Note: Descriptions are shown in the official language in which they were submitted.
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PROVISIONING MEDICAL RESOURCES TRIGGERED BY
A LIFECYCLE EVENT
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This is a PCT Application based on U.S. App!. 16/913,662 filed Jun. 26,
2020, which is a
continuation-in-part of U.S. App!. 16/685,888 filed Nov. 15, 2019, which is a
continuation-in-part of
pending U.S. App!. 16/520,906 filed Jul. 24, 2019, which is a continuation-in-
part of U.S. App!.
15/055,076 filed Feb. 26, 2016, which is a continuation-in-part of U.S. App!.
14/874,004 filed Oct. 2,
2015, which is a continuation of U.S. App!. 14/827,026 filed Aug. 14, 2015,
which is a continuation-in-
part of U.S. App!. 14/461,209 filed Aug. 15, 2014, now issued U.S. Patent
9,123,072 issued September 1,
2015, which claims the benefit of Provisional App!. 61/866,922 filed Aug. 16,
2013, the contents of which
are all incorporated herein in their entirety by reference thereto.
BACKGROUND OF THE INVENTION
[0002] Medical services are services provided to a medical patient. Some
medical services may help
improve or maintain a patient's health, based on disease prevention,
diagnosis, or treatment. The
practice of medicine encompasses medical procedures performed for a patient,
which may include both
preventive care and treatment. Medical service providers include doctors,
hospitals, and health insurers.
A provider may offer medical services to patients by provisioning medical
resources such as, for
example, laboratory, imaging, treatment, or surgical facilities, to provide
the services. Some medical
services may require specially trained or licensed medical professionals. For
example, a medical
practice providing diagnosis and treatment for joint pain may provide medical
services through the
work of an orthopedic specialist. In some scenarios, patient access to a
specialized professional or
facility may be limited by cost, or availability. Some specialized medical
professionals and related
facilities may be scarce.
[0003] A medical practice may also limit the medical procedures offered to
patients based on the
availability of specialized professionals and facilities at a given time or
location as increasingly seen
with the onset of the COVID-19 pandemic. For example, the services offered to
a patient may be
determined based on allocating surgeons to various surgical facility locations
at specific times. Services
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supplied, to. patients may be limited to the allocated Medical professionals
and facilities, even when
medical servitedemand exceeds supply at a given location or time. A medical
practice providing many
types of medical services may expend significant resources adapting the
offered services to demand as
cctst and demand change. Some medical practices may fail to capture: potential
revenue lost .when
resources to provide medical services are underutilized relative to medical.
service demand.
00041 The price of healthcare. services varies depending on specialty,
procedure; and physician
practice. In the United States, many patients do not have access to. a simple
way to shop and compare
the price of common medical procedures. Due -to the current managed.
carebased. payor system in the
US, the cc* oftteatment is often determined by managed care organizations.
10051 These managed care organizations have specific formularies .for drugs
and. procedures
designed specifically to patients' individual health plans, which restrict the
drugs and procedures
available to patients in their particular plans, Patients have historically
had no access to these price lists
or fOrniularies and have had very few tools to atisig thein in finding and
comparing health care services
or predetermining the cost of a procedure. Currently prospective patients who
Chose to compare
medical costs are forced to conduct extensive, often inefficient, and time-
consuming research to
compare medical procedures prior to treatment.
100061 The rising cost. of healthcare is having a dramatic effect on. the U.S.
healthcare system.
Healthcare costs continue to outpace pace inflationary growth, provider
reimbursement rates continue
-to fall, and the -cost of patient insurance premiums are. increasing: To
lower monthly premium costs,
many patients are Choosing to purchase (and employers are choosing to offer)
high deductible health
plans as an alternative totraditional higher preinitint PPO health plans.
[00071 These high deductible plans require patients to pay cash payments for
medical services until
the high deductible is satisfied, and once this deductible has been met, the
insurance carrier begins to
cover medical costs. As a result, many patients are seeing exponential
increases in out-ofpocket
expenses for medical procedures and services. hi addition to more patients
selecting high deductible
plans, many patients cannot afford increased payments and are becoming
uninsured or underinsured.
As the number of patients who are uninsured, underinsured, or on high
deductible plans. grows; the
needfor a mechanism that allows patients to find discounted medical services
increases and an efficient
payment system.
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SUMMARY OF THE INVENTION
100081 Herein presented is an apparatus and associated methods related to
determining medical
services appropriate to a patient in response to a patient lifecycle event:
presenting the medical services
to the patient for selection; optionally scheduling the selected medical
services; and automatically
presenting the selected services for prepayment. The patient lifecycle event
may be, for example, a
doctor's order, diagnosis, condition change, payment. admission, or discharge.
The services presented
to the patient may be determined in response to, and as a function of; the
lifecycle event. For example,
the services presented may include procedures deterniined after the lifecycle
event, in view Of.patierit
medical history. than illustrative example, the servicespre.sented may be
based on medical indication,
contraindication, provider or facility availability, or patient scheduling
preference, advantageously
permitting more medically relevant, beneficial, convenient, or cost-effective
services. Various
examples may advantageously provide a. discount for a .service bundle provided
at a particular time or
facility or by an affiliated physician or medical group:
100091 In one wiped, S process iS provided, comprising: in response to
detecting a patient lifecycle
event, offering medical services to the patient, tompriSing: determining.
Medical services appropriate
to the -patient; presenting the .medical services to the patient for
selection; scheduling the selected
medical services; and, automatically presenting the selected services for
prepayment.
100101 Detecting the patient lifecycle event 'may further cOMprise
receiYing.an -electronic message
comprising an IiHR ailectronic Health. Record):
100111 Determining medical services appropriate to the patient may further
comprise determining
optional medical services that are not contraindicated for the patient based.
On the lifecycle event and
the patient medical history determined as a function of the EHR..
100121 Detecting the patient lifecycle event may further comprise comparing a
historical patient
lifecycle state with the current patient lifecycle state.
1001.31 Detecting the patient lifecycle event may further com:prisedetermining
if the patient lifecycle
state changed,. based on comparing the previous patient lifecycle state with
the currentpatient lifeeyele
= state.
100141 Detecting the patient lifecycle event may further comprise determining
the. current. patient
lifecycle state based on medical. evaluation of the. patient. condition.
100151 The historical patient lifecycle state may be: one. of. new patient;
well patient, acute care
patient, chronic. care patient, or recovering patient.
100161 The. current patient .lifecycle state may be one of: new patient, well
patient, acute care patient,
chronic care patient; or recovering patient.
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10011 The patient lifecycle event may be one of: doctor's order- issued,
patient service scheduled,
patient admitted, patient -discharged, patient diagnosed, patient diagnosis
changed, patient medical
condition changed, patient age threshold readied, patient life expectancy
changed, patient account
balance due changed,.or patient insurance changed.
1100.18] Presenting the selected services for prepayment may further comprise
presenting the selected.
services to a health insurance provider.
100191 Presenting-the selected services for prepayment may further compri.Se.
presenting the selected
services; to the patient.
100201 The process may .further comprise bundling the selected services for
and accepting -payment.
10021.1 Scheduling the selected medical services may further comprise sending
the selected medical
services to a hospital to be scheduled by the hospital.
100221 The selected services may be sent to the hospital after the selected
services are scheduled, .in
.Pir4pmsete: a scheduling event
100231 In an aspect, an apparatus is provided, comprising: a processor; a user
interface, operably
coupled with the processor; and, a memory, operably coupled with the
processor, wherein the memory
encodes processor executable program instructions and data to program and
configure the processor to
cause the apparatus to peiform operations comprising: receive tut electronic
message- complisina an
MIR; determine the current patient lifecycle state based on the MIR; determine
if a patient lifecycle
event occurred, based -On comparing a historical patient lifecycle state with
the current patient. lifecycle
state; in response to determining a patient lifecycle. event occurred;
determine medical services to be
offered to the patient, wherein the medical -services are not contraindicated
for the patient based. on the
lifecycle event and the patient medical history determined as a function of
the ERR; present the medical
services to be offered to the patientin the user interface fir selection as a
function of available service
location and available service time; and, automatically present the selected
serVices to the patient in
Itt.11.10.rketitface for prepayment.
100241 The operations performed by the apparatus may further comprise schedule
the selected
.medical services based on associating an available service location and an
available service time with
a patient selected service location and a patient-selected service time.
100251 Schedule the selected medical services may further comprise send the.
selected medical
services to a hospital to be scheduled by the hospital based on associating an
available service location
and an available service time with a patient selected service location and a
patient selected Service time.
100261 The patientlifecycle event may further comprise patient service
scheduled,
[0027] The patient lifecycle event may further comprise doctor's order issued.
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100281 The medical services appropriate to the patient may further- comprise a
medical service.
determined-as a function of -the-patient lifecycle event.
100291 The medical services to be offered to the patient may further comprise
a medical -service
bundle based on medical facility- utilization determined as a function of
time.
100301 The. operations performed. by the apparatus-may further comprise
sending the medical service
bundle to the patient in a shopping cart format rendered in an email or
textmessage.
100311 The process may further comprise offering the patient a discount for
prefinyment.
100321 In an aspect, an apparatus is provided,. comprising: a processor; and,,
a memory, operably
coupled with. the processor, w.herein the memory encodes processor executable
programa instructions
and data to program and configure the processor to cause the apparatus to
perform operations
comprising: receive an electronic message comprising an EHR; determine the
current patient lifecycle
state based on the ERR; determine if a patient lifecycle event occurred, based
on comparing a historical
patient lifecycle state with the current, patient lifecycle state; in response
to determining a patient
lifecycle event occurred: determine medical services, to be offered to the
patient, wherein the medical
services are not contraindicated for the patient based on the lifecycle event
and the patient medical
history determined as a function of the EHR, Wherein the medical services to
be offered to the patient
are determined as a fuuction of the patient lifecycle event, and wherein the
medical services te.) be
offered to the patient further comprise, a medical service bundle based on
medical facility utilization
determined as a function of fime; present the medkal serviceSta.be Offered to
thepatient In a shopping
cart format rendered. in an email or text message to the patient for selection
as a function of available
service location and available service time; schedule the medical services
selected by the patient based
orrassociating an available service location and an available service time
with a patient selected service
location and a patient selected service time; and, automatically: present the
scheduled services to the
patient With a discount offered for prepayment before a predetermined date.
100331 The patient lifecycle event may be patient service scheduled, and the
medical service .bundle
may further comprise a follow-up medical service medically indicated by-the
patient service- scheduled.
100341 The histories] patient lifecycle state maybe new patient, and the
current patientlifreycle state
may be well patient.
100351 The historical patient lifecycle state may be new patient, and the
current patient lifecycle state
may be chronic care patient.
100361 The historical patient lifecycle state may be acute care patient, and
the current patient li&eyele
state may be recovering patient.
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[00371 Thc patient lifecycle event may be one of: doctor's order- issued,
patient service scheduled,
patient admitted, patient -discharged, patient diagnosed, patient diagnosis
changed, patient medical
condition changed, patient age threshold readied, patient life expectancy
changed, patient account
balance due changed, or patient insurance changed.
[00381 Schedule the medical services may further comprise send the selected
medical services to. a
hospital to be scheduled by-the hospital.
100391 Various embodiments may achieve one or more advantages. For example, le
some
embodiments, medical practice profit may be improved. Such improved medical
practice profit may
be a. result. of reduced cost based on improved utilization of -medical
practice resources that may be
otherwise spent sending bills, collecting payment, handling payment in-person,
and the like. Various
implementations may reduce the effort required by a medical practice to offer
medically relevant or
beneficial services to a patient. This facilitation may be -a result of a
patient lifecycle event triggering
an offer for services Mated to the patient lifecycle event. For example, a
patient lifecycle event or
status change such as a doctor'.s order, patient registration, for a primary
service, diagnosis, or Change
in medical condition may automatically trigger other service offers medically
indicated or beneficial
with the primary service or change in lifecycle status. Some. embodiments may
improve the cost
effectiveness of medical service offerings. Such intim oved medical service
cost effectiveness may be a
result of improved resource utilization based on offering additional. medical
services optionally
available within the Same service window as a primary Service. For example, a,
printery service ordered
by a doctoror scheduled by a patient May trigger an offer of optional services
that are within the same
or simile .fileility or time slot service window as the primary service. In an
illustrative, example, such
an offer of optional services may enable a medical service provider to reduce
cost and offer a discount
to patients, as a result of improved resource utilization. Some examples may
increase the quantity of
medical -services performed by A medical. praCtice. This facilitation inay be
a. result of increasing the
chance of a patient scheduling an additional Or optional procedure selected
from offered procedures
determined in rosponse to a patient li&cycle event that has already occurred.
For example; a medical
practice may be able to offer more medically -relevant -orbenericial services,
or offermore costeffective
service schedules, from. the temporal perspective after a patient lifecycle
event has occurred, in view
Of the patient's. medical history. In addition, after a patient lifecycle
event, there may be -enhanced
patient motivation to Schedule additional procedures- or respond to a discount
offer, intprOving the
chances for the. medical practice to provide additional services to the
patient.
100401 Some embodiments may improve a patient's ease of access to medical
services. This
facilitation may be a result of reducing the patient's effort selecting,
scheduling, and paying for medical
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.services.. Some examples may improve a patient's medical care experience.
Such improved patient
medical care experience maybe a resUltof a medical practice offering a patient
-a bundle of multiple
services that could be performed in fewer visits, thereby reducing the
numberof times a patient has to
revisit a medical service facility: Some embodiments may improve, a patient's
benefit from medical
services. This facilitation may be a result of a medical. service provider
offering the patient more
medically beneficial services- tailored to the patient's condition or status
in the patient lifecycle. in some
embodiments, a patient's cost for medical services may be reduced. Such
reduced Medical service ocist:
to a patient may be a result of a medical practice passing on to the patient.
medical practice cost savings
based on improved medical practice resource= utilization .frorn optional
services available within the
same service window as a primary service. In some designs, a patient's cost
for medical services may
he reduced as a result of a medical practice providing a prepayment discount
to the patient.
100311 Various implementations may construct a proposed medical service bundle
for a patient in
response to detecting a. patient lifecycle event has occurred. A. patient
lifecycle event may be, for
example, patient registration for a service, or; arty patient lifecycle event,
including; but not limited to,
a doctor's order, scheduling, administrative updates to patient records,
patient admission, patient
discharge, overdue payment, change in payment account balance due, and the
like. The medical service
bundle proposed. to the patient may include, fot example, the services dial
weje actually provided or
scheduled, or any additional or related services the patient Might be
interested in.
100421 An exemplary implementation may, for example, receive electronic
notification from an EHR
or other source,, determine the appropriate procedure(S) to offer to the
patient, based on the data or
codes in that electronic notification, create a shopping cart including a
proposed medical semicebundle
for the patient, and optionally email or text-the shopping cart to-the
patient. The shopping cart may also
be. saved in a portal. (for example, an exemplary .rvIDsave Direct portal
implementation). In: an
illustrative example, a 'provider using the portal where. the shopping cart
was saved may --directly look
up the shopping cart or service bundle to aid completing. the purehase, either
in person, online (t7or
example by live chat), or on the phone with the. patient.
100431 Some exampledesigns may include offered optional services that are
chosen based on future
procedures indicated for the patient, medical contraindication, provider or
facility availability, or
patient scheduling preference. Some embodiments may offer a discount for
scheduling a particular
bundle ("cart") of services at a particular date, time, or facility, or with a
particular provider or doctor.
In an illustrative example, some implementations may permit a patient to
select from the offered
services and prepay for the selected services. In an example illustrative of
various implementations'
usage, in addition to minimizing the number of times = a patient has to
revisit the facility, a medical
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practice may reduce resources spent on sending bills, collecting payment,
dealing with payment in-
person , -and the like.
100441 In an example illustrative of technical effect that may result from
various implementations'
usage, the trigger condition to construct a service offer using the time value
of the temporal perspective
after a patient lifecycle event. may improve, medical care. and reduce cost.
for example, a medical
service- bundle determined after a patient lifecycle event may be more closely
customized to the
patient's medical Condition and medical history in view of the lifecycle
event. Such a perspective yid*
triggered in response to a patient lifeeyele event may permit offering, more
medically relevant
additional procedures, may increase the. chance a patient may select an
additional procedure, and may
improve medical practice resource utilization, in contrast with offering the
patient optional services
before a patient lifecycle event (Such as before the patient is registered
for. a procedure, or commits to
a procedure schedule). In an illustrative example, a patient that has already
scheduled a primary
procedure on a given day may have already arranged their personal or
professional .schedule to
accommodate the primary procedure. Such a patient may be more likely to:
schedule an additional
procedure at the same facility on the same day in response to a discount offer
iftheadditional procedure
Is not. medically contraindicated by the primary procedure.
100.451 hi some examples, a service may be scheduled by a hospital. For
example, an embodinieut
process or apparatus may determine a service, bundle, present the service
bundle to a patient for
selection of services the patient may be interested in, and then leave
scheduling to a hospital. The
services selected by the patient may be sent to a hospital. for scheduling by
the hospital. Some designs
may send out a shopping cart of services after scheduling, takes place, in
response to the scheduling
event; that is, using the scheduling event as a trigger to send out the
shopping tart of services.
100461 Various implementations may create a shopping cart inresponse to a
trigger condition to offer
services. The trigger -condition to offer services may be a patient lifteyde
event (for example, patient
registration for a procedure, change in patient condition, diagnosis, doctor's
order, admission,
discharge, and the like). For example, patient registration for a primary
service. may trigger other
service offers that are-within the same service window- (for example, time
slot and/or facility) of the
primary service, permitting a medical practice to enhance utilization of
facility services and resources,
-.reducing the number-of times A patient may have to revisit the facility, and
providing it Coat saving WI
the patient through prepayment.
100471 Exemplary embodiments of the present invention relate to the marketing
and facilitating the
sale of services and products. More specifically, exemplary embodiments relate
to methods and
apparatuses for providing a web-based mechanism allowing prospective patients
to search for and
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compare healthcare services and products offered by local providers, including
bundled sets of services,
and facilitating prepaid purchases of such healthcare services and products by
prospective patients at
discounted rates.
