coverage for patient with scheduled appointments in the hospital practice information management system (300) and displaying the appropriate action in the pet insurance system user interface (500).
  • Figure 5 illustrates an example of a user interface displaying the appropriate insurance based on the method illustrated in Figure 4.
  • Figure 6 illustrates a method (700) for obtaining insurance and tracking insurance offers using the pet insurance system
  • Figure 7 illustrates an example of a user interface for offering pet insurance to a pet owner.
  • the pet insurance system makes it easier for a pet owner to get pet insurance and then quickly be able to have proof of the pet insurance in the form of an insurance offer that can be presented to the veterinary practice to establish the insurance of the pet.
  • a veterinary practice may provide a pet owner an insurance offer (701) which is recorded in Trupanion systems (702) through the data integration agent (200).
  • an employee of the veterinary practice may enter the insurance offer into the client (201), such as shown in Figure 7, and the information about the insurance offer is passed onto the backend component 106 through the data integration agent (200).
  • the pet owner using a computing device 102, may then activate the insurance offer, and obtain pet insurance, using an email link or by phone which is sent to the backend component 106.
  • the pet owner receives proof of insurance which is also passed back to the veterinary practice through the data integration component 200 so that the veterinary practice receives quick notice of the insurance for the pet.
  • the computing device 104 and the backend component 106 are integrated as shown in Figure 2, all parties involved are rapidly notified of changes to the pet's insurance coverage. For example, this means the veterinary practice can be comfortable that the pet has insurance for the procedure that is about to be performed.
  • the system may also display the treatment or procedure that is, has been or will be performed on a particular patient or by a particular employee at the veterinary practice.
  • Figures 8 A and 8B illustrate examples of a user interface for tracking pet insurance offers through the pet insurance system user interface in the client/browser (201) in the veterinary practice.
  • Figure 9 illustrates an example of a user interface of a particular pet's insurance coverage eligibility once the insurance offer has been activated.
  • Figure 10 illustrates a method (800) for requesting and receiving medical record information used to determine a pet's eligibility for insurance coverage.
  • the computing device 200 and the pet insurance systems 106C may obtain a history of a pet from any veterinary practice that has seen the pet in the past through the data integration component 200.
  • the pet insurance components (106C) may then structure that data and generate an eligibility of coverage.
  • the system may then display that eligibility of coverage to the users of the system which allows all of the users to rapidly see the coverage status for a pet in a user interface (refer to Figure 9).
  • Figures 11 A and 1 IB illustrate an example of a user interface for notification of a request for medical records and tracking of medical records requests.
  • Figures 12A and 12B illustrate an example of a user interface for submitting requested records and completing medical records requests.
  • Figures 13 illustrate a method (900) for submitting and processing a claim in the pet insurance system. Since the backend component and each computing device in the veterinary practice are integrated, as seen in Figure 2, and the system has determined a patient's eligible coverage, an insurance claim may be quickly processed by the claims processing component of the pet insurance component (106C).
  • a claim starts when an employee or doctor of a veterinary hospital completes services for a pet and the veterinary practice submits a claim (see Figure 14A for an example) for the treatment using a claim form (such as shown in Figure 14B) that is generated by the client/browser (201) in combination with the data integration agent (200).
  • the pet insurance company through the pet insurance systems 106C, may then process the claim.
  • the pet insurance company has the status of the pet's eligibility for coverage and this is able to quickly approve or deny the insurance claim for the pet. If the claim is approved, the claim may be paid directly to the veterinary practice (in one implementation, electronically via ACH) and then the pet owner pays their portion to the veterinary practice. In this manner the system allows a claim to be quickly processed and then paid if the insurance claim is approved.
  • Figure 15 is an example of a user interface of pet insurance system 100 highlighting display of communication from Trupanion to the veterinary practice claim outcome information.
  • Figure 16 is an example of a user interface for pet insurance system 100 for tracking of the status of claims submitted and the outcomes and payments for those claims.

