Inventors:
Peter M. Kramer - Miami Beach FL, US
Jeffrey T. King - Miami FL, US
Assignee:
eReceivables, LLC - Hollywood FL
International Classification:
G06Q 50/00, G06Q 10/00
Abstract:
A system and method for automating and standardizing an appeals process, facilitating both business-to-business (i. e. , insurance companies to providers) and business-to-consumer (i. e. , insurance companies to patients) relationships, and educating users on the healthcare industry and patient rights. The system and method provides automated and standardized electronic communication for any business with a regulated or contractual appeals or grievance process. In one application, the system and method provide electronic communication between patients, providers, and insurance plans; convenient access to an “anytime” appeals process; and an efficient follow-up and appeals status tracking. There are standardized forms for the appeal, and the provider appeal format is compatible with current billing forms. The system includes an on-line web site with the ability to manage “behind the scenes” the overall appeals process, including data collection, data management, correspondence generation, process status tracking, and individualized client accounts.