Brian David Peterson
Massage Therapy in Salt Lake City, UT

6343271, Jan 29, 2002

Jul 17, 1998

09/118668

Brian E. Peterson - Salt Lake City UT
Vaughn C. Cecil - Crossville TN
Wayne A. Provost - Salt Lake City UT

P5 e.Health Services, Inc. - Salt Lake City UT

G06F 1760

705 4, 705 2

A claims processing system for electronically reviewing and adjudicating medical insurance claims. The claims processing systems include a benefits system, an automated adjudication system, a payment system, and a payment tracking system. The benefits system allows patients and health care providers to access patient and benefits information on-line. Using the automated adjudication system, health care providers may electronically prepare and submit claims for payment. Before a claim is submitted, a claims precheck process is used to determine whether the claim may be automatically adjudicated or instead must be manually adjudicated. If manual adjudication is indicated, the health care provider may the claim in an effort to achieve automated adjudication prior to claim submission. The claims processing system performs automatic adjudication on submitted claims or forwards the claims to a shop for manual adjudication. The payment system initiates payment to the health care provider using electronic funds transfer.

6341265, Jan 22, 2002

Dec 3, 1998

09/204886

Wayne A. Provost - Salt Lake City UT
Vaughn C. Cecil - Crossville TN
Brian E. Peterson - Salt Lake City UT

P5 e.Health Services, Inc. - Salt Lake City UT

G06F 1760

705 4, 705 2

Methods and systems for interactively creating and submitting insurance claims and determining whether the submitted claims are in condition for payment by an insurer. A medical technician operating a client computer establishes communication with a remote server. The remote server transmits a claim form to the client computer for display to the medical technician. Using the claim form, the technician enters patient identification information, which is transmitted to the server to determine whether the patient is a beneficiary of an approved insurance plan. If the patient is a beneficiary, the technician can prepare an insurance claim using the claim form displayed by the client computer. The technician enters a diagnosis code and a treatment code representing the diagnosis and treatment of the patient. The diagnosis and treatment codes are transmitted to the remote server, which processes the codes to determine whether the claim corresponds to health care services that are approved for payment. If the insurance claim is not in condition for payment, the medical technician is notified.

7072842, Jul 4, 2006

Jan 8, 2001

09/756077

Wayne A. Provost - Salt Lake City UT, US
Brian E. Peterson - Salt Lake City UT, US

P5, Inc. - Salt Lake City UT

G06F 19/00, G06Q 10/00, G06Q 40/00

705 4, 705 2, 705 35

Methods and systems for promptly paying health care providers for rendered health care services. A medical technician operating a client computer establishes communication with a remote server. Using a claim form, the technician enters patient, insurance, and treatment information which is transmitted to the server to determine whether the claim is eligible for advance payment. If the claim is eligible, the server transmits claim information to an appropriate carrier for claim processing. The remote server also transmits claim information to a payment entity which requests from a financial entity that funds be credited to an operational account and a reserve account. The funds of the operational account are immediately accessible to the health care provider. The funds of the reserve account are debited for expenses. When the carrier finally processes the claim, any payment for the claim is deposited into the reserve account.

7962350, Jun 14, 2011

Apr 18, 2005

11/108221

Wayne A. Provost - Salt Lake City UT, US
Brian E. Peterson - Salt Lake City UT, US

PPS Data, LLC - Salt Lake City UT

G06Q 10/00

705 4, 705 2, 705 3, 705 35

Methods and systems for promptly paying health care providers for rendered health care services. A medical technician operating a client computer establishes communication with a remote server. Using a claim form, the technician enters patient, insurance, and treatment information which is transmitted to the server to determine whether the claim is eligible for advance payment. If the claim is eligible, the server transmits claim information to an appropriate carrier for claim processing. The remote server also transmits claim information to a payment entity which requests from a financial entity that funds be credited to an operational account and a reserve account. The funds of the operational account are immediately accessible to the health care provider. The funds of the reserve account are debited for expenses. When the carrier finally processes the claim, any payment for the claim is deposited into the reserve account.

2002001, Feb 14, 2002

Sep 14, 2001

09/952568

Brian Peterson - Salt Lake City UT, US
John Kwant - Midvale UT, US
Vaughn Cecil - Crossville TN, US
Wayne Provost - Salt Lake City UT, US

G06F017/60

705/004000

Claims processing systems for electronically reviewing and adjudicating medical insurance claims. The claims processing systems include a benefits system, an automated adjudication system, a payment system, and a payment tracking system. The benefits system allows patients and health care providers to access patient and benefits information online. Health care providers may electronically receive partially completed claim forms containing patient and benefit information. Health care providers complete the claim forms with proposed health care treatment information and check whether the proposed claim qualifies for automated adjudication. The health care provider may amend unqualified claims in an effort to achieve automated adjudication prior to claim submission. The claims processing system performs automated adjudication on qualified claims. The payment system initiates payment to the health care provider using electronic funds transfer. The payment tracking system allows health care providers to monitor the payment status of a claim after submission.

7194416, Mar 20, 2007

Nov 28, 2000

09/724097

Wayne A. Provost - Salt Lake City UT, US
Vaughn C. Cecil - Crossville TN, US
Brian E. Peterson - Salt Lake City UT, US

P5, Inc. - Salt Lake City UT

G06Q 40/00, G06Q 99/00

705 4, 7071041

Methods and systems for interactively creating and submitting insurance claims and determining whether the submitted claims are in condition for payment by an insurer. A medical technician operating a client computer establishes communication with a remote server. The remote server transmits a claim form to the client computer for display to the medical technician. Using the claim form, the technician enters patient identification information, which is transmitted to the server to determine whether the patient is a beneficiary of an approved insurance plan. If the patient is a beneficiary, the technician can prepare an insurance claim using the claim form displayed by the client computer. The technician enters a diagnosis code and a treatment code representing the diagnosis and treatment of the patient. The diagnosis and treatment codes are transmitted to the remote server, which processes the codes to determine whether the claim corresponds to health care services that are approved for payment. If the insurance claim is not in condition for payment, the medical technician is notified.