100481 Exemplary embodiments of the present invention are related to an
apparatus for facilitating
purchases of services offered by service providers.. The apparatus includes
an, application server
providing a network service that is accessible to aplurality of users-through
a plurality of client systems
communicatively coupled to the .application server via a network and a. data
storage system storing a.
service, offer database that is maintained by the application server.
100491 The service offer database comprises a plurality of service offer
information records
respectively associated with a plurality of service offers. The plurality of
service offers includes at least
one service .offer for a bundled set. of services. Each service offer
information record comprises an
indication of a primary service of the associated service offer, a purchase
price tbr the associated service
offer, a payment amount for the primary service, and compensation information
for the primary service.
'Upon. receiving purchase information. for the user for purchasing the
selected service offer iliD/11 the
client system, the network service is operable to issue. a request to the
funding source for funds
corresponding to the purchase price included in the service offer information
record associated with
the selected service offer to pi mess- a purchase of the selected SUI vice
offer by the user.
100501 In exemplary embodiments, each service offer for a bundled set of
services comprises a
bundled set of healthcare services provided by corresponding healthcare
service providers.
10051] In exemplary embodiments, at least one service offer information record
associated with a
set-vice offer for a 'bundled set of services further comprises an indication
of a facility for performing
the primary. service, a facility fee for the facility, and compensation
information for the facility fee.:
100521 In exemplary embodiments, at least one service offer information record
associated with a
service offer for a bundled set of set-vices further comprises an indication
that at least one of the
secondary services associated with the primary service is an optional
seeondaty service.
100531 In exemplary embodiments, the data storage system stores a profile
database that is
maintained by the application server. The profile database comprises a
respective account information
record. for each of a. plurality of user accounts registered with the
application server: The plurality of
user accounts includes n plurality of customer accounts and a plurality of
provider accounts. The.
account information record -for each user account comprising information for
authorizing a user
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accessing the network service from one of the client systems to access the
network service, in
assOeiation with the user account.
100541 In exemplary embodiments, the plurality of provider accounts includes a
plurality of
physician accounts and a plurality of practice group accounts, the 'account
information record for each
practice group account comprises an indication of one or more of the physician
accounts being affiliated
with the practice group account
100551 In exemplary embodiments, the data storage system stores a transaction
information database
that is maintained by the application server. The transaction information
database comprises a
respective purchase information record for each processed purchase, by a user
accessing the network
-service from one of the client systems in association with a customer
account, of a service offer that
has been created by a user accessing the network service from one of the
client systems in association
with a provider account, the respective purchase- information record for each
processed purchase
comprising an indication &the service offer information recordassociated with
the purchased service
offer and, for each of the primary service and any secondary service .of the
service offer, and an
indication of whether the purchase has been redeemed with respect to the
service.
100561 In exemplary embodiments, the network service, upon being accessed by a
user of one Of the
client systems to process a purchase of a service offer, generates a voucher
for the user that specifies a
unique confirmation number for the purchase and the corresponding service
provider for each of the
primary service: and any secondary service of the purchased service offer,
and, for each of the primary
service and any secondary service of the purchased service offer, sets the
purchase information record
for the processed purchase to indicate that the purchase has not been redeemed
with respect to the
service.
100571 Exemplary embodiments of the present invention that are related to
computer-implemented
processes and computer systems corresponding to the above-summarized exemplary
embodiments
directed to an apparatus are also described and claimed herein.
00581 The above-described and other features and advantages realized through
the techniques of the
present disclosure will be better .appreciated and understood with reference
to the following detailed
description, drawings, and appended claims. Additional features and advantages
are realized through
the techniques of the present invention. Other embodiments and aspects of the
invention are descii bed
in detail herein and are considered. a part of the claimed invention.
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BRIEF DESCRIPTION OF THE DRAWINGS
100591 The subject matter that is regarded as the invention is particularly
pointed out and distinctly
claimed in the claims at the conclusion of the Specification. The foregoing
and other objects, features,
and advantages of the invention are apparent from the following detailed
description. of exemplary
embodiments of the present invention taken in conjunction with the
accompanying drawings in which:
100601 FIG. 1 is a Schematic diagram illustrating an example network
architecture for a healthcare
marketplace system that can be configured to implement exemplary embodiments
of the present
invention.
100611 FIG. 2 is a block diagram illustrating a server systeni in accordance
with an exemplary
embodiment of the present invention.
100621 FIGS. 5A-3D are. a number of screen shots illustrating examples of a
graphical user interfaces
that may be implemented by services provided within *customer portal in
accordance with exemplary
embodiments of' the present invention,
[00631 FIG. 4A is an illustration of an example voucher that may be generated
within a user interface
by functions provided within a customer portal for a purchased service in
accordance with. exemplary.
embodiments of the present invention.
100641 FIG. 4B is an illustration of an example Voucher that may be generated
within, a user interface
by functions provided Within a customer portal for a purchased service that is
offered as g bundled set
of services in accordance with exemplary embodiments of the present invention.
100651 FIG. 5 is a block diagram of an exemplary computer system -that can hc
UscdfOr implementing
exemplary .embodiment S of the present invention.
100661 FIG. 6 is a schematic diagram illustrating a second example network
arehitecture for a
healthcare- marketplace. system that can be configured. to implement exemplary
embodiments of the
present invention; and
[00671 FIGS. -7A-7C are a number of screen shots illustrating examples of a
graphical user interfaces
that maybe implemented by services. provided, within a. provider portal in
accordance with exemplary
embodimentsof the preSent invention11
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100681 FIG, 8: illustrates a flow chart of an insurance policy stored in the
insurance database executed
by the application server in accordance with exemplary embodiments of the
present invention.
100691 FIG. 9 illustrates -a block diagram of a virtual payment system manager
communicating with
client system in. a healthcare marketplace system.
100701 FIG. 10 illustrates a block diagram of the application server showing
deductible checker,
shopping cart, and drug discounted card :in accordance with another embodiment
of the present
nvernion .
1007.11 FIG. 1.1 is a process flow illustrative of an example aspect of
patient lifecycle event triggered
shopping cart provisioning design.
100721 PIG. 1.2 is a. process flow illustrative aim example aspect cif patient
lifecytte event triggered
shopping cart provisioning design.
100731 FIG. 1..3 is a process flow illustrative of an example aspect of
patient lifecycle event triggered
shopping cart provisioning design.
100741 FIG. 14 is a process flow illustrative of an example aspect of patient
lifeeyele event triggered
shopping cart provisioning design:
100751 The detailed description explains exemplary embodiments of the present
invention, together
with advantages and Features, by way -of example with reference -to the
drawings, in which similar
numbers refer to shriller parts throughout the drawings. The flow diagrams
depicted herein are just
examples. There may be many variations- to these diagrams or the steps. (or
operations) described
therein-without departing from the spirit of the invention.. For instance, the
steps may be performed in
a differing order, or steps may be added, deleted, or modified. All of these
variations are considered to
be within the scope of the claimed invention
100761 Like reference symbols in the various drawings indicate like elements.
DETAILED DESCRIPTION
100771 While the specification concludes with claims defining the features of
the invention that are
regarded as novel, it is believed that the invention will be better understood
from a consideration :ofthe
description of exemplary embodiments in conjunction with drawings. It is of -
course to be understood
that the embodiments described herein are merely exemplary :of the invention,
which can be embodied
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in various forms. Therefore, specific structural and functional details
disclosed in relation to the.
exemplary embodiments described herein are not to be interpreted as limiting,
but -merely as a
representative basis for teaching one skilled in the art to variously employ
the present invention in
virtually any appropriate form, and it will be apparent to those skilled in
the art that the present
invention may be practiced without. these specific details. Further, the terms
and -phrases, used herein
are not intended to be limiting but rather to provide an -understandable
description of the invention.
100781 Exemplary embodiments oft transactional marketplace system in
accordance with the present
invention will now be described with reference to the drawings. Exemplary
embodiments of the present.
invetitien may be implemented to provide healthcare service providers and
pharmacies with a.
mechanism to remotely offer healthcare services and prodUcts to prospective
patients at discounted
rates in exchange. for prepayment. of the costs for the services and products
via a- network-based.
application (for example, a web-based application).
100791 In this regard, exemplary embodiments may 'further be implemented to
provide prospective
patients with a mechanism to remotely search, compare, and make pre-paid
purchases of such
healthcare services and products offered by local medical service providers
and pharmacies via a
network-connected device configured to access the network-based application,.
Exemplary
embodiments may be. further implemented to provide healthcare service
providers with the ability to
remotely offetabundled set of healthcare services that are petforrned
separately by -multi pie providers
to prospective patients through such a network-based Mechanism in which the
patient is provided the
opportunity to make a prepaid purchase of such a bundled set of services.in a
Single transaction via the
network-connected device., whereby the network-based application facilitates a
disbursed distribution
of the payment among the multiple healthcare service providers that perform
servicesineluded in the.
bundled set of services.
MUM] Rxemplaty embodiments may also be further implemented to provide a
virtual payment
system for facilitating and accounting for the exchange of payment for
services and products purchased.
by (or otherwise on behalf of) patients and -offered by healthcare providers
via the transactional
marketplace system in which a respective virtual money account is established
and utilized far each
participant in transactions conducted within the marketplace system to manage
and track the process
Of exchanging 'actual currency and/or credits used to pay for the transactions
through the use of
corresponding virtual .funds created within the virtual payment system.
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100811 In such exemplary embodiments, the virtual funds may be allocated and
distributed to,
exchanged among, and redeemed for -corresponding amounts of actual currency by
various participants
to etteli transaction for which payment is facilitated through the virtual
payment system, and the
participants to transactions within the virtual payment system for which
respective virtual money
accounts are established. and utilized may include, in. addition to patients,
healthcare providers, or other
-entities specified for receiving payments for .services or products offered
through the marketplace
system, third patty payers, and an entity that provides the transactional
marketplace system.
100821 Exemplary embodiments may be further implemented. to provide various
types of healthcare
service providers, which may include individual physicians, practice groups,
and hospital systems, with
the ability to establish affiliations with one another -through such a network-
based mechanism and
provide various . options allowmg the -service providers to remotely offer
healthcare services in
association with these affiliations.
100831 Ti should further be noted that vatious aspects of exemplaiy
embodiments Of the piesent
invention described herein are not. limited to healthcare services (also
referred to herein as procedures)
and products but; rather,.rnay be implemented with respect to any suitable
classes and types of services
and products. that may be offered by any suitable classes and types of service
providers and retailers.
[0084] Referring now to FIG. 1, a schematic diagram illustrating an example
network architecture
for a healthcare marketplace system MO that can be configured to implement
exemplary embodiments
of the present invention is provided. It should of course be understood that
FIG: 1. is intended-as an
example, not as an architectural limitation, for different embodiments of the
present invention, and
therefore, the particular-elements depicted in FIG.. 1 should riot' be
considered limiting with regard to
the environments withinwhich exemplary embodiments of the present invention
may be implemented.
100851 In the examrth, illotrated in FIG. 1, healthcare marketplace system 100
is implemented as a
client/server system that includes a central server system 110 that is
commonly accessed by each user
of the system through operation of any of a plurality of client systems 140
that are operatively coupled
to the central server system via a communication network .150. Central server
system 110 further
includes a database server 112 that is coupled to .a data store 114 and an
application server 116, and.
each client system 140 is a user terrninal or other client device implementing
software for and running
a respective Client application 142 for accessing services provided via a
network-based application
(also referred to herein as. a network service) implemented-by application
server 116.
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100861 As further illustrated, exemplary marketplace system 100 may also
include at least one third-
party server system 1.60 to enable Other functionality that may be accessed
and utilized by server system
na to provide and/or enhance the network service discussed herein. In
exemplary embodiments,
marketplace system 100 can include additional servers, clients, and other
devices not shown in FIG... 1.,
The parti cular architecture depicted in FIQ.. I is provided, as an example.
for illustrative purposes and,
in exemplary embodiments, any number of client systems 140 may be connected to
server system 110
at any given time via network 150, and server system 110 can comprise multiple
server components
and databases located. within a single server system or within multiple server
systems, -where the
mut tiple server systems are integrated with or accessible by users of client
systems 140 as a distributed.
s.erver.system via network 130..
1.00871 in exemplary embodiments, network 1.50 can be configured to
facilitate. communications
between server system 110 and client systems 140, as well as communications
with and between other
devices and computers connected together Within marketplace 'system .100, by
any suitable wired
(including optical fiber), wireless technology, or any suitable combination
thereof, including, but not
limited to, personal area networks (PANS), local area networks (LANs),
wireless networks, wide-area
networks (WAN), the Internet (a network of heterogeneous networks using the
Internet Protocol, IP),
and virtual private networks, and the network. may -also utilize' any suitable
hardware, software, and
firmware technology to connect devices such -as, for example, optical fiber,
Ethernet, ISDN (Integrated
Services Digital Network), T-1 or T-3 link, FLO' (Fiber Distributed Data
Network),. -cable or wireless
LlvIDS.network Wireless LAN, 'Wireless PAN' (for example,.1tbA, Bluetooth,
Wireless LISB, Z-Wave
and ZigBee), HontePNA, Power line communication, or telephone line network.
Such a network.
connection can include intrariets, extranets, and the Internet, may contain
any Dumber of network
infrastructure elements including routers, switches, gateways, etc., can
comprise a Circuit switched
network, such. as the Public Service Telephone Network (PSTN), a packet
switched network, Such as.
the -global Internet, a private WAN or LAN, a telecommunications -network, a
broadcast-network, or a
point-to-point network., and may utilize a variety of -networking. protocols
now available or later
developed including, but not limited to the Transmission Control
Protocol/Internet Protocol (TCP/IP)
suite of protocols for communication.
100881 In exemplary embodiments, application server 116, database server 112.,
and any other servers
employed within server system 110 and third-party servers utilized Within
marketplace system I00 can
be implemented within any suitable Computing system. or systems such as a
workstation computer, a
mainframe eoniptiter, a. server system (for example, SUN ULTRA workstations
running the SUN
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operating system, IBM RS/6000 workstations and servers running the AIX
operating system, or an
IBM e.Seriee eServer running -710S, NM,. or LINUX OS), a server cluster, a
distributed computing.
system, a cloud based computing system, or the like, as well as any of the
various types ofecimpating
systems and devices described below with reference to the client systems 140..
Server system 110 may
be implemented using any of a variety of architectures.. For example,
application server 116 and.
database server 112 may also be implemented independently or as a single,
integrated device. While
the exemplary embodiment illustrated in FIG. 1 depicts application server 116
and database server' .112
as individual components, the applications provided by these servers, or
various combinations of these
applications, may actually .b.e server applications running on
separatephysicaLdevices. In this. regard,
server- system 110 may comprise, a number of computers connected together via
a network and,
therefore, may exist as-multiple separate logical and/or physical units,
and/or as multiple servers acting
in concert or independently, wherein each server may be comprised of multiple
separate logical and/or
physical units. In exemplary embodiments, server system 110 can be
connected.tonetwork150 through
a collection of suitable security appliances; which. may be implemented in
hardware, software; or a
combination of hardware and software.
100891 As illustrated in FIG. 1, application server 116:is communicatively
coupled to database server
112. Database server 112 is connected to data store 114, which comprises a
plurality of databases that
are maintained by database server 112, accessed by application. server 116 via
database services.
provided at a front end by database server 112, and store information on a
variety of matters that is
utilized in providing the services offered via the network service provided
bythe application server, as
described below in greater detail.
100901 The machine learning algorithm 15 instructs the service offer database.
114h to store each
healthcare service provider service corresponding to the user selection and
displays the bundled set of
service, offers via thegraphical user interface/provider portal 130 that
matches the users selection,
100911 Any machine-learning algorithm 1.5 can be employed, such as neural
networks, expert
systems, Bayesian. belief networks, fuzzy- logic, data fusion engines and the
like. The system may also
employ combinations of various artificial intelligence techniques to the
service offer database 114h.
1009.21 The. machine learning algorithm IS takes into account of each and
every parameter of user
inputs such. as type of disease, location, expertise, procedures, hospitals,
pricing etc. Thus, the machine
learning algorithm 15 displays the best restilts/hits based on the inputs and
preferences of the user.
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100931 As used herein, the term "data store," "data storage unit," storage
device", and the like can to
any suitable memory device-that may be used for storing: data including manual
tiles, machine-readable
files, and databases. In exemplary embodiments, application server 116,
database server 112, and data
store 114 may have implemented together a single computing device, implemented
within a plurality
of computing devices locally coupled. to each other via a suitable
communication medium, such. -as a
serial port cable, telephone line or wireless frequency transceiver;
implemented within a plurality of
computing -devices remotely coupled to each otlier via hetvVoi-k- 150, or any
suitable combination
thereof.
100941 C116P1 Systems 140 are doinputer devices to which one or more users,
which May be healthcare
providers offering services or products or patients seeking to purchase heal
thcare'servicesor products,
or their human agents (for example personal representatives or assistants)õ
have, access, It should be
noted that: the term "user" is used herein to refer to one who uses a computer
system, such as one of
client systems 140. As described in greater detail belOw., client systems 140
are each operable by such
users to access server system 110 via network 150 and act as clients to access
services offered by the
network service provided by the server system within exemplary marketplace
system 100. For this
purpose, each client system includes a respective client application 142 that
executes on the client
system and allows a user to interact with server system 110 via application
server 116.
100951 In exemplary embodiments, the computer systems of client systems 140
can be any of a wide
range of Suitable coinputing devieeS such as one Or more workstations, desktop
computers, laptops, or
other personal computers (PCs) (for example, 'IBM or compatible PC
workstations running the
MICROSOFT 'WINDOWS operating, system or LIMA OS, MACINTOSH computers running
the
MAC OSX operating system, or equivalent). non-traditional-computer digital
devices such as Personal
Digital Assistants (PDAs) and other handheld 'or portable electronic devices,
smart phones and: other
mobile: handsets, tablet computers, neibook computers, game consoles, home
theater PCs, desktop
replacement computers, and the like, or any other suitable information
processing devices. An
exemplary computer system for client systems 140 is described in greater
detail below with reference
to Fla. 5..
