Nicholas D Conti

US Patent:

20030018496, Jan 23, 2003

Filed:

Dec 5, 2001

Appl. No.:

10/005137

Inventors:

Lynn Hambright - Chester Springs PA, US
Douglas Cole - Valley Forge PA, US
Geraldine Miklowcic - Chester Springs PA, US
Nicholas Conti - Spring City PA, US
Starr Stanley - Norristown PA, US

Assignee:

Siemens Medical Solutions Health Services Corporation

International Classification:

G06F017/60

US Classification:

705/002000, 705/034000

Abstract:

A system consolidates records of services from multiple customer accounts, encounters, cases or visits into one account to facilitate comprehensive billing and reimbursement compatible with selected contract (e.g., Medicare health plan) rules for disparate services provided to a customer. A method determines payment for provision of multiple different services based on predetermined reimbursement rules. The method involves receiving a record identifying a service provided to a specific entity and automatically creating a reimbursement record. The reimbursement record groups an item identifying the provided service together with an item identifying an other service provided to the specific entity based on predetermined service record allocation rules. A reimbursement amount for the identified provided service and the other service provided to the specific entity is calculated based on a reimbursement contract. Predetermined allocation rules are automatically applied for identifying a reimbursement record indicating a group of services provided to the specific entity on separate occasions to be billed together on a single bill.