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Abstract

Cette invention concerne un système et un procédé mis en oeuvre pour permettre la couverture médicale en temps réel pour des hôpitaux vétérinaires. Plus spécifiquement, la présente invention concerne un système et un procédé d'assurance maladie pour animaux de compagnie utilisant des données disponibles dans des systèmes d'informations de pratique d'hôpitaux vétérinaires pour permettre la souscription d'assurance en temps réel et le traitement de demandes de règlement.
PCT/US2016/059095 2015-10-27 2016-10-27 Système et procédé d'assurance pour animaux de compagnie WO2017075207A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US14/924,606 2015-10-27
US14/924,606 US10013530B2 (en) 2013-03-15 2015-10-27 Pet insurance system and method

Publications (1)

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WO2017075207A1 true WO2017075207A1 (fr) 2017-05-04

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PCT/US2016/059095 WO2017075207A1 (fr) 2015-10-27 2016-10-27 Système et procédé d'assurance pour animaux de compagnie

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Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10013530B2 (en) 2013-03-15 2018-07-03 Trupanion, Inc. Pet insurance system and method
US10255993B2 (en) 2013-03-15 2019-04-09 Trupanion, Inc. Pet insurance system and method
CN110909683A (zh) * 2019-11-25 2020-03-24 支付宝(杭州)信息技术有限公司 基于保障项目的保障核验方法以及装置
US20200387977A1 (en) * 2015-09-18 2020-12-10 Adubb Llc Systems and methods for pet insurance underwriting, rating, adjustments, and enrollment
US10909501B2 (en) 2013-03-15 2021-02-02 Trupanion, Inc. Pet insurance system and method
WO2022180591A1 (fr) * 2021-02-26 2022-09-01 Dessington Nicole Roseline Procédé mis en œuvre par ordinateur et système pour programmer le bien-être d'un animal de compagnie
WO2022185182A1 (fr) * 2021-03-01 2022-09-09 Dessington Nicole Roseline Autorisation à distance

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060074724A1 (en) * 2004-09-24 2006-04-06 Schwartz James D Method and apparatus for bundling insurance coverages in order to gain a pricing advantage
US20070203758A1 (en) * 2005-11-15 2007-08-30 Jack Stephens Automated insurance enrollment, underwriting, and claims adjusting

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20060074724A1 (en) * 2004-09-24 2006-04-06 Schwartz James D Method and apparatus for bundling insurance coverages in order to gain a pricing advantage
US20070203758A1 (en) * 2005-11-15 2007-08-30 Jack Stephens Automated insurance enrollment, underwriting, and claims adjusting

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10013530B2 (en) 2013-03-15 2018-07-03 Trupanion, Inc. Pet insurance system and method
US10255993B2 (en) 2013-03-15 2019-04-09 Trupanion, Inc. Pet insurance system and method
US10891590B2 (en) 2013-03-15 2021-01-12 Trupanion, Inc. Pet insurance system and method
US10909501B2 (en) 2013-03-15 2021-02-02 Trupanion, Inc. Pet insurance system and method
US20200387977A1 (en) * 2015-09-18 2020-12-10 Adubb Llc Systems and methods for pet insurance underwriting, rating, adjustments, and enrollment
US11508013B2 (en) * 2015-09-18 2022-11-22 Adubb Llc Systems and methods for pet insurance underwriting, rating, adjustments, and enrollment
CN110909683A (zh) * 2019-11-25 2020-03-24 支付宝(杭州)信息技术有限公司 基于保障项目的保障核验方法以及装置
WO2022180591A1 (fr) * 2021-02-26 2022-09-01 Dessington Nicole Roseline Procédé mis en œuvre par ordinateur et système pour programmer le bien-être d'un animal de compagnie
WO2022185182A1 (fr) * 2021-03-01 2022-09-09 Dessington Nicole Roseline Autorisation à distance

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Publication number Publication date
CA2946608C (fr) 2022-09-06
CA2946608A1 (fr) 2017-04-27

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