100961 hi general, during operation of exemplary marketplace system 100, a
client system 140 -first
establigheg connection to server system 1.10 via network 150. Once the
connection has been
established, the connected client system may directly or indirectly transmit
data to and access content
from the application server 116. A user accessing application server 116
through the connected client
system can thereby to use a client application 142 to access services provided
by the application server,
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which are described in greater detail below, via a User interface implemented
by th.e client application
within which the Client application renders the information served by the
application server.
100971 In exemplary embodiments, application server 116 can implement network
service as a non-
web client application (kith as a mobile application); a Web client
'application, or 'both to provide the
services accessed by client systems 140 within server system 110, and client
applications 142 can
correspondingly be implemented as non--web client applications, web client
applications, or both for
operation by users of the client systems to interact with application server
116 and access the services
provided thereby. For example; application server 116 can comprise a web
server configured to provide.
a web application for the respective client applications implemented on client
Systeins 140 thatare
configured to provide web-based user Interfaces for utilizing the services
provided by the web server.
For instance; the user interfaces of client applications implemented on client
'systems 140 can be
configured. to provide 'various- options corresponding to the functionality
offered. in exemplary
atelididitheirts described herein through suitable user interface controls
(for example, by way Of menu
selection, point-and-click, dialog box, or keyboard command). In one gtheral
example, the user
interfaces may provide "send" or "submit" buttons that allow users of client
applications to transmit
requested information to application server 116. The user interfaces can be
implemented, for example,
as a graphical user interface (GM) that renders a common display structure to
represent the network
service, provided by application server 116 for a user of a client platfonn_
100981 More specifically, in such an.example, application server 116 can, for
example, be configured
to provide services.via a web-based software application hosting a
corresponding website that includes
a number of web pages (e.g., screens), and client applications 142 can
comprise a web browser
executing on client systems 140, such that the services provided- by
application server 116. are
accessible to Client systems 114 using the lriternet or an intranet. Users of
client systems 140 may
thereby access the website provided by application server 116 by, for example,
inputting or following
.a link to the uniform resource locator (LAW for the website in the web
browser, which then enable
users to display and interact with information, media, and other content
embedded within the web pages
of the website provided by application server 116. The web-based software
application can transmit
information that can be processed by the web browsers to render a user
interface using, for .example, a
browser-supported programming languages such as JavaSeript, ltrlML, tr.rmi,5,
and CSS, or the like,
and can communicate with theweb browsers using, for example, liTTPS, POST
and/or GET requests.
Client applications 142 and application server 1.16 may be configured so that
information transmitted
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between client systems .140 and server system 110 can be encrypted and sent
over a secure network
connection to protect, for example, patient privacy.
100991 Referring now to FIG. 2, a block diagram illustrating an exemplary
embodiment of server
system. 110 is provided. AS illustrated in. FIG. 2, application sexver 116 is
implemented to provide a
plurality of services via a customer portal 120 and a plurality of .services
via a provider portal 130, As
described herein, application server 116 can be implemented to provide a.
respective set services for
each of various types of users (for example, unregistered guests; customers,
individual. phySicians,
nurses, office staff, practice grout.) administrators,: hospital systern
administrators, pharmacy
administrators, and the like), and write of the services offered by
application server 116 can be
commonly applicable to and accessible by all types of users, While other
services can be applioable to
and accessible only by specific. types Of users.
[0100] For purposes of descriptiony, the terms. "providers and "previder
users" are used herein to
reef to the general Class of users that register with the system offer
healtheale services or products for
-
purchase by customer users registered with the system, which can include
individual physician users,
practice group administrators, hospital system administrators, pharmacy
administrators, and the like.
In addition, a user account for a particular provider can have any number of
authorized users, As an
example, an account established for a physician can have the physician as one
of its users. It can. also
have nurses or office staff working for the physician as other authorized.
users. The other authorized
users can log into the account and perform various. actions with the
permission and under the
supervision of the physician.
101011 .A single hospital system account May be established and -shared by
multiple staff inember's
higlittiTMEtn. For purpose of illustration., there can be a designated user
(for example', an account
administrator) who is responsible for managing the account, The administrator
can be provided with
greater access rights within server system 110 with respect to the account. tn
exemplary embodiments,
the particular client applications 142 or the particular client systems 140
that are utilized for accessing
application server 116 can be respective to and customized. for each type of
user account. For example,
the particular-client application thatis utilized for each type of account can
be implemented to a provide
virtual computing platform that is specific to the services offered for that
type of account.
101021 As further illustrated in. exemplary embodiment of FIG. 2, and as will
also be described hi
greater detail below, data store 114 comprises a plurality of databases that
ate maintained and
accessible by application server 11.6 via database server 112, including a
customer profile database
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114a, a physician profile database 11413, a practice group profile database
114c, a hospital system
profile database 114d, a pharmacy profile database 114e, a .condition
information database 114f, an
available services database 114g, a service offer database 114h, an available
products dittabasz 1141,e
product offer database 114j, a transaction information database 114k, and one
or more additional
databases 1141 that may be. used for 'storing any other suitable information
that may be utilized by
server system 110 (for example, -system usage data, audit trail data, data
used internally within, the
system by appl cati on sewer 116 and the
101031 The customer -profile database 11.4a is configured to register users
thereby providing user's
personal information for purchasing healthcare services. The physician
profile. database 114b is
configured to register and maintain records of individual physician offering
healthcare Services. The
condition information database 1141 is configured to register and maintain
information records for
Various health conditions and diseases for which corresponding healthcare
services arc offered.
101041 Physician profile database 114b is used to maintain account i
TlibiThati on records Ibr individual
physician users that register with server system 110 to offer healthcare
services for purchase by
ti,T(iTs registered with the system, as well As account information records
for individual
physicians that arc registered with the system in association with a practice
group or hospital :system
(as described in greater detail below). For each physician for which an
account is registered With server
system 110, various items of informatien relevant to the physician, Such as
name, practice 'specialty,
office location(s) and hours, a profile picture, contact information,
biographical inforinaticin (Such as
awards, honors, publications, patient testimonials, and other information that
can be helpful for
marketing the physician to customers accessing The system),111RLs or
references to websites and social
media profiles:, group- practice and hospital affiliation(s), outside
facilities that are used for particular
procedures performed by the physician (for example, particular hospitals or
clinics), compensation
information (indicating a financial account for receiving payment
for.purehases-Of services offered by
the physician via the system), and any other suitable identifying information,
as well as a unique user
name and password associated. with the account that can be used to log into
the account, may be
included in the respective account information record for the physician that
is maintained within
physician profile database 114b. The account information record for each
physician can also be:
associated with an. account status and a unique physician account identifier
within physician profile
database 114b that is used by application server 116 for performing various
operations.
101.051 practice group profile database 114e is used to maintain account
information, records for
practice group administrator users that register with server system 110 to
offer healthcare services
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provided by physicians affiliated, with a practice group for purchase by
customer users registered with
the system. For each practice-group for which-an account is registered with
server system 110, various
items of information relevant to the practice, such as practice group name,
location and hours, -contact
information, I.J.Rts or references to websites and social media profiles for
the practice group, physician
and. hospital affiliation(s); outside facilities that: are used for particular
procedures performed! by
physicians affiliated with thepractice group, compensation information
(indicating a financial account
for receiving payment for purchases of seiviees offered by affiliated
physicians via -the systeM), and
any other suitableidentifying.information, as well as a unique user name and
password associated with
the account that can be used by the practice group administrator to. log into
the account, maybe inetuded
in the respective account information record for the practice group that is
maintained within practice
group profile database 114c. The account information record for each practice
group can also be
associated with an account status and a unique practice. group account
identifier within practice group
profile database 114c that may be used by physician users. registered with the
system for affiliating
with the practice group and used by application server 116 for performing
various operations.
101061 The hospital system .profile database 114d is configured to register
and maintain account
information records for hospital system administrators -providing pre-paid
healthcare services. Hospital
system profile database 114d is used to maintain account information records
for hospital system
administrator users that .register with server system 11.0 to make on-site, in-
person sales of pre-paid
healthcare services provided by physicians affiliated -with a hospital system
for purchase by patients
operating:client systems within marketplace system 100: For each hospital
systemfor which an -account
is registered with serversystern 1.10, various items of information relevant
tO the hospital system, Such
as practice group and physician affiliation(s), facilities that are used for
particular procedures
performed by physicians affiliated with the hospital -system, compensation
information (indicating a
-c. ............. .
briaricuti aecount for receiving payment for purchases. of services offered by
affiliated physicians via
the system), and any other suitable identifying infoffnation,as well as a
unique user name and password
associated with the account. that can be used by the hospital system
administrator to log into-the account,
may be included in the respective account-information record for the hospital
system that is maintained
within hospital system profile database 114d. The respective account
information record for the
hospital system may further include a plurality of unique user names and
passwords associated with
the account that can be respectively used by hospital' system staff members to
log into the account The
account information record for each hospital system can also be associated
with an account status and
a unique hospital system account identifier within hospital system profile
database 114d that may be
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used by physician users registered with the system for affiliating with the
hospital system and used by
application server 116 for performingvarious operations.
101.071 :Phamiacy profile database 114e is used to maintain account
information records for pharmacy
administrators that register with server system 110 to oiler healthcare
products, such as prescription
drugs and medical supplies, for purchase by customer users registered with the
system. For each
pharmacy for which an account is registered-with server system 110, various
items of information
relevant, to the pharmacy., such as name, location(s) and hours, contact
information, URLs or references
to web.sites and social media profiles, compensation information (indicating a
financial account for
receiving payment for purchases of ph:ducts offered by th.e .phatady via the
system), and any other
suitable identifying information, as well as a unique user name and password
associated with the
account that can be used to log into the account, may be included in the
respective account information
record for the pharmacy that is maintained within pharmacy profile database I
14e. The 'account
inforination -record for each pharmacy can also be associated -with an account
status and a unique
pharmacy account identifier within pharmacy profile database 114e that is used
by application server
116 tbr perforthing 'various operations.
fp 108] Condition information database 114f is used to maintain information
records for -various
health conditions and diseases for which corresponding healthcare services
(for example, test and
treatments)That can be offered by providers registered with server system 110
for purehate by customer
users registered with the system. In exemplar* embodiments, the various
cOnditions, and diseases for
which respective information records are maintained in condition information
database 114f and the
information that populates the respective information record for each
condition or disease can be
created and maintained by. a baekt-end administrator of server system 110. For
each condition or disease
for -which an information-record-is created, various items of information
relevant to the condition or
disease, such as name, description, causes, risk factors, symptoms, common
treatments, corresponding
healthcare services that can be offered by providers registered with server
system 110 (for example,
each associated healthcare service may be identified within the information
record using a unique
procedure identifier that is used to identify an information record for the
service within available
services database I Mg as discussed below), and any other suitable information
may be included in. the:
respective information record for the condition or disease that is maintained
within condition.
information database 114f.
101091 'fhe available service database 114g is configured to register and
maintain records of various
healthcare services offered by at least one of a physician; and a hospital..
Available services- database
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114g is used to maintain information records for various healthcare. services
(for example, test and
treatments) that can he offered by providers registered with server system 110
for purchase by customer
users registered with the server system. In exemplary embodiments, the
respective information records
for healthcare servi ces that are maintained in available services database I
1.4g and the information, that
populates the respective. information. record for each service can. be created
and. maintained by a back-
administrator of server system 110. For each service for which an information
record. is .created,
various items Of information relevant 'to the service, such as riaine,
procedure detail, one Or More
medical specialties- with which the procedure is commonly associated., cost
information (ter example,
average prices for the service for patients that are uninsured arultur have a
high deductible insurance
plan and an average price for purchasing the service that is offered by
providers registered with server
system 110), a medical code number id:WWI:111,g the service according to the
nomenclature used by a
formal medical classification system (for example, a code that is used to
identify the service according.
to the Current Procedural Terminology (CPT) code set), a procedure identifier
that is used by
application server 116 to uniquely identify the. particular service, and any
other suitable information
may be included in the respective information record for the service that is
maintained within available
services database I litg,
t 10f Additionally, in exemplar), .embodiments, the information record for
each service that is
maintained within available services database 114g may further include an
indication of the whether
the service can be offered by providers within marketplace system 100 *man
individual primary .service
or as a primary service of a bundled set of a plurality of services (for
Which. a single payment for the
bundled set of Services will be disbursed to different provider an- each a the
services in the bundled
:set). In such embodiments, for each service for which. the information record
includes an indication
that the service is offered as a primary service of' a bundled set of
services, various items Of additional
information. relevant to the. bundled set of services associated with the
service, that is indicated to be a
primary service may be included in the respective information record for the
primary service that is:
maintained within available services database 114g. Suchitems of information
relevant to the bundled
set of services included in the respective information record for a primary
service may include, for
example, items of information describing one or more secondary services
associated with the primary
service (Such as name, a.medical code. number such as a CPT code identifying
the service according to
the nomenclature used by a. formal medical classification system, and a
secondary procedure identifier
that is used by application server 116 to uniquely identify the particular
secondary service in association
with the unique procedure identifier for the primary service), one or more
procedure identifiers for
other services for which an information record is maintained within available
services database 1.14g
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that are considered to be secondary services associated with the primary
service, an indication of
whether performance of each of the one or more secondary setviceS (for which a
single customer
payment for the bundled set of services will be -di gbursed among different
respective providers for the
services in the bundled. set) is optional or required in, association. with
performance. of the primary
service, and an indication of Whether the primary service is required to be
performed at an outside
.facility. In addition, in such embodiments, for each service for which the
information record includes
an indication that the service is offered As a pineal), service of a bundled
set of services, the Cost
information that is included in the respective information record for the
primary service that is
maintained within available services database. 114g can include respective
cost information for each of
the primary service, the one or secondary -services, and, if required, the use
of an outside facility for
the primary- service individually (for example, average prices for each
service and facility of the
bundled set of services for patients that are uninsured and/or have a high
deductible insurance plan) in
addition to an average price for purchasing the bundled, set of services that
is offered by providers
registered with server system 110.
101111 Semis:* offeredatatetee 1 Otis used to maintain information records for
healthcare services
that are being.offered by providers registered with the system for. purchase
by customer users registered
with the system. In this regard., it should be noted that the same service may
be separately offered by
multiple different providers registered with the system and, thus, service
offer database 11.4h can
include multiple information records for the same service that are each
associated with a different
provider. For each offered service for which a respective information record
is maintained within
service offer database 114h, various items ofitiforittatiorereleVant to the
service being offered, such as
the unique procedure identiner for the information record within available
services database I 1 4g for
the service, the unique Account identifier for the account information record
(within physician profile
database 1.141',, practice grow. profile database. 114c, or hospital system
profile database 114d) of the.
provider that is offering the service through the system, the unique:
physician account identifier forthe
account information record. within physician profile database 11.4b of the
physician. user that will
perform the service, a location at which the service will be performed, a
discounted price for purchasing
the service within marketplace system- 100, a regular price for the-service-
when the service is purchased
outside of the system, the unique account identifier for the account
information record (within
physician profile database 114b, practice group profile database 114c, or
hospital system profile
database 114d) of the provider for which payment for the service when
purchased through the system
is to be directed, a payment amount to be transferred to the-provider for
Which payment for performing
the service is to be directed, additional descriptive information that may be
provided by the provider
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offering the service, a procedure offer identifier that is used by
application. server 116 to uniquely
identify -the offering of the particular service: by the provider within the
system,. and any other-suitable
information may be included in the respective information record for- the
offered service that is
maintained within service offer database .114h.,
[01121 Additionally, in exemplary embodiments, the information records for
offered services that are
maintained within service offer database 11411 can include information records
that include additional
information for services that are offered by providers registered with the
system as a bundled set of
services. In this regard, the infonnation record foreadh offered service that
is maintained within service.
offer database 114h may further include an indication of the whether the
offered service is being offered
as an individual primary service or as a primary service of a bundled set of a
plurality of services (for
which a single customer payment for the bundled set of services will be
disbursed among different
respective providers for the sulfites in the bundled set):. In such
embodiments, fortach offeredserviee
for which the information record includes an indiction that the service is
being Offered by a provider
as a primary service of a bundled set of services, various items of additional
information relevant to
the bundled set of services associated with the offered service that is
indicated to be a primary service.
may be included in the respective information 'record for the offered service
that is maintained within
service offer database 114h. Such items of information relevant-to the bundled
set of services included
in the respective information record for an offered service within service,
offer database 114h that is.
indicated to be a primary service of a bundled set: of services may include
for example, items of
information for each secondary service such as the -unique procedure
identifier for the information
record within available services database 114t for the secondary service (or
the. Secondary procedure
identifier that is included in the available services database 114g to
uniquely identify the particular
secondary service in association with the unique procedure identifier for the
offered primary service
where the inforination, record for the primary service being offered in the
available services database.
114g includes an indication that the-service-is offered as a primary service
of a bundled set of services),
the unique physician account identifier for the account information record
within physician, profile.
database 114b of the physician user that will perform the secondary service, a
location at which the
.7117.7144.11rec3r6e performed, a discounted price for purchasing the
secondary service within marketplace
system 100, a regular price for the secondary service when the service is
purchased outside of the
-system, the unique account identifier for the account information record
(within. physician profile
database 114b, practice group profile database 114c, or hospital system
profile database 114d) of the
provider for which payment for the secondary service when purchased through
the system is to be
directed, a payment amount to be transferred to the provider for Which payment
for performing the
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secondary service is to be. directed, and an indication of whether performance
of the secondary service.
is Optional or required in. association with performance of the primary
service. The items of i nformati on
relevant to the bundled set of services included in the respective information
record for an offered
service, within service offer database 114h that is indleated. to be a primary
service of a bundled set of
services may further include, for example, an indication of Whether the
primary service is to be
performed at an outside facility and, if the primary service is to be
performed at an outside facility,
items of information pertaining to each of one or Morefacilities thatna ay be
used to perform the priMary
service such as, for example, name,: address, contact. information, facility
fee, and compensation
information indieatinga financial account thatis used by thefaeility
forreceiving a facility fee:.
101131 Available products database 114i is used to maintain information =
records for various
healthcare products (for exaMple, prescription drugs and medical supplies)
that can be offered by
pharmacies registered with server system 110 (that is, pharmacies for whiehr
an:account' infbrmation
record is maintained Within pharmacy profile database 114e) fOrpurchase by
customer users registered
with the system. In exemplary embodiments, the respective information records
for the healthcare
products that are maintained in available products database 114i and the
information th:at populates the
respective information record for each product can be created and maintained
by a back-end
administrator of server- system 110. For each product for which an information
record is created, various
items of information relevant to the product, such as name(s), a list of
dosage level options .(for
prescription drugs), size options (for certain medical' supplies), and the
like, a description of the
product, an indication Of whether a prescription is required to purchase the
product, information for
rendering a respective predefined finable form for submitting prescription
information for the product
within a user interface; cost information (for example, average prices for the
product for patients that
are uninsured and/or have a high deductible insurance plan and a lowest price
for purchasing the
product that is offered for the.service by pharmacies registered with server
system 110), a product
identifier that is used by -application server 116 to uniquely identify the
particular product, and any
other suitable information may be included in therespective intormationsecord
for the product that is
maintained within available products database 1141.
101141 Product offer database 114j is used to maintain information records.
for healthcare products
that are being offered by pharmacies registered with the system for purchase
by customer users
registered with the system. In this regard, it should be noted that the same
product may be separately
offered by, multiple different pharmacies registered With the system and,
thus, product offer database
114j can include multiple infoi-mation records for the same product that. are
each associated with a
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different provider. For each product. offered. by a pharmacy for which a
respective information record
is maintained within product offer database -114jõ variousiteins onnDoinati on
.'%!.1eYant.teilhe product
being offered, such as the unique product identifier for the information
record within available products
database 1141 for the product, the unique pharmacy account identifier for the
account information
record. withi n. pharmacy profile database 114e of the pharmacy that is
offering the product, 4 discounted.
price for purchasing the product from the identified pharmacy within
marketplace system 100, a regular
price for the product when the service is purchased -outside of the system
from the identified pharmacy,
a payment amount to be transferred to the pharmacy that is offering the
product, additional descriptive
information that may be provided by the pharmacy offering the product, a
product offer identifier that
is used by application server 116 to uniquely identify the information record
for the offering of the
particular product by the pharmacy within the system, and any other suitable
information may be
included in the respective information record for the offered product that is
.maintained within product
offer database 114j,.
101.151 The transaction information database 114k is configured to maintain
records of purchases
made by registered users. Transaction information database 114k is used to
maintain information
records for purchases that have been made via the system by registered
customer users of healthcare
services and products being offered by registered providers. For each purchase
of a service or product
that has been made using the system, various items of information relevant to
the purchase may be
included in the respective information record for the purchase that is
maintained 'within transaction
information database 114k. In general, the items of information relevant to
each purchase that is
included in the respective information record for the purchase: that is
maintained within transaction
information database 114k can include, for example, the unique customer
account identifier. of the
account information record for the purchasing customer within customer profile
database 114a, the
unique procedure offer identifier:of the information, record for 4 purchased.
service within service offer
database .1.14h or the unique product offer identifier of the information
record for a purchased product
within product offer database 114j, a purchase date, and a unique :transaction
identifier that is. used by
application server 116 to uniquely identify the information record for the
purchase of the service or
product within the system.. For each purchase ofa service that has been made
using the system, the
items of information relevant, to the purchase included in the respective
information record for the
purchase that is maintained within transaction information database 114k may
further. inelude = the
unique physician account identifier for the .account information record within
physician profile
database 114b of the physician user that is designated as performing the
purchased service. in the
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information record for the purchased service within service offer database
114h, an indication of
whether the purchase-has been redeemed and,. if the purchase has been
redeemed, a redemption-date:
101.161 Additionally, in. exemplary embodiments, the information records for
purchased services that
are maintained within transaction information database 114k- can include
information records that
include additional information for purchases and services that are offered by
providers registered with
the system as -a bundled Set. of services, In this regard, the information
record for each purchased
bundled. set of services that is maintained within transaction information
database 114k may include an
indication of a particular otitside sfacility that has been selected for
performing the primary service of
the 'bundled set of services and, for each service of the bundled set of
services thatis included within
the purchase (for example, each required secondary service or each Optional
secondary service selected
by the customer user to. he included within the purchase, as. well as. the
primary service), the unique
physician account identifier for the account information record within
physician profile database I 14b
of the physician -user that is designated as performing the service in the
information record for The
purchased service within service offer database 114h, an indication of whether
the purchase has been
redeemed with respect to that particular service, and, if the purchase has
been redeemed with respect
to that particular service, a redemption date for that particular service:
101171 FIG. 3A is a screen shot illustrating an example of a graphical user
interface, provided by such
a home page 300 tbr customer portal 121M4he ilht. exilthple, the search
interface provided at
home page 300 can include a drop-down mono- 302, a search entry field 304, a.
location entry field 306,
and a search button 308õ Drop-down menu 302 provides a set of' selectable
options that allow the user
to search for particular procedures offered by provider users registered with
the system, particular
products offered by pharmacy users registered with the system,: information on
providers- registered
with the system, and information on health conditions that is maintained
within system. In exemplary
embodiments, navigation and search service 124 can be configured- to use
location information that
may be gathered by any.suftable'lmAttion determining functionality implemented
on. the client system
to provide a default location entry (for instance, city name and/or zip
code)within location entry field
306. In such embodiments, navigation and search service -124 may be further
configured to request
permission from the user via the user interface to be able to access and
utilize- such location: information
for this purpose:
[01181 In one example, when the user selects the option Within, drop-down menu
302 to search for a
particular service offered by provider users registered with the: system, the
user can then proceed to
enter the name of the service within search entry -field 304 in conjunction
with selecting the particular
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service, the user can also enter a city name and/or zip. code or opt to
utilize a default location entry
Within location entry field 306 to localize a search radius for providers
offering the. selected service for
purchase via marketplace system 100.
101191 Once the appropriate search information is entered, the user can then
select-the search button
to direct navigation and search service.124 to conduct a search of local
providers registered with server
system 110 and offering the inputted healthcare service for purchase via
marketplace system 100.
Navigation and search. service 1.24 can conduct such a location-based search
by accessing, tbr example,
service oiler database 114h in conjunction with physician profile database
11.4b, practice group prOfile.
database 114c, hospital system -profile database 114d, and/or any other
suitable infOrmation and
databases to which the application server has access to filter the information
records included within
available services database 114g for healthcare: services: that match the
specified search criteria, and.
then present the -results of the search to user within a search result listing
page.
101201 in exemplary- embodiments, whenever navigation and search service 124
is. directed to
conduct a location-based search by a user (for example, for local providers
offering the inputted
healthcare service or, as discussed below, for local providers generally or
for local pharmacy providers
offering healthcare products), the navigation and: search service can be
configured. to maintain the
location specified within location entry field 306 for search within a data
object for a session with
application server 116 that. is maintained for the user.
101211 FIG. 3:B is a screen shot illustrating an example of a GUI provided by
a search result listing.
page 310 for customer portal 120 that presents a list of providers offering
the service specified within
search ontry field 304 within a default search radius (firr exarriple, 50
miles) of the location specified
within location entry field 306 returned in the search conducted by navigation
and search service 124.
In the illustrated example, search result listing page 31.0 includes a result
listing section 311, a result
filtering section 16, and a result ..sorting section .1 g. Result filtering
section 116 provides various user
.,.......
interface. controls for refining the results of the search presented within
result listing section .3-11 by
modifying the search criteria or inputting additional search criteria. In the
illustrated example, result
filtering section.
101221 In exemplary embodiments,. such a. search result listing page 310 can
be implemented to
present any other appropriate information relevant to the search criteria
specified by the user, such as,
for example, a graphic depicting the average cost information included in the
information record for
the particular product spthfied iii the search criteria that is maintained in
available products database
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114j (for prescription drug products, the average cost information can be
provided fora default quantity
of the prescription drug..or, alternatively, based on a calculation r
performed by navigation and search
service 124 for the quantity specified by the user using the average cost
information for a default
quantity as a reference).. Each. entry for an offered product. listed in the.
product search result listing
page can include portions presenting information from. the account information
record of the pharmacy
that is offering the product through the system (for example, pharmacy name
address, = and contact
information.), cost information for purchasing the offered. product-through
marketplace system 1.00 (for
example, the discounted price for the product. that is specified in the
information record for the offered
product within product offer database. 1).4j or, for -prescription drugs, a
price that is calculated based.
on the specified discounted price in relation to the quantity specified by the
user) and a cost savings
difference between the discounted price and the regular price for the product
when the product is
purchased outside of-the system as specified in the information record for-the
offered product), and an
option to select to purchase the offerral product listed in the entry (for
example, via an "Add to. Cart"
button). Whena user selects the option to purchase an offered product listed
in the product search result
.listing page, navigation and search service 124 can be configured to update
the session data object for
the session with application server n6 that is presently being maintained for
the user to include an
indication that. the user has selected the offered product for purchasing (for
example, by including the
product offer identifier that is -maintained within product offer database
11.45. to uniquely identify the
offering of the particular product by the pharmacy) in association with any
other requited information
(for example, in the case of a prescription drug, the quantity that is
specified by the user and the price
that is calculated based on the discounted price for the product that is
specified, in the information
record for the offered product within product offer database 114j in relation
to the quantity specified
by the user). Upon selecting one or More services and/or products for purchase
in association with a
session With application server 116, the user may thew have an option to
navigate to, a Customer
purchase. page (for example, a "Check-Out" page) to proceed with purchasing
the selected item(s) With
respect- to an account information record .maintained within customer profile
database 1.14a for a
leitgiamstomer user,
1231 For each offered service for which a respective entry is included in the
purchaseinfortnation
section, the entry- may include, for example, information retrieved from
physician profile database
114b, available services database 114g, service offer database 114h, and the
session data object such
as the name of the physician that will -perform the service, a service name,
and an indication of whether
the service is being -offered as a. primary service of a bundled set of
services. Each entry for an Offered.
service that is included in the purchase information section may further
include user interface controls
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accessible by the user to remove the offered service from the purchase
information sectien (and
correspondingly direct purchasing service-126 to remove the indication the
offered setviceas having.
been selected in the session data object) and/or to adjust a service quantity
to be purchased by the user,
a.n.d a:price for purchasing the offered service that is calculated based on
the service quantity specified
by the user and the discounted price for the service that is specified in the
information record .for the
offert.td. service within service offer database 114b- in relation to the
quantity specified by the user.
10124.1 In addition, for each entry for an offered service induded.in the
purchase information section
that is being offered as a primary service of a bundled set of services, the
entry may further include
user interface controls accessible by the user to present Additional
information about the bundled set of
services and .make additional selections regarding the offered service. The
additional information .may
include, for example, - information retrieved, from physician profile database
114b, available services
database 114g, and service ofkr database 114b, such as the name of physician
that will perform each
secondary Service, a serViet natrit for each secondary service, an indication
of whether each secondary
service is required or optional, and an indication of 'whether the primary
service is required to be
performed at an outside facility. In association with each secondary service
for Which an indication that
the secondary service is optional is presented, the additional information may
further include the
discounted price for the secondary service that is specified in the
information record for the offered
service within service offer database 114b, and an associated user interface
control may be provided
that allows the user to select whether to purchase the optional secondary
service in association with the
offered service. In -association with an indication that the primary service
is required to be performed
at An outside facility, the additional information May further include name
and location information for
each facility for. which information is Specified in the information record
for the offered service within
service offer database 114h, and, i finformation is specified for more than
one facility in the infonnation
record for the offered service, the facility fee for each specified facility
may be presented in association
with a user interface control that is provided to allow the user to select one
of the facilities at -which to
have the primary service performed. Purchasing service 126 can be configured
to, based on any optional
secondary service and facility selections that are made by the user with
respect-to an entry for an offered
service included in the purchase information section that is being offered as
a primary service of a
bundled set of services, recalculate and update the price for purchasing the
offered service that is
presented in the: entry for the offered service. In exemplary embodiments, the-
default initial settings for
any optional secondary service and multiple facility selections for a service
being offered as a primary
service of a bundled set of services and, thereby, the default initial price
for purchasing the offered.
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.service that is presented in the entry for the Offered service, may be based
on a selection. to purchase.
each optional secondary service and a selection of the facility having the
lowest facility fee:
101251 :En the example screen shot depicted in FIG. 3B, each entry for an
offered service listed in.
result listins section 311 -includes a first portion 312 presenting
information from. the account
information record within physician profile database 114b of the physician
that will perform the service
as specified in the information record for the offered service Within service
offer database 114h (for
example, the physician's name, specialty, and profile picture), a second.
portion 313 presenting
information from the aceount inforrnati on record of the provider that is -
offering the service through the
system (for example, provider name) and the location at which the offered
Service will be performed
(for example, address and telephone number), and a third portion 314
presenting cost. information for
purchasing the offered service through application server 116 (for example,
the discounted .price-for
The service that is specified in the information record. for the offbred
service within service offbr
database 114h and a cost savings difference between:the discounted price and
the regular price for-the
service when the service is purchased outside of the system from the; provider
as specified in the
information record for the offered service within service offer database
114h), and an option to select
to purchase the offered service listed in the entry (for example, via an "Add
to Cart" button included
within-third portion 314). When a user selects the option to purchase an
offered service listed in result
listing section 311, navigation and search service 124 can be
co,gfigigkAtompOtegtte session data
object for the session with application server 116 that is presently being
maintained for the user to
include an indication that. the Lisa has selected the offered service for
purchasing (for -example, by
including the procedure Offer identifier that is maintained Within Service
offer database 1.1=4h to
uniquely identify the offering of the particular service by the provider).
101261 Referring now to FIG. 3C, a screen shot -illustrating an example of a
GUI provided by a
healthcare service information page 320 implemented by navigation and search
service 124 for a
particular healthcare service i s provided. In the illuatrated example,
healthcare service information page
320 includes a procedure overview section 322, a cost comparison graphic 324,
and a. provider listing
section 326.
101271 The information presented in provider listing section 326 can be
generated in a manner similar
to the. information included in result listing section 311 of example search
result. listing- page 310
depicted in -FIG. 3B to present a list of providers offering the particular
service within a default search
radius (for example, 50 miles) of a location determined by navigation and
search service 124. The
particular location that is utilized for this puipose may be determined using,
for example, a location
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that is stored within the session data object for the session with application
server 116 that is presently
being- maintained for the user or location information that is gathered by any
Suitable location
determining functionality implemented on the client system to provide a
default location entry. hi the
present example, provider listing section 326 presents an entry for each
offered service for which a
respective information record is maintained .within service offer database
114h that matches the
particular service for which healthcare service information page 320 is
generated and along with the
determined locution. Each entry for an Offered service. listed in provider
listing section 326 presents-
information from the account. information record within physician profile
database 114b of the
physician that will perform the service as specified in the information record
for the offered service
within service offer database 114h (for example, the physician*s name and
profile picture) and cost
information for purchasing the offered service through application server 11.6
(for example, the
discounted price for the service that is specified in the information record
for the offered service within
service offer database 11.411). In-the present example, provider listing
section further indedes. a location
entry field 327 that, in conjunction With a "submit" button 328, allows a user
to specify a particular
location (for example, a city name and/or zip code) and submit a request for
navigation and search
service 124 to conduct a search and update the information presented in
provider listing section 326 to
present a list of providers offering the particular service within the default
searCh adius of the newly
specified location. Navigation and search service. 124 can also be configured
to, in response to such a
request update the location that is maintained within the session data Object
for the session with
application server 116 that is presently being maintained for theuser.
101281 In exemplary embodimentS, .as further illustrated in FIG. 3D, physician
information section
.332 can farther include .additional user interface elements such as a 'Leave
a review" button '333., a
"Request. an appointment" button 334, and a map element 335 depictinga mapped
location of an office
location included within respective account information record that. is
maintained for the particidar
physician user in physitiart profile database 114b (which navigation and
search service 124 may be
configured to. generate by remotely accessing a third-party mapping service).
In response to a user
selecting 'Leave a review" button 333, navigation and search service 124 can
be configured to
implement suitable user interfate controls for allowing the user to post or
submit a review of the
particular physician to server system 118. in response to receiving such a
review; navigation andsearch
service 124 can be configured to, for example, 'include information pertaining
to the review within the
respective account information record that is maintained for the particular
physician user in physician
profile :database 114b or send an electronic message. to the:physician user
pertaining to the. review, for
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example, by way of email utilizing: the contact information specified in the.
respective account
nform anon record for the physician.
101291 In response to a user selecting "Request an appointment button 334,
navigation and search.
service 1.24 Can be configured to, implement suitable user interface controls
for allowing the user to
submit a request for scheduling an appointment to the particular physician
user (for example, by
sending a notification to the physician user by utilizing the contact
information specified in the
respective account. int7ortnation record for the physician. that includes
contact information for the user).
Navigation and search service 124 may alSo be configured.toimpleMent suitable
user interface controls
for allowing the user to Schedule an appointment with the particular physician
user. Navigation and
search service 124 may provide this fianetionality by, for example, accessing
a service with which the
particular physician user is associated, which may be a service offered by
application server 116 or
ofThicd. by a third-party service provider.
101301 In the present example, as illustrated in F10. 3D, the information
presented in offered
procedures section 336 of physician profile page 330 can includes listing of
healthcare. services offered
by the particular physician for purchase through marketplace system 100.
101311 In the illustrated example, physician profile page 330 includes a
physician information section
332 and an offered procedures section 336. The information presented in
physician information section
112 can be generated based on the information that is included in the
respective account information
record that is maintained for the particular physician .user in physician
profile database 114b and may
include various items &information 'relevant to the physidan, such as name,
practice specialty, office
location(s) and hours, a profile picture, contact information, biographical
infonfnation (such as awards,
honors publications, patient testimonials, and Other information that may be
of interest to prospective
customers accessing the system), URLs or references to websites and social
media profiles, and group
practice and hoSpital -affiliation(s).
101321 In exemplary embodiments, the user interface implemented by account
management service
122 may he further configured to provide user interface- controls for
requesting authorization for
payment of a predetermined fee to gain access to the ability to make prepaid
purchases of healthcare
services and products offered within marketplace system 100. The payment.
information input by the
user may be an instruction to use the billing information- included within the
respective account
information record established for the user within customer profile database
114a or -submission of
-alternative payment information such as, for example, bank account
information, Credit or debit card
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information, or other electronic payment information (such as information for
utilizing an account the
User has with Pay Pal or any another- entity facilitating payments and money
transfers to be made
through the-Intemet), which may be for an account maintained for the user or
an account maintained
for another person or entity that the user is authorized to utilize for this
purpose
[01331 Account management service 122 can be configured to, upon the
authorization and
appropriate payment information being provided. by the user, access a
corresponding third-party
payment servicing system and utilize the payment information to direct the
payment servicing system
to transfer the amount for the payment authorized by the user from the account
servieer of theuSer to
finariCial account maintained = by the providers of marketplace System 100, In
this regard, the
respective account information record established for the user within customer
profile database 1.14a
can further include an account status that is managed by account management
service. 122 for the user
indicating whether the user is presently provided with the ability to make
prepaid purchases of
healthcare services and products offered within marketplace syStem 100.
101341 Upon a user registering a customer account with server system 110 to
establish an account
information record within customer profile database 114a and logging into his
or her customer account
(for example, by accessing a login user interface element or a login screen
within the user interface.
implemented by customer portal 120 to provide the user name and password
associated with the
sarlobnU **Amer then proceeds with purchasing any Offered service or product
for which the session
data object fOr the session with application server 116 that is being
maintained fcir the user includes an
indication that the user ha.s selected for purchasing. For example upon the
user selecting an option
within the user interface implemented by navigation and search services 124 to
navigate to a customer
purchase page and initiate a purchasing session with purchasing service: 126
to purchase one or more
of the offered items -indicated as having been selected by the user in the
session data object in
association -with the registered customer account for the user.
101351 The purchase information section included, within the user interface
implemented for the
payment page may further include a.total price for the purchase that is equal
to. a Sum of the respective
price for purchasing the corresponding offered item included for each entry
included in the purchasing
inforination section. lii exemplary embodiments, purchasing service 126 may be
configured to adjust
the total price based on any applicable state taxes or any discount codes
submitted by the user. In this.
regard, purchasing service 126 may be further implemented to provide A user
interface element
allowing a. user to submit any application discount codes to application
server 116,
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101361 For this purpose, the user interface controls: implemented within a
payment .section may
include a button that is accessible by the user to provide authorization for
the request to be issued to
the specified funding source (for example, a "Submit" or "Purchase" button)
along suitable user
interface elements accessible by the user to input the, purchase information
specifying. the funding
source to use for the. purchase. The purchase. information input by the user
may be an instruction to use
the billing information included within the respective account- information
record for the customer-
aticount of thei user within customer profile database 11.4a Or submission of
.alternative purchase
information such as, forexample,_ bank account. information, credit or debit
card information, or other
electronic payment. information. (suchus information for utilizing an account
the user has with. PayPal
or any another entity facilitating payments and money transfers to be made
through the Internet). The
purchase information may, for example, specify an account maintained' for the
user,. an account
maintained .for another person or entity that the user is authorized to
utilize for this purpose, or an entity.
that has arranged to be invoiced and provide reimbursement for purchases, of
healthcare services and.
products made by the user within marketplace system 100.
=11)131.1 airchasing server 1:26 can also be configured to, upon processing
the payment for the
purchase of the offered service, generate a voucher for the customer user
within the user interface for
the purchased service that can be utilized by the customer user-to redeem the
purchase and receive the
service, from the physician specified. for the offered service (the providers
of marketplace system 100
can have pre-arranged agreements with providers registered with the system
that the providers will
-agreeto honor -such vouchers generated by purchasing server 126 for purchased
services). An example
of such a voucher is illustrated in HO, 4/IL As depicted in the example,
example windier-400 can be
generated to include identifying information for the customer user- 402,
identifying and contact
information for the physician specified for the offered service 404, a
description of the purchased
service. 406, a confirmation number 408 for the:purchase, which may be
generatedby purchasing server
1.26 based on the unique transaction identifier that is included in the
respective information record for
the purchase that is maintained within, transaction. information.. database
11.4k, and instruetions for
redeeming the voucher 410. The confirmation number may also be provided- in
the electronic
confirmation message to the customer user and electronic notifications to the
physician user that will
be performing the service and the.provider user for the offered service sent
by purchasing system 126
to the customer user. The voucher can be presented to the user within the user
interface, for example,
as printable and/or machine readable form.
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101381 Purchasing server .126 can be configured to, upon processing the
payment for the purchase of
the offered service that is being offered as a primary service in conjunction
with a bundled set of
services, navigate the user interface to a purchase. confirmation page and
send an electronic
confirmation. message to the customer user and electronic notifications to
each physician that will
perform a service of the bundled set of services and the provider user for the
offered. service. (as
specified according to the information record for .the offered service within
service offer- database
114h), for example, by way of email utilizing the contact- information
specified in the respective
account information records for the customer, the physicians, and the provider
for the offered service.
Purchasing server 126 can be. also be configured to generate a. respective if
record .for the
completed purchase with corresponding information within transaction
information database 114k,
which initially indicates that the purchase has not yet been redeemed with
respect to the primary
service, each secondary service, and any facility specified .for the purchased
offered service.
101391 Purchasing server 126 can also be configured to, upon prOcessing the
payment for the
purchase of the offered service that is being offered as a primary service in
conjunction with a bundled
set of services, generate .a voucher for the customer user within the user
interface for the purchased
service that can. be utilized by the customer user to redeem the purchase and
receive the -service from
the corresponding physician specified for each of the services of the bundled
set of services (the
providers of marketplace system 100 can have pre-arranged agreements with
providers registered with
the system that the providers will agree to honor such vouchers generated by
purchasing server 126 for
purchased services). An example of such a voucher for a bundled set of
services is. illustrated in FICI:
4B, As depicted. in the example, example Voucher -400 can be generated to
inelude identifying
information for the customer user 402,. identifying and contact information
for each physician specified
for a service and any facility included in the offered service 404, a
description of each service of the
purchased service 406, a confirmation number 408 for the purchase, which may
be generated by
purchasing server 126 based on the unique transaction identifier that is
included in the respective
information record. for the purchase That is maintained within transaction
information database 114k,
and. instructions- for redeeming the voucher 410. The confirmation number (or
any other suitable
redemption information such as a one or two dimensional bar code, a QR. code,
or any other form of
machine readable information) may also be provided in the electronic
confirmation message to the
customer user and electronic notifications to -the physician user that will be
performing the Service and
the provider user for the offered service sent by purchasing system 126 to the
customer user. The
voucher can be presented to the user within the user interface for example, as
printable and/or machine
readable form.
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101401 Upon the user indicating an intention to register as a physician user;
the user will be able to
initiate a negi strati On session with account management service-131 to
register a physician account with
server system 110. Account management service 131 may be configured, for
example, to implement a
user interface that includes a series of pages with user interface controls
accessible by the user to guide
the user through the account registration process and prompt the user to input
various types of
information or media to be maintained by database server 112 -within a
respective aceountinformation
record that is established for the LetOtr within physician profile = database
114h such as, for ektirnple,.
name, practice specialty, office location(s) and hours, a profile picture,
contact information (Such as an
email address and/or a telephone itupthet), biographical information (such as
awards, honors,
publications, patient testimonials, and other information that can be helpful
for marketing the physician
to customers accessing the system), 1.1Rts or references to websites and
social media profiles,
compensation information (indicating a financial account for receiving payment
for purchases or
services offered by the physician -via the systeral information pertaining to
outside facilities that. are
used for particular services performed by the physician (for example,
information pertaining to
particularhospitals or clinics such as name, address, contact information,
facility fee, and compensation
information indicating a financial account. that is used by the-facility for
receiving a facility fee), and
any other suitable identifying (a descriptive information.. The uses.
interface may also be implemented
by account management service 131 to prompt the user for any group affiliation
codes or hospital
affiliation codes..
101411 Procedure management service 133 may be configured, for example, .to
implement a user
interface that includes a series of pages with user interface controls
accessible by the usetto guide the
user through the service offering process and prompt the user to input various
types of information to
be maintained by database server 112 within a respective information record
that is. established in
association with the uniquephysician account. identifier for the physician
within service offer database.
114h. Upon the user indicating an intention to offer a healthcare service for
purchase (for example, by
selecting a "Offer Service" tab withinthe practicegroup account page
implemented by provider portal
130), the user will be able to initiate a service offering with procedure
management service 133 to offer
a healthcare service performed by affiliated physicians for purchase via
server system 110. For
example, the user may be provided with a drop-down menu providing a list of
selectable medical
specialties and, upon selecting a particular medical specialty, the user can
be presented with a list of
selectable healthcare services for which an information record for the service
is maintained within
available seniCes database 114g in association with the specialty.
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pm]
:Upon the user selecting a particular service from this list,
procedure management service 133
can assist the user with offering the service for purchaseand establish the
respective information record
for the offered service within service offer database 114h. in particular,
procedure management-service
133 can present the user with a selectable list of the physician users
affiliated with the practice group
from which the: user can submit. an indication one or more of the. affiliated
physicians with which. to
offer-the service in conjunction with the practice group account. For each
selected affiliated physician
user, procedure management service 133 can establish a respective information.
record f& the offered
service within service offer database 114h by populating the information
record with the unique
procedure identifier for the information recordwithin available services
database 114g for the selected.
service, the unique account identifier for the account information record for
the practice group within
physician profile database 114b as the provider that IS offering the service
through the system,: the
unique account identifier for the account information record for the physician
user within physician
profile database 114b as. the physician user will perform. the service, a
location at which the -service
will be performed, the unique account identifier for the account information
record (within physician
profile database I.14h, practice group profile database :1:1.4c, or hospital
system profile. database 1.14d)
of the provider for which payment for the service when purchased through the
system is to be directed
(or, alternatively, other financial account information) as indicated by user
input received from the
practice group administrator, a payment amount to be transferred to the
provider or other financial
detwill6tuahich payment for the service is to
as specified by user input received frorrithe
practice group administrator, a discounted price for purchasing the service
within marketplace system
100 (Which may be calculated, for example, by adding a negotiated commission
fee to the payment
amount specified by the-practice group administrator), a regular price for the
service when the service
is purchased outside of the sy.stern,; additional descriptive information that
may be provided via input
received from the practice group administrator, a procedure offer identifier,
and any other suitable
information (such as an indication that the service is required.to be.
performed at an outside facility and
relevant facility information as specified by user input received from the
practice group administrator).
101431 in exemplary embodiments, procedure management service 133 can also
assist the practice
group administrator with offering services for purchase as a bundled set of
services within marketplace
system 100 and establishing the respective information record for the service-
offered as a bundled set
of services .within service offer database 114h. in particular, procedure
management service 133 can
present-the user with an option to indicate that a particular service selected
by the user should be offered
as a ptimary service of a bundled set of services.or, alternatively, the
information record for a particular
service .selected by the user that is maintained within available services
database.' I4g can include an
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indication that the service can be offered by providers within marketplace
system 100 as a primary
service of a bundled set of a plurality of Services,
101.441 For a selected service for which such. an indication is provided,
procedure management
service 133 may be configured, for example, to implement user interface
controls accessible by the
user to guide the user through the process for offering the selected service
as a primary service of a
bundled set of services and prompt the. user to input various types of
information to populate a
respective information record that is established in association with the
unique practice group- account
identifier for the practice group within service offer database. 1.14h.
Procedure management service 133
cari first present the user with a selectable list of the physician users
affiliated with the practice group
from which the user can submit an indication of affiliated physicians with
which to offer the primaiy
service in conjunction with the practice group accOuntaind then populatethe
information pertaining to
the primary service in the information record with the unique procedure
identifier-for the information
record within available services database 114g for the selected service, the
unique account identifier
for the account information record forthe practice group within physician
profile database 114b as the
provider that is offering. the primary service through the system, the unique
account identifier for the
account information record for the physician user within physician profile
database 114b as the
physician user will perform the primary service, a location at which The
primary service will be
performed, the unique account identifier for the amount information record
(within physician profile
database 114b,. practice group profile database 114c, or hospital system
profile database 1144) of the
provider for which payment for the primary service when purchased through the
system is to be directed
or, alternatively, other financial account information) as indicated by user
input received from the
practice group administrator, a payment amount -to be transferred to the
provider or other financial
itOtotoe.Uor which payment Ibr the. primary service is to be directed ..as
specified by user input received
from the practice group administrator, a discounted price for purchasing the
primary service Within
marketplace system 100 (which may be calculated, for example, by adding a
negotiated. commission
fee to the payment amount for the primary service- specified by the practice
group administrator), a
regular price for the primary service when the primary service is purchased
outside of the system,
additional descriptive information that may be provided via input received
from the practice group
administrator, a procedure offer identifier, and any other suitable
information.
101451 Procedure management service 133 can then receive an indication, either
from the
information record for a particular service selected by the user that is.
maintained -within available
services database 1-14g or through selections made by the User of Services
offered by affiliated
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physicians for which an information record for the service is maintained
within available services
database. 114g,. of one or more secondary services to be included in the
bundled set of services.
Procedure management service can then populate the information pertaining to
each secondary -service
in the information record with the unique procedure identifier for the
information record within
available services database I I 4g: for the secondary service (or the
secondary procedure identifier that.
is included in the available services database 114g to uniquely identify the-
particular secondary -service
in association with the. unique procedure identifier for- the offered primary
service where the
information record for the primary service being offered in the available
services database 114g.
includes an indication that the service is offered. as a primary service of a
bundled set of services),.-the
unique physician account identifier .for the account information record within
physician profile
database 114b of the physician user that will perform the secondary service, a
location at which the
service will be pertbrmed, the unique account identifier for the account
information record (within
physician profile database 114b, practice group profile. database 1.14e, or
hospital system profile
database 114d) Of the provider for which payment for the primary service when
purchased through the
system is to be directed for, alternatively, other financial account
information) as indicated by user
Input received from the practice group administrator, a payment amount to be
transferred to the
provider or other financial account. for which payment for the secondary
service is to be directed as
specified by user input received from the practice group administrator, a
discounted price for
purchasing the seeoridttry service within marketplace system 100 (which may be
calculated, for
example, by adding a negotiated commission fee to the. payment amount for the
secondary service
specified by the practice group administrator), a regular price for the
secondary service when the
secondary service is purchased outside of the system, and an indication of
whether performance of the
secondary- service is optional. or required in association with .performance
of the primary service.
Procedure managentent service ten fiirther populate the information in the
information rebord With an
indication of whether the primary service is to be pertbnned at an outside
facility and., if the primary
service is to be. performed at an outside facility, items ofimformation
pertaining to each Of one or more.
facilities that may be used to perform the -primary service such as, for
example, name, address; contact
information, facility fee, and compensation information indicating a financial
-account that is used by
the facility for receiving a facility fee (as specified by user input received
from the practice group
administrator).
f01461 Upon the user indicating an intention to request payment for a
purchased service that have
been performed (for example, by selecting a "Voucher Processing" tab: within
the physician account
page implemented by -Novi derportal 130), the user will be able to initiate a-
voucher processing-session
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with transaction processing service 136. In particular, transaction processing
service 136 may be.
configured, for example, to implement a voucher history page- within the user
interface that presents
information relevant to the physician user for a list of purchases for which
the respective, information
record for the purchase that: is maintained within transaction information
database 1141. includes the
unique physician account identifier for the physician. user within physician
profile database I Mb as the
physician user that is designated as performing.aserviee included-the purchase
(for example; a primary
or w,tzoodary liervice for -a bundled set of ervides): The relevant
inforthation for each listed purchase
may include, for example, the voucher confirmation number or redemption code,
name and contact
information for the customer user, a description of the service the physician
user is designated as
performing for the purchase, a purchase date, and a voucher redemption status.
Such a voucher history
page may also be accessed in association with the user account. for the'
physician user to verifY vouchers
presented customers requesting to have a service performed in association with
a voucher.
101471 The Voucher history page can also provide a user interface demerit in.
association With each
of the listed purchases for which the voucher redemption status for the:
service the physician user is
designated as performing indicates the service has not been performed that is
accessible by the
physician user to submit a verification to application server 116 that the
physician user has performed
the service for the customer user in accordance with the purchase.
INA Referring again to FIG. 2,. in exemplary embodiments, when a
user operating a Client system
to access application Server 116 via a corresponding client application
executing on the client system
initiates a registration with server system 1 le and specifies an intention to
register as a practice group
administrator Oar example, via a user interface element on any page
implemented by navigation and
search service 124), the user will be able to initiate .a registration
session: with account management
service 131 to register a practice group account With server system 110.
Account Management service
131 may be configured, for example, to implement a user interface that
includes a series of pages with
user interface, cOntrols accessible by the user to guide the user through the
account registration process
and prompt the user to input various types of information or media to be
maintained by database server
112 within a respective account information record that is established for the
user within practice-group
profile database 114c such as, for example, practice group name, *location and
hours, contact
information (such as an email address andior a telephone number). URI,s or
references to websites and
social media profiles for the practice group-, information pertaining to
outside facilities that are used
for particular procedures by physicians affiliated with the practice group,
(for example, information
pertaining to particular hospitals or clinics such as name, address, contact
information, facility fee, and
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compensation information indicating a financial account that is used by the
facility for receiving a
facility fee), compensation information (indicating a financial account for
receiving payment for
purchases of services that are performed by affiliated physicians via the-
system), and any other suitable
identifying or descriptive information...
[01491 The voucher history page can also provide a user interface element in
association with each
of the listed purchases for which the voucher redemption status for the
service indicates the servi cehas-
not been. performed that is accessible by the practice group user to submit. a
verification to application
server 116 that the affiliated physician user specified as performing the
service has performed the
service for the customeruser in accordance with the purchase.
101501 In exemplary:embodiments, when a user operating a client system to
access application server
116 via a corresponding client application executing on the client system
initiates a registration with
server system 110 and specifies an intention to register as a hospital system
administrator (for weal-14e,
via a user interface element on any page implemented by navigation and search
service 124), the User
will be able to initiate a registration session with account management
service 131 to register a hospital
system account with server system. HO. Account management service. 131 may be
configured, for
example, to implement a user interface that includes a series of pages- with
user interface controls
accessible by the. user to guide the user through the account registration
process and. prompt the user to.
input various types of information or media to be maintained by database
'server 112 within a respective
account information record that is established for the user within hospital-
system profile database 114d
such as, for example, contact intbrmation (such as an email address and/or a
telephone number),
information pertaining to outside facilities that can be used for particular
procedures by physicians
affiliated with the hospital system (for example,, information pertaining to
particular hospitals or clinics
such as name, address, contact information, facility- fee, and compensation
information indicating a
financial account for that is used by the facility for receiving a facility
fee), compensation. information
(indicating a financial accountfor receiving payment for purchases of services
performed by affiliated
physicians via the system)õ and any other suitable identifying. or descriptive
information.
101511 In exemplary embodiments, the functionality that is provided within
provider portal 130 for
users of hospital system accounts can vary in certain respects from the
functionality that may be
provided within provider portal 130 for users of practice group accounts. For
example, with respect to
physicians that are affiliated with the hospital system account, users of
hospital systein accounts may
only be provided with access. rights (for example, to view, modify, and
specify in a service being
offered by the hospital system fin- purchase) :to services offered for
purchase by affiliated physician
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users that have been specified by the physician users as being hospital
procedures with respect to the.
physician accounts. Hospital system users may also beprovided with
functionality to, as an alternative
to selecting a service by .accessing a list of selectable medical specialties
when initiating a service
offering with procedure management service 133 to offer a service.performed by
affiliated physicians
for purchase. via server system. 110, submit a search query for a service by
inputting descriptive terms
or a medical code number that is used to identify the service (for example,
according to the CPT code
set) or access a list of affiliated physicians and, upon selecting a
particular affiliated physician from the
list, be presented with a list of selectable healthcare services for which an
information record for the
= service is. .maintained within service offer database 114h that indicates
.the selected physician as the
physician that will perform the service.
101521 In addition, because ahOspital system may be more likely tootUr a
higher quantity of services
for purchase as a bundled set of services -within marketplace system 100 than
other types of provider
users, the functionality implemented by provider portal 130 within the user
interface for allowing a
user of a. hospital system account to manage information pertaining to
services offered by the hospital
system for purchase and to view .a history of transactions performed for
services offered for purchase.
by the hospital system within server system 110 may include an .additional
user interface element that
is accessible by a user for the hospital system account manage and view
information pertaining to only
services that are offered by thehospital system as a bundled set of services.
101531 FIG, 5 is a block -diagram of an exemplary computer System 600- that
can be used for
implementing exemplary embodiments of the present. invention, computer system
600 includes one or
more processors, such as processor 604. Processor 604 is connected to a
communication infrastructure
602 (for example; a communications bus, cross-over bar, or network). Various
software. embodiments
are described in-terms: of this exemplary computer system. After reading tin s-
description, it will become
apparent to a person of ordinary skill in the relevant: art(s) how to
implement the invention using other
cornpurer systems and/or computer architectures.
101541 Exemplary computer system 600 can include a display interface 608 that
forwards graphics,
text, and other data from the communication infrastructure 602 (or from a
frame buffer not shown) for
display on a display milt 610. Computer system 600 also includes a main memory
606, which can be
random access memory (RAM),. and may also include a secondary memory 6.12.
Secondary memory
61.2 may ineludeõ for example; a hard disk drive 614 and/or a removable
storage drive 616, representing
a floppy disk drive, a magnetic tape drive, an optical disk drive, etc.
Removable storage drive 6.10 reads
from and/or writes to a removable storage unit 618 in a manner well known to
those having. ordinary
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skill in the art. Removable storage unit 618, represents, for example, a
floppy disk, magnetic tape,
Optical disk, etc. which read by and written to by removable-Storage drive
6.16. As will be appreCiated,
removable storage unit 618 includes a computer usable storage medium having
stored therein computer
software andfor data.
[01551 In exemplary embodiments, secondary memory 612 may include other
similar means for
allowing computer programs or other instructions to be loaded into the
computer system. Such tneans
may include, for example, a removable storage unit 622 and. an. interface 620.
Examples of such may
include a program cartridge and cartridge interface (Such as that found in
video game devices); a
removable memory Chip (such as an EPROM, or PROM) and associated socket, and
other removable
storage units 622 and interfaces 620 which allow Software and data to be
transferred from the
removable storage unit 62.2. to computer system 600.
1:01561 Computer system 600 may also include a coin muniCations interface 624.
Communications
interface 624 allows software- and data to be transferred between the computer
system and external
devices. Examples of communications interface 624 may include a modem, a
network inteiface (such
as an Ethernet card), a communications 0311, a PCMCIA slot and card etc.
software and data transferred
via communicadons interface 624 are in the form of signals which may be, for
example electronic,
electromagnetic, optical, or other signals capable of being received by
communications interface 624.
These signals are provided to communications interface 624 via a
communications path (that is,
channel) 626. Channel 626 carries signals and may be implemented using wire or
cable, fiber Optics, a
phone line, a. cellular phone link, an RF link, and/or other communications
channels.
[0157] In this document, the torimi "computer program medium," "Computer
usable Medium," and
"computer readable medium" are used to generally refer to media such as main
memory 606 and
secondary memory 612, removable storage drive 616, a hard disk installed in
hard disk drive 614, and
signals:. These computer program products are Means for providing software to
the computer system.
The computer readable medium allows the computer system to read data,
instructions, messages or
message packets, and. other computer readable information from the computer
readable medium. The
computer readable medium, for example, may include non-volatile memory, such
as Floppy, ROM,
Flash memory, Disk drive memory, CD-ROM, and other permanent storage. It can
be used, for
example, to transport Information, such as data and computer instructions,
between computer systems.
Furthermore; the computer readable medium may comprise computer readable
information in a
transitory state medium such as..a network link and/or, a network. interface
including a wired network
or a wireless network that allow a computer to read such computer readable
information.
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101581 Computer programs (also called computer control logic) are stored in
main memory 606
and/or Secondary memory 612, Computer programs may also be received via
communications interface
624. Such computer programs, when executed, can enable the computer system to
perform the features
of exemplary embodiments of the present invention, as discussed herein. In
particular, the computer
programs, when executed,. enable processor 604 to. perform the features of
computer system 600.
Accordingly, such computer programs represent controllers of the computer
system.
10159] Referring now.to FIG. 6, a Schematic diagram illustrating an example
network architecture
for healthcare marketplace system 100 within which an exemplary embodiment of
a provider pricing
tool in accordance with the present invention is implemented. It should of
Course be understood that
"FIG. 6 is intended as an example, not as an architectural limitation for
different embodiments of the
present invention, and therefore, the particular -elements depicted in Bkli: 6-
should rot be. conSidered
limiting with. regard to the environments within. whi ch. exemplary
embodiments of the present invention
may be i in plertiented.
101601 in the example illustrated in FIG. 6, the particular components that
are utilized for providing
the provider pricing tool are integrated within system 100 in conjunction with
the components of the
system Its described above with reference to the exemplary embodiments
illustrated FIGS, 1 and 2.
More specifically, the. pricing tool 137 is shown in FIG. 6 as being
implemented within procedure
management setvice 133 included within provider portal 130, and data store
1.14 further comprises a
service pricing informatiOn database 114m and a cost adjustment information
database 1.14n that are
maintained by database server 112, are accessed by application server 116 via
database services
provided at a front end by database server 112, and retain information
collected from a variety of data
sources that is utilized in providing the services offered via the provider
pricing tool within the network
service provided by the application server, as described below it greater
detail.
tot 6 tj in the present 'exemplary embodiments, for Use in conjunction with
the physician service
pricing information within service pricing information database 114m, a
corresponding set of cost
adjustment data can be compiled and maintained Within cost adjustment
information database 114n
that can be applied to account forgeographical variances in physician costs.
The cost adjustment data
can, for instance, be compiled from and/Or determined based upon the
Geographic Practice Cost Indices
(GPOO, which is used along with IWITs-in Medicare Physician Fee Schedule (PPS)
provided by CMS
to determine allowable payment amounts for medical procedures in a manner that
reflects geographical
variations in practice cost. GPCis are used to help standardize the
differences in resource costs incurred
in operating a private medical practice across geographic areas when those
costs are compared with the
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national average costs for the physician work, practice expense, and
malpractice insurance components
of the fee schedule.
101.621 More specifically, the CMS- has established a GPC1 for every Medicare
payment locality-for
each Of The three relative value unit components for a procedure (that is, the
RN/Us for work, practice
expense, and malpractice), and the GPCis are applied. in the calculation of a
fee schedule payment.
amount by multiplying the RVI./- for each component times the GPCI for that
component.: A listing of
the current OPCI locality structure, including state, locality area (and when
applicable, counties
assigned .to each locality area), and the corresponding GPCis for each
locality, can be obtained from
the CMS website, and this information can be compiled and maintained within
cost adjustment
information database 114n by a back-end administrator of server system 110. In
exemplaiy
embodiments, a-specific cost adjustment factor can be determined based on the
GPC1 information for
each designated locality area and maintained Within cost adjustment
information database 114n. For
example, a standard rate adiustment factor for each designated lOcality area
can be determined by
calculating an average (or any other suitable aggregate or composite-based)
factor by which the
corresponding. GPCis for the locality impact the standard national rate
derived for each service. As
another example., such a standardrate adjustment factor for each. designated
locality area can be derived
directly from the Geographic Adjustment 'Factor (GAF) that is determined- for
.the locality by CMS.
The GAF for each designated locality area is calculated. as the weighted
average of the three GPCis,
where the weights are the percentage of RA/Us:nationally made up by the PW,.
PE, and MP RVUs.
101631 In another example, for each service for which the information record
within service priding
information database 114m includes an indication that the service is offered
as a primary service of a
bundled set of services along with an indication that the primary service is
required to be performed at
an outside facility, the respective pricing information that is included in
the information record for the
use of the outside facility can be determined by whether the use of the
outside facility is classified as a
facility outpatient service or a facility inpatient service. For instance, for
each facility outpatient
service,. the respective pricing information that is included, in the
information record for the use of the
outside facility can be obtained from the APC price data that is maintained in
association with CPT or
HCPCS procedure codes by CMS. CMS assigns: individual services classified
according to HCPCS
codes to APCs based on similar clinical characteristics and Sinii ar costs.
Thus, APCs are essentially
line-level fee schedules 'in which each HCPCS code for a service is assigned
to one of hundreds of
individual APCs, and for almost every APC, the fee is determined by
multiplying a prospectively
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established scaled relative weight for the. services clinical APC by a
conversion factor (CF) to arrive.
at a national unadjusted payment ratefor the APC.
101.641 Accordingly, in exemplary embodiments, for each service for-which a
respective information.
record is maintained within service pricing information database 114m and a
corresponding APC is
provided by CMS, the corresponding national unadjusted payment rate for the
facility outpatient.
service: can be included in the set of pricing information of the respective
information record for the
service within service pricing information database 114m.
101651 In the present exemplary embodiment, for use in conjunction with the
facility outpatient
service pricing information within service pricing information database 114m
discussed above, a
corresponding set of cost adjustment data can be compiled and maintained
within cost adjustment
information database 1.14n that: can be applied to account for geographic
differences. The cost
adjustment data for the .facility outpatient service pricing information can,
for instance, be compiled
from and/or determined based upon the facility wage index that is maintained
by the CMS.
101661 In the present exemplary embodiment; for use in conjunction with the
ladil ity inpatient service
pricing information within service pricing information database 114m discussed
above, a
corresponding Set of cost adjustment data can be compiled and maintained
within cost adjustment
information database I 14n that can be applied to account for geographic
differences.
101671 Similar to the example discussed above with regard to the cost
adjustment data for the facility
outpatient service pricing information, the costadjustment data for the
facility inpatient service priding
information can, for instance, be compiled from and/or determined based upon
the facility wage index
that is maintained by the CMS. As noted above, in exemplary embodiments, the
facility wage index
intbrmation can be obtained from CMS and maintained within cost adjustment
information database
11,1 n,
[0168] In this regard, it should be noted that certain services. for which the
respective information
record. within service pricing information database 1.14m includes an
indication that the service is
offered as a primary service of a bundled :set of services along with an
indication that the primary
service is. required tei be. performed at an outside facility may facilitate a
mapping of the use. of the
outsidefaeility to both facility 'outpatient service pike data and facility
inpatientservite price data. in
exemplary embodiments, for such services, a back-end administrator of server
'system 110 can make a
determination of which set of facility price data is more suitable to include
in the set of pricing
information of the information record. For example, such a determination may
be based upon whether
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the particular service is more typically perfornied as a facility outpatient
service or a facility inpatient
service in alternative exemplary embodiments, for each Service for which the
respective:information
record within service pricing information database 114m includes an indication
that the service is
offered as a primary service of a bundled set of services along with an
indication that the primary
service is required to be performed at an outside facility for which the use
of the outside facility can be
mapped to both facility outpatient service price data and facility inpatient
service price data, respective
information records can be maifitaitiedlbr the service as an outpatient
facility service and for the service
as an inpatient, facility service within service pricing information database
114m.
101691 In this regard, anesthesia time is a -continuous time period from the
start of anesthesia. to the
end of an anesthesia service, and one-time unitCorresponds to a 15-minute
interval, or fraction thereof,
starting from the time the physician begins to prepare the patient for
induction and ending when the
patient .may safely-be placedunder post-operative supervision and the
physician is no longer in personal
attendance The conversion factors are listed by the CMS according- to
locality. Thus, the conversion
factor in the formula listed above will correspond to the locality of the
performing provider.
101701 In exemplary embodiments, to access the functionality provided by
pricing tool 137õ a
provider user, upon registering a provider account With server system 110 (for
example, a physician,
practice group, or hospital system account) to establish an account
information record. within the
corresponding profile database Maintained -within data. Store 11.4 and logging
into his or her 'physician
account, the tiger may be directed to a provider account page implemented by
provider portal 130 that
provides a set of user interface controls that. can be accessed by the user to
access functionality provided
by procedure management service 133 to offer healthcare services fOr purchase
by customer users
registered with the system. As noted above, in the present exemplary
embodiment the accessible
functionality- provided by procedure management service 151 in this regard
includes the functionality
provided by .pricing tool 137,
101711 In particular, upon the provider user indicating an intention to
utilize pricing tool in
conjunction with offering healthcare services for purchase via server system
110 (for example, by
selecting a "Service Pricing Tool" tab within the provi der account.page-impl
emented by provider portal
130), the user will be directed man interactive service pricing page with.
information that is generated
haagd..en emlnrotmation maintained in the respective information record for
the provider within the
corresponding profile database maintained within data store 114 and
therespecti ve information records
for healthcare services that are maintained in service pricing information
database 114m. Price setting
tool 137 may be configured, for example, to implement the interactive service
pricing page to provide
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the provider user with detailed pricing information and recommended rates for
services that may be.
offered by the provider for purchase via Server system 110, as well as various
user interface controls
accessible by the user to petform adjustments to the recommended rates as
desired.
101721 FIG. 7A is a screen shot illustrating a first -example of a graphical
user interface provided by
such a service pricing page 700 for a user accessing provider portal 130 in
association with a registered
iftpital system account. In the example illustrated in FIG. 7A, the user
interface provided at Service
pricing .page 700 includes a medical. specialty drop-down menu 702, a locality
adjustmentsection 704,
a recommended rate adjustment Section 706, a detailed pricing information
section 708, and. a set of
selectable buttons 71.0a ("Email Prices"), 71-0b ("Save CharigeS")õ and 710c
("Take Live"), the use of
which will be described in greater detail below. Drop-down menu 702 provides a
list of selectable
medical specialties (for example, orthopedics, general surgery; cardiac
imaging, etc.), and pricing tool
is implemented to, in response to the user selecting a particular medical
specialty using drop-down
Menu 702, configure the user interface options and populate the inforniation
displayed within locality
adjustment section 704; recommended rate adjustment section 706, and detailed
pricing. information
section 708 in accordance with the selected medical specialty and further
based on information
maintained in the respective information record for the provider that is
maintained within hospital
system profile database 114d, information that is maintained in the respective
i nformati on records tbr
each service indicated as being commonly associated with the selected medical
specialty within service
pricing information database I 1-4m, and. infortnation maintained within cost
adjustment information
database 114n., which, as discussed above, can be. accessed by pricing loci!
137 via database services
provided. at .a front end by database server 112.
101731 For -instance,, in the example screen shot illustrated in. FIG. 7A, the
user has selected
"Radiology" from medical specialty drop-down menu 702, and pricing tool 137
has, it response to this.
selection, configured the user interface options and populated the information
displayed within locality
adjustment section 704, recommended rate adjustment section 706, and detailed
pricing information
section 708 in accordance with the selection of "Radiology" from drop-down
menu 702. More
specifically, as shown in FIG: 7A, locality adjustment section 704 has been
configured to include a
physician locality section and. a facility section in response to the
selection of "Radiology" from drop-
down menu 702. The physician locality section is provided for making pricing
adjustments based on
the locality of a physician that is affiliated with the hospital system and
would be performing the
radiology services being priced. The facility section is included within
locality adjustment section -704
in response to pricing tool 137 recognizing that the respective information
records for services indicated
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as being commonly associated with the selected medical specialty of radiology
within service pricing
information database 114m include- information records having an indication
that the service is a
primary service of a bundled set of services that is required to be performed
at an outside facility and
is provided for making pricing adjustments based on the facility that is
affiliated with the hospital
system. at which. the radiology services being priced would be performed.
101741 In the present. example, the physician locality section includes a,
physician location field 704a
and a physician location rate field 704b, and the facility section includes a.
facility field 7046 and a
facility rate -field 704d. The physician location field. 704a is for receiving
and displaying an entry
specifying the location of a physician that would be performing the. Services
indicated Its -bdittg
commonly associated with the selected medical -specialty of radiology within
service pricing
information database 114m, and. the physician location rate field 704h
isconfigured to provide a rate
adjustment factor for thc pricing information included in detailed pricing
information section 708 for
the services indicated as being 'commonly associated with radiology. In
exemplary embodiments,
pricing tool 137 can be configured to derive an initial physician location
catty based on the location
assmiated with physician affiliation(s) included in hospital system profile
database 114d and include
This derived physician location entry as a default value within physician
location field 704a. Physician
location rate field 704b is .provided -for receiving and displaying a
geographic adjustment rate -for
physician services that, by default, is derived based on information
maintained in cost adjustment
information database 114n and provided by pricing tool 137 in correspondence
with the physician
location entry that is currently specified -within physician location field
704.a. More particularly, in
exemplary embodiments, pricing tool 117 can be configured to access the
physician rate coat
adjustment data in cost adjustment information database 1140 that corresponds
to the physician
location entry that is currently Specified within physician location field
704a (for example, a Standard
rate adjustment factor determined for a designated locality area that.
encompasses the specified
physician location entry) and derive a corresponding geographic adjustment
rate that is displayed as a
default-value within physician location. rate field 704b
101751 In the present example, pricing tool 137 is further configured to allow
the provider user
accessing service pricing page 700 to proceed to enter text corresponding to a
desired location of the
physician that would perform the -services associated with the selected
medical specialty within
physician location field 704a. In this regard, pricing tool 137 may be
configured to require that the text
entered by the user in physician location field .704a correspond to a
particular locality area for which
corresponding physician rate adjustments are maintained in cost adjustment
information database 114n.
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101761 The fiat of suggested physician locations provided by pricing tool 137
can further include an
Option for the user to select a standard, national physician rate rather than
a particular geographic
location. in response to a specification of a new physician location within
physician location field 704a,
pricing tool 137 can be configured to dynamically access the physician rate
costadjustmentdata in cost
adjustment information database I 1.4n that corresponds to the newly-
specifiedphysician location entry
that iscurrently specified within physician location field 704a and derive a
corresponding geographic
adjustment rate that is displayed as the current value within physician
location rate field 704b.
101771 In exemplary embodiments, pricing tool 137 can be Configured to derive
an initial outside
facility- entry based on the facility affiliation(s) included the respective
'information record for the
hospital system accountin hospital system profile database 114d being used to
access the: pricing tool
137 functionality via provider portal 130. and include this derived facility
entry as a default value within
facility field 704c. Facility rate field 704d is provided for receiving and
displaying an adjustment rate
for facility services-That, by default, is derived and provided by pricing
tool 137 in correspondence with
the characteristics of 'the facility that is currently specified as the entry
within, facility field 704c.
101781 In the present example, pricing tool 137 is further Configured' to
allow the provider user
accessing serviCepricing page 700.tOproceed to enter text corresponding to a
name of a desired atitside.
facility at which the services associated widi the selected medical specialty
would be. performed within
facility-field 704e. In this regard, pricing tool 137 may be configured to
require that the text entered by
the user in facility field 704c correspond to the name of a particular
facility specified in the facility
affiliations included the respective information record for the hospital
system account in hospital
system profile database I I4d being. used to access the pricing tool 137
functionality via provider portal
130,
101791 With continued, reference to the example screen shot illustrated in
FIG. 7A, pricing tool 137
has, in response to the user selection *Radiology" from -medical specialty
drop-down menu 702,
configured the user interface options and populated. the. information
displayed within rate adjustment
section 706. More specifically,, as shown in FIG. 7A, rate adjustment section-
706 has been configured.
to include a physician rate adjustment field 706a and a facility rate
adjustment field 706b in response
to the selection of' "Radiology" from drop-down menu 702. Physician rate
adjustment 'field 706a IS
provided for making a general pricing adjUStiliallt to.the pricing information
included in detailed pricing
information section 708 for 'physician fees for the services indicated as
being commonly associated
with radiology as desired by the provider user that may be based on any
budgetary considerations
-spfie the provider and/or physician..
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101801 With continued reference to the example screen shot illustrated in FIG.
7A, as noted above,
pricing tool 137 has, in response to the tiger selection "Radiology" from
medical specialty drop-down
menu 702, configured the user interface options and populated the information
displayed within
detailed pricing information section 708. In general, as. shown in FIG. 7A,
detailed pricing information
section. 708 is generated by pricing tool 137 as a table with various
interactive user interface, controls
that includes a procedure column 711, a facility price column 71.2, a
physician price column 713, an
additiotial fee colurnn 714, eind a: total: amount column 71$.
10181I The information in procedure column 71.1 is generated by pricing FA 137
to include a row
entry for oath procedure category listed in the respective information records
for services 'that are
maintained in Service pricing information database 114m and include an
indication that the service is
commonly associated. with the: medical specialty selected via drop-down menu
702, which is
"Radiology" for the example screen shot depicted in FIG. 7A. For instance, the
procedure categories
listed in procedure column 711 in the present example include "Bone Density
DXA Extremity"
radiology procedures, "Bone Density DXA Scan"- radiology procedures, and
"Videofluoroseopic
Swallowing Study" radiology procedures. As further illustrated in FIG. 7A for
the example of the
"Bone. Density DXA Extremity" radiology procedures listing in in procedure
column 711, detailed
pricing information section 708 is implemented -to include user interface
elements that are accessible
by the user.
101821 In the present example, the expanded information for the "Bone 'Density
DXA Extremity"
radiology procedures liSting includes row entries for a "Dx.a bone
density/peripheral" service and a
"Fracture assessment via dxa" service. As fiuther illustrated in FIG. 7A, the
expanded information for
a particular procedure category further includes, for each servict categorized
as a sub-procedure of the.
procedure category, a medical code number used to identify' the service (for
example, a CPT code), a
base facility rate, a base -physician rate, an adjusted facility rate, and an
adjusted physician rate: The
base physician rate for each service listed in the expanded display is
obtained by pricing kid 137 from
standard national physician rate derived for the service and the adjusted
physician rate for each service
listed in the expanded -display- is calculated by pricing tool 137 for display
within detailed pricing
information section 708 by multiplying the corresponding base physician, rate
by both the: current value:
that: is specified in physician location rate field 704b of locality
adjustment section 704 and the current
percentage value that is specified in physician rate adjustment field 706a of
retornmended rate
adjustment section 706.
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101831 in the present example, as further illustrated in FIG. 7A, the expanded
information for a
parfiedilerrOcedure category further includes a physician price field 71 I a
that specifies a price-that
will be set by the provider user for each of the services that have-been
categorized under the expanded
procedure category and a facility price field 711b that specifies a price that
will he applied by the
provider user for the use of an outside facility foreach of the services that
have been categorized under
the expanded procedure category.
101841 in exemplary embodiments, pricing tool 137 can be configured to derive
and include initial,
default price values within physician price field. 711a and. physician price
field. 711.a As further
indicated in the example screen shot illustrated in FIG. 7A, the row entry for
aparticular procedure
category will include a pricing value under physician price column 713 that
corresponds to the pricing
value- that is speeified within physician price field 71.1a in the expanded
display for the procedure
category, and, likewise, the row entry for a particular procedure category
will include a pricing value
under facility -price cola-inn 712 that corresponds to the pricing value that
is specified within. facility
price field 711b. in the expanded display for the procedure category.. In this
regard, pricing tool 137 can
be configured to dynamically update the. pricing values provided under
physician price column 71.3 and
facility price column 712 in response to changes to the price values within
physician price field. 711a
and facility price field71.1b respectively. As further illustrated in FIG. 7A,
the row entry fora particular
procedure category can include a pricing value under total amount column 715
that is provided as a
sum of the price values listed under facility price. column 712õ physician
price column 713, and, if
included, additional fee column 714 in the rowentryfora particular
procedure.category This represents
the actual pride at which each service listed in the expanded display for a
procedure category would be
offered for -poi-Chase via marketplace system 100 as a bundled set or services
from the provider user
accessing servieepricing page 700 via providtirportal
101851 As noted above and further illustrated in FIG. 7A, the user interface
provided at service
pricing page 700 in the present example :also. includes a set of accessible
user interface controls 710a
("Email Prices"), 710b ("Save Changes"), and 710c ("Take Live"). For purposes
of the present example,
these user interface controls are provided within service pricing page 700 as
selectable buttons. In the
present exemplary embodiment, pricing tool 137 can be configured to, in
response to a provider user
selecting "Save Changes". button 710b, generate an information record that
includes indications of all
of the i nformation
101861 In the.present exemplary embodiment, pricing tool 13.7 can. be
configured to, in response to a
provider .user selecting "Email Prices" button 710a, provide user interface
controls for allowing. the
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user to specify an email address and send an electronic document that includes
indications of the pricing
nform ati on .
[01871 Finally, with reference: to the present example, pricing tool 137 can
be configured to., in.
response to a preVider tiger selecting "Take Live" button 710e, automatically
initiate, on behalf of the
provider user, a service offering with procedure management service 133 to
offer each of the services
currently included within detailed pricing information section 708 of service
pricing page 100 for the
particular medical specialty presented..selectedby the user from drop-down
menu. 702 for purchase via
server system 110. In this manner, -priting tool. 137 can provide a Mechanism.
for a provider-to Offer a
large number of services for purchase via Marketplace.systein 100 by customer
users registered with
the system without having to perform full set. of operations described above
for accessing flinctionality
provided by procedure management service 1.3.3 to offer each of the services
individually..
1.01881 FIG. 713 is a screen shot illustrating a second example of a
.graphical user interface provided
by service pricing page 700 for a user accessing provider portal 130. in
association with a registered
hospital system account. In the example illustrated in Ma 713, the user has
selected "General Surgery"
from medical specialty drop-down menu 702,. and pricing tool 137 has, in
response to this selection,
configured the user interface options and populated the information displayed
within locality
adjustment section 704, rate adjustment section 706, and detailed pricing
information section 708 in
accordance with the selection of -"General Surgery" from drop-down menu 702..
.More specifically, as
Shown in FIG. 7B, locality adjustment Section 704 has been configured, to
include, in addition to the
physician locality section and the facility section described above with
reference to the example
illustrated. in FIG. 7C, an anesthesia locality section in response to the
selection of "General Surgery"
from drop-down menu 702. The anesthesia locality section is included within
locality adjustment
section 704 in response to pricing tool 137 recognizing that the respective
information records for
services.
101891 in the present example, the anesthesia locality section includes an
anesthesia location field.
704e and an anesthesia location rate- field 704f The anesthesia location field
704c IS for receiving and.
displaying an entry specifying the location at which the services indicated as
being commonly
associated with. the selected medical specialty of general surgery within
service pricing information
database 114M would be-Performed, and thean.esthesia location rate field 704f
is configured to provide
a rate adjustment factor for the pricing information. included in. detailed
pricing information. section. 708
for the services indicated as being commonly associated with radiology.
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101901 Anesthesia location rate field 704f is provided for receiving and
displaying a geographic
adjustment rate for physician services That, by. default, is derived and
provided by pricing tool 137 in
correspondence with the anesthesia location entry that is currently specified
within anesthesia location
field 704e.. More particularly, in exemplary embodiments, pricing tool 137 can
be configured to access
the information pertaining to anesthesia rate adjustments in service pricing
information database I 14n
corresponding to the anesthesia location entry that is currently specified
within anesthesia location field
704e and derive a corresponding geOgraphie adjuAinent rate that is displayed
as. a -default yalutt daft.
anesthesia location rate field 704e. The corresponding geographic adjustment
rate can be derived, for
.ex,ample, based on. a ratio of the -CMS anesthesia conversion :factor to a
standard, national anesthesia
conversion factor.
101911 Specification of anew location within anesthesia location field 704e,.
pricing toed 137 can be
configured to dynamically access the information pertaining to physician rate
adjustments in
geographic -factors database I .14n corresponding to the newly-specified
phySician-locationtatry within
anesthesia. location field 704e and derive a corresponding geographic
adjustment Tate that is displayed
as the current value within anesthesia location rate field 704f. In the
present example, pricing WO! 137
is also configured to allow the provider user to directly access anesthesia
location rate field 704f and
specify a desired value 'for the geographic adjustment rate that will override
the particular geographic
adjustment rate that i.s derived by pricing tool. 137 based on thelocafion
entry within anesthesia location
.field 704e and displayed as the current value within anesthesia location rate
.field 7041 The effect of
such an entry- being submitted within anesthesia rate field 704f will be
described below with reference
to detailed pricing information section 708.
101921 With continued reference to the example screen shot illustrated in FIG.
7B, as noted above,
pricing tool 131 has, in response to the user selection "General Surgery" from
medical specialty drop-
down menu 702, configured the user interface options and populated
theinformation displayed: within
rate adjustment section 706:
1=01931 With. continued reference to. the example screen shot illustrated in.
FIG. 7B, as noted above,
pricing tool 137 has,. in response to the user selection "General Surgery"
from medical specialty drop-
down menu 702, configured the user interface options and populated the
infOrmation displayed within
detailed pricing. i nforrnaticin section 70:8, In general, as shown in FIG.
7B, detailed pricing: information
section 708 is generated by pricing toOl .137 a -a table with various
interactive user interface controls
that includes, in addition to procedure 'column .711, facility price column
7IZ physician price column.
713, additional fee column 714, and total. amount column 715:,. -an anesthesia
price column 716. As
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illustrated. in FIG, 7B, the expanded information for a particular procedure
category further includes,
for each service categorized as a sub-procedure of the procedure' category, in
addition to a medical code
number used to identify the service, a base facility rate, a base physician.
rate, an adjusted facility rate,
and an adjusted physician rate.as described above with reference to FIG. 7A,
a. base anesthesia rate and
an adjusted anesthesia rate.
101941 In the present example, as further illustrated in. FIG, 714, the
expanded information fel- a
particular procedure category further includes, in addition to physician,
price field 711a and facility
price field 711 b, an anesthesia price field 711e that specifies a price that
will be applied by The provider
user for each anesthesia service -performed in assoCiation With the services
that have been, categorized
under the expanded procedure category.
[01051 For example, pricing tool 13/ can be configured to enable the user
select between using the
average of the corresponding adjusted anesthesia. rates: for all services
listed in the expanded display
for a procedure category for the price values within anesthesia prieelield 711
e -or the highest of the
corresponding-adjusted anesthesia rates for all:services listed in. the
expanded display for a procedure
category for the price values within anesthesia price field 711e. In exemplary
embodiments, pricing
tool 137 can be further configured to allow the provider user accessing
service pricing page 700 to
access anesthesia price field. 711e to input a particular price value within
this field.
101961 As further indicated in the example screen shot illustrated in FIG. 7B,
the row entry for a
particular procedure category will include a pricing value under anesthesia
price column 716 that
corresponds to the pricing value, that is specified within anesthesia price
field 711c in the expanded
display for the procedure category. In this regard, pricing tool 137 can be
configured to -dynainieally
update the pricing value provided under anesthesia price column 71.6 in
response to changes to the
price value within anesthesia price field 711c. As discussed above, in
exemplary configurations of
pricing tool 117, such changes -to the price -value within anesthesia price
field 711e in the expanded
display for a particular procedure category may occur in response. to. changes
to any of the current. value
that is specified in anesthesia location rate field 704f of locality
adjustment section 704, the current
percentage value that is specified in anesthesia rate adjustment field /06c of
recommended rate
adjustment section 706., changes in the particular method employed by pricing
tool 137 to derive and
set the price value within anesthesia price field 711c, and directentries Of a
particular price value by a
provider user within anesthesia price -field 71.1c.
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101971 As further illustrated in FIG, 7B, the row entry for a particular-
procedure category can include
a pri cing value under total amount column 715 that is provided as a. sum. of
the price values hated under
facility price column 712, physician price column 713, anesthesia price column
716, and, if included,
additional fee column 714 in. the row entry for a particular procedure
category. This represents the
actual price at which each service listed in the expanded display for a
procedure category would. be
offered for purchase via marketplace system 100 as a bundled set of services
from the provider Um-
liodeashig service pricing page 700 via provider portal 130. In exemplary
embodiments, pricing tool
137 can be further configured to provide an option via user interface controls
implemented -within
= service pricing page 700 for a. provider user that is accessing the
service pricing page 700 and has
selected a medical specialty from drop-down menu 702 for which pricing tool
137 recognizes that: the
respective information records for services:indicated -as-being commsaly-
As,..so4ated ---17111111e selected
medical specialty within service pricinginformation database 114m include
information records having
an indication that the service is. a: primary service of a bundled set. of
services that a secondary -service
associated with the primary service in the bundled set is an anesthesia
procedure to not include
Information and options pertaining to the associated anesthesia procedures and
anesthesia pricing
information within the service pricing page for the selected medical
specialty.
101981 FIG. IC is a screen shot illustrating a third -example ofa graphical
user interface provided by
service pricing page 700 for a user accessing provider portal. 130 in
association with a registered
hospital system account. In the example illustrated in FIG. 7C, the user has
selected "GI"
(gastroenterology) from medical specialty drop-down menu 704 and priCingtool
137 has, in response
to this selection, configured the user interface OptionS anti populated the
information displayed Within
locality adjustment section .704, rate adjustment section 706, and detailed
pricing information section
708 in accordance with the selection of "OP from drop-down menu 702..
101991 In general, as shown in FIG. 7C, detailed pricing information section
708 is generated by
pricing tool 131 as a table with various interactive user interface controls
that includes, in addition to
procedure column 711, facility price column 112, physician price column 713,.
additional fee column
714, and total amount column 71.5, a pathology price column 717.
102001 As illustrated in FIG. 7C, the expanded information fora particular
procedure category further
includes, for each service categorized as a sub-procedure of
thepraxiwiairenategaty; 'in addition to a
medical code number used to identify the service, a base facility rate, a base
physician rate; an adjusted
facility rate, and an adjusted Physician rate as described above with.
reference to FIG. 7A, a base
pathology rate. The base pathology rate for each service listed in the
expanded display is obtained by
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pricing tool 137 from the patholegy rate. for the. service that is stored
within the respective, information
record maintained for the service Within service pricing information database
114m for display within
detailed pricing information section .708.
102011 In the present .example, as further illustrated in FIG, 7C, the
expanded information for a
particular procedure category further includes, in addition to physician price
field 711a and facility
price field 71.1 b, a pathology price field 711 d that specifies a price that
will be applied by the provider
user for each pathology service performed in association with the services
that have been. categorized
under the expanded procedure category. In exemplary embodiments, pricing tool
137 can be configured
to derive and include an initial, default pride value within pathology price
field 711d. For example,
pricing tool 137 can derive and set the default price value within pathology
price field 7.11d as the
average of the base pathology rates for all services listed in the expanded
display for a. procedure
category. In exemplary embodiments, pricing tool 137 can be further configured
to allow the provider
user accessing service pricing page 700 to access pathology price field 71.1d
to input a particular price
value within this field,
102021 As further indicated in the example screen shot illustrated in FIG. 7C,
the row entry for a
particular procedure category will include a pricing value under pathology
price column 717 Thar
corresponds to the pricing value that is specified within pathology price
field 711d in. the expanded
display for the procedure category. hi this regard, pricing -tool 1.37 can be
configured to dynaittically
update the Pricing value provided. under pathology price column 717in response
tO changes to the price
value Within pathology price field 711d. As further illustrated in FIG. 7R,
the row entry for a particular
procedure category can 'include a pricing value under total amount column 715
that is provided as a
sum of the price values listed under facility price column 71.2, physician
price column 713, pathology
price column 717, and, if included, additional fee column 714 and anesthesia
price column 716 in the
row entry for a particular procedure category. This represents the actual
price at which each service
listed in the expanded display for a procedure category Would be offered for
purchase as a bundled set
of services via marketplace system 100 from the provider user accessing
service pricing page 700 via
provider portal 130.
102031 in exemplary embodiments, the functionality that is provided within
provider portal 130 for
users of -hospital system accounts can Anther include a set of user interface
controls implemented by
service selling service 135 that can be accessed by .a user of a hospital
system account to sell prepaid
purchases of services to a customer in-person by operating a client system
located at, for example, a
medical clinic being -visited by the customer to access application server -
11.6. In this regard, service
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soiling service 135 may provide. functionality allowing a user of a hospital
system account to sell, in
addition to services that are offered for purchase by the hospital within
server system 100, services that
are constructed by -a user of a hospital system account, including bundled
sets of services.
102041 In exemplary embodiments, the user interface implemented by account
management service
131 may be further configured to provide user interface controls for
requesting authorization for
payment of a predetermined fee to gain access to the ability to offer
healthcare products for putellase=
within marketplace system 100. Such a fee may beõ for example, a one-tit-Me
charily or a. periodic:charge
(such as a monthly, biannual, or annual fee).
102051 'Upon the user indicating an intention to offer a. healthcare product
for purchase (for example,
by selecting a "Offer Service" tab within the 'Pharmacy account
page:implemented by provider portal
1.30), the user wilt be able to initiate a. product offering with, product
management service. .134 to offer
a healthcare product for purchase via server system 110.
1020611 Upon the user indicating an intention within. the pharmacy account
page implemented by
provider portal. 130 to access various account management functions, the
pharmacy administrator can
access various user interface elements provided by account management service
131 to, for example;
manage pharmacy and payment or compensation information, Manage information
pertaining to
products offered for purchase by the pharmacy, and view a history of
transactions performed. for
products offered for purchase by the pharmacy within server system 11Ø
I02071 In exemplary embodiments disclosed herein, because certain healthcare
information may be
consideredhighly confidential, marketplace system 100 canbe implemented to
provide for a high-level
of security for information transferred between Clientapplications executing
on client systems 142 and
application server 116. For illustration, whenever applicable, marketplace
system 1.00 (for example,
for operations and. functionalities) may be implemented to comply with
requirements under the Health
Insurance Portability and Accountability Act (1-11PAA). For example, if
certain type of information
-should not beaccessible to a specific party (for example, a prescription
product manufacturer or service
provider) according. to 1-11P:AA. requirements OT other confidentiality
concerns, system 100 can
implement information-control or information-protection measures that ensure
the specific party
cannot access that type .of information. As another example, to protect
patient privacy, information
'transmitted over a computer or 'communication network, such- as information
'transmitted between
application server 116 and any client system 140 and electronic messages
transmitted by server system
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110, can be encrypted. In exemplary embodiments, system 100 can be HIPAA-
validated to ensure.
privacy and comply with all requirements,
102081 FIG. 8 illustrates a flow chart of an insurance policy stored in. the
insurance database (114o,
shown in FIG. 2) executed by the application server (.1.16, shOwn in FIG.. 2).
The insurance database is
programmed to provide an optimized bundled price. 802 for healthcare services.
For exemplary
purposes, the system maximizes .collections at. each phase in the user's care
cycle. For various phases.
there is an option for paying the payment 804. The patient is referred or
scheduled for a procedure,
where the patient may receive a push notification to: pay prospectively.
Alternatively; the patient
checks-in at a provider's location and the patient pays: at the point of
service such as by cash, card,
digital wallet, etc. Alternatively, the patient is made to pay after services
are provided and/or at
discharge wherein, the patient receives a push notification to pay
retrospeetively.
102091 Further, each of the patients information is monitored such as but not
limited to a doctor's
order/schedule (for example, CRC Redox), propensity to pay data (C.TIC-
Vendor), benefit Status (CRC-
ribbon health) and CareCredit pre-approval. Based on the patient intbrmation,
a doctor's order is
matched. Further, the price is set based on the patient's capacity and/or
willingness:to pay for the service
and/or product_ Further, each payment is monitored.to check if a patient is
paying out-of-pocket. The.
system compares the bundled Price. to the remaining. patient deductible to
determine the patient's
sIt'stpheif3rallry for the services and/or product.. Furthermore, patients are
allowed to pay either in fiill
or through CareCredit.
102101 The system is configured to pay the optimal price in fnii every time to
the
hospital/phy.sicianlpharmacy and any associated service provider. The-
procedure is transparent and
acceptable to both patients and the provider. The service providers collect
the maximum data on the
patients who are willing to pay, Further, the hospital may leave revenue on
the table by charging less
than what patients are willing to pay
[02111 The application server (.116; Shown in FIG.. 2) processes the data
stored in the insurance
database 114o and allows the user to access the insurance information via, an
insuranee management
service (14, shown in FIG. 2). The hospital sends an electronic claim to the
system after care is
delivered to the patient. The -system then distributes payment and sends an
electronic remittance file
based on the information stored in the insurance database 114o. The system
passes the electronic claim
to the insurance company 806 to update the patient's accumulator (not for
reimbursement). The
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insurance 806 then notifies the system of accumulator status. The system then
.sends an update to the.
patients.
102121 FIG. 9 illustrates a block diagram of a virtual payment system-manager
170 communicating
with a client system in a healthcare marketplace system in accordance With
another exemplary
embodiment of the present invention. As noted above, exemplary embodiments of
the present invention
may be implemented to provide, a. virtual payment system for facilitating and
accounting for the
exchange of payment for services and products purchased by (or otherwise.
purchased on behalf of)
patients and offered by healthcare providers via the creation, transfer, and
redemption of Virtual funds
within A central server system 110.
102.131 In some exemplary anibodiments, the virtual payment. system manager
170 is configured to
facilitate the tracking and rnanagement of promotional credits that may be
offered by the providers of
a healthcare marketplace system 100 to registered users of the server system
110 for taking certain
-ea.le.An the system in association with their registered accounts.
102141 For example, the providers of a marketplace system 100 may offer a.
promotion to potential
customer users in whicheach user, upon completing registration of a respective
customer account with
server system 110, will receive a credit of a specified amount of funds (far
instance, a credit Of $25)
that the customer user may use to purchase services and/or products offered
within marketplace system
100 by provider users that are registered with server system 110.
102151 In one embodiment, the virtual payment System manager 170 is configured
to, access the
database server 112 to create the respective account information record. for
the virnial money account
for the customer within :the virtual money account database 114o, and access
database. server 11.2 to
create a new virtual fund corresponding to a specified amount for a
promotional credit within the
database of virtual fund objects included, in the respective account
information record.
102161 In this regard, the virtual payment system manager 170 generates a
unique identifier for the
new virtual Rind object being created and defines the attributes of the object
to include an indication
of the value of the corresponding virtual funds, the unique identifier
generated for the object., an
indication that the original funding source IS a credit that was conveyed by
theproviders of marketplace
system 100, a creation timestamp for the object, an indication that the
corresponding virtual fun& for
the object are not presently allocated to use as payment for an offered
service or product' purchased
within the marketplace system, and, optionally, an indication of an expiration
date for the promotional
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credit by which-the-customer user must use the credited funds to purchase the
services and/or products
offered within marketplace-system 1-00.
102171 In such an example, the virtual payment system manager 170 is
configured to further access
database server 112 to also create a corresponding.new virtual fund object for
the pitmotional credit
within the container of virtual fund objects included in the respective
account information record for a
ilaspeoliWifietual money account that is being maintained within virtual money
account database 114o
for an entity that. provides, the marketplace system (which may have already
been established, for
example, by a backend adininistrator of 'server system 110). More
specifically, virtual payment system
manager 170 generates a: unieue identifier for the new Virtual fund object
being treated and define the
attributes of the object. to include an indication of the value of the
corresponding virtual funds as a
negative value, the unique identifier generated for the 'object, an indication
that the. original funding
source is-a corresponding amount of real currency hcldWithin an external
financial account maintained.
by the providers of marketplace system 100 (and thereby owed -to the virtual,
payment system. by -the
marketplace system providers), and. a creation tirnestamp for the Object.
102181 In one embodiment the virtual payment system manager 170 is also
configured to, upon.
creating the -corresponding virtual fund objects for the promotional ereditwi
thin the respective account
information records for the. virtual money accounts for-the custOmer user and
the entity that provides
the marketplace systein within virtual Money account database-114o; updates
the total Mande values
and available balance values included, in the sets of general information
within the respective account
information records for the respective virtual money accounts appropriately to
reflect-the newly-created.
virtual fund objects.
102191 In the example illustrated in FIG. 9, the particular components that
are utilized for proaiding
the virtual payment system are integrated within system' 100 in conjunction
with the components of the
system AS described -above and herein below with refereaee to the exemplary
embodiments illustrated
FIGS. 1 and 2. In particular, as depicted in Fla 9, application server 116 is
further implemented. to
include virtual -payment system manager 170. As also depicted. in FIG. 9, data
store 114 further
comprises virtual money account database 114p, which is maintained by database
server 112, is
accessed by application server 116.
102201 in the present exemplary embodiment, virtual payment system manager 170
is shown in FIG:,
9 as including a virtual account management module 171, a transaction tracking
module 172, a
communication module 173, a virtual fund creatiOn and disbursement module 174,
a virtual payment
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processing module 175, and an adjustment processing module. 176. In general,
the various modules
implemented Within virtual payment system Manager 170 in the present exemplary
embitidiments are
configured to interact with one another, customer portal 120, provider portal
130, and data store 114
via database server 112 to perform the various operations described in the
examples. provided above
pertaining to exemplary embodiments in which a virtual payment system is
implemented within server
system 11Ø.
102211 The virtual account management module 171 is configured to access
virtual money account
database 11.4p to create respective account information records for respective
virtual money accounts
of .participants to transactions conducted within marketplace system 100. The
virtual account
management. .module 17.1 retrieves, maintains, performs .modifications to
respective information
account records as necessary M response to participants that are logged-tit to
server system 110
accessing the account management functions provided by account management
service 122 or account
Management service 13.1 to manage and viewinformatiOn pertaining to the
respective virtual money
accounts for the participants within the virtual payment system.
102221 Transaction tracking module 172 cart, for example, be configured to
dynamically perform
updates to the .accounting details pertaining to transactions conducted within
the virtual payment
system.. The module 172 dynamically calculates and performs updates to the
balance values that are
included within the general information in the reSpectiveaccount intbrination
records for the respective
virtual Money accounts in response to transaCtions conducted within the
virtual payment. system
102231 Further, module 172 dynamically -perfornit- processing for handling
virtual fund objects- that
have been created within the virtual .nioney zittotuit based on promotional
croditsthat have expired in
response to such expirations occurring, and dynamically perform processing for
reversing payment
processing operations performed within the virtual payment system for
purchases of offered services
and products that have not been redeemed within expiration periods specified
for sueb purchases in
response. to. the end of such expiration periods being reached
102241 Communication module 173 can, for example, be configured to :generate
notifications and
reports:with respect to virtual money accounts managed and transactions
conducted within the virtual
payment system:, transmit generated notifications and reportsto corresponding
components of customer
portal 120 and provider portal 130, receive notifications and information from
corresponding
components of customer portal 120 and provider portal 130, and process such
received notifications
and information.
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102251 Virtual fund creation and disbursement module 174 can, for example, be
configured to
implement -functionality-for creating or instantiating. neskvirtual fund
objects within -respective account
information records for virtual money accounts as needed for transactions
conducted within the virtual
payment system, processing disbursal requests within the virtual payment.
system (including
functionality for deleting virtual fund objects), and performing automatic-
periodic disbursals for virtual
money accounts within the virtual payment. system.
10226.1 Virtual payment processing module 175 can, for examplmi
Itieffeentissrad. re implement
functionality for performing operations for facilitating payment processing
within the virtual payment.
systeM for purchases of Offered services and products by customers users
registered with server systeM
110, as well as to perform corresponding updates to the attributes defining
the virtual fund Objects
within the respective .account information records in response. to perfenning
such operations for
facilitating payment processing within thc virtual payment: system. Adjustment-
processing- module. 176
can, fbr example, be configured to implement functionality for- performing
operations for processing
cancellation requests, refund requests,. and other modifications to purchases
of offered services and.
products for which payment processing is handled within the virtual payment
system, as well as to
perform corresponding updates to the attributes defining the virtual fund
objects within the respective
account intbrmation -records in response to performing such operations for
processing cancellation
requests, refund requests, and other modifications to purchases within the
virtual payment system.
102271 In exemplary embodiments disclosed herein, because certain healthcare
information may be
considered highly confidential, marketplace system 100 can be implemented to-
provide fora high-level
of security for information transferred between client applications executing
on client systems 142 and
application server 116. For illustration, whenever applicable,. marketplace
system 100 (for example,
for operations and furictionaliti es) may be implemented tocomply with
requirements underthenealth
Insurance Portability and Accountability Act (IIIPAA). As another example, -to
protect patient 'privacy,
information transmitted over a computer or communication network, such as
information transmitted
between application server 116 and any client system 140 and electronic
messages transmitted by
server system 110, can be encrypted. In exemplary embodiments; system 100 can
be HIPAA-validated
to ensure privacy and comply with all requirements.
102281 R.G. 10 illustrates -a block diagram of the application server showing
a deductible checker,
shopping cart -and drug discount card in accordance with another embodiment of
the present invention.
The.. application server 116 may further include a deductible checker 1002 to
look up the patient's
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deductible, a shopping cart 1004 for providing details of pricing to the user,
and a drug discount card
1006 forthe user for subscription of healthcare Services.
102291 The deductible checker 1002 allows patients/user's to look up their
deductible and to let the
user know whether the healthcare service offered is at better and/or
competitive prices. The Shopping
cart 1004 is automatically .communicated to the registered users with the
pricing details of the
healthcare services with which they intend to proceed. The shopping cart 1004
is automatically
communicated such as but not limited to email, SIvIS, flashing on the
graphical user interface, and any
other similar communication networks etc. The shopping Cart 1004 automatically
checks for any
deductibles, insurance and accordingly generates the pricingfor the user.
102301 In another embodiment, the shopping can 1004 is verified by an mtalyst
to confirm the
pricing. Thus., the shopping cart is sent to the analyst system and 'then to
the user. ThiS allows the user
to pie-pay for the. healthcare services. Further, the shopping cart 1004 is
generated with the right
bundled prices (e.g. accounting for discounts when certain procedures
arepurchased together etc.). The
drug discount card 1006 is provided to the users who subscribe to the
healthcare services
102311 FIG. 11 is a process flow illustrative of an example aspect of
patient lifecyde event
triggered shopping cart provisioning. design. The method depicted in FIG. 11
is given from the
perspective of an exemplary patient lifecycle event tri ggered shopping cart
provisioning engine (SCPE)
implemented via processor-executable program. instructions executing on the
SCPE processor 604,
depicted in .F10, 5. in various embodiments, the processor 604 implementing
the process 1100 may-be
configured in an exemplary system. 100 as described herein with reference to
any of Has.. I, 6, and 9.
For -example, the depicted process may execute as processor executable program
instructions on
processor 604 configured in the application server 116, depicted in FIGs. 1,
6, and 9. In various
embodiments, the method depicted. in FIG. 11 may also be understood as from
the perspective of
proee.ssomexectitable program instructions executing on a -mobile device
operably coupled with the
network 150, depicted at least in. FIGs. 1, 6, and 9. In the illustrated.
embodiment, the SCPE. executes
as program instructions on the processor 604, depicted in FIG. 5. In some
embodiments, the SCPE May
execute as a cloud service communicatively and operatively coupled with system
services, hardware
resources, or software elements local to and/or external:10 the SCPE processor
604,
102321 The depictedmethod 1100 begins at step 1105 with the Processor 604
receiving an electronic
message comprising a patient medical data update. The electronic message may
include an ERR
(Electronic Health Record). The. EHR may include updated patient medical data.
The patient medical
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data may be upd.ated. relative. to historical patient medical data. The
processor 604 may access and store.
the patient medical data using the. customer profile database 114a, depicted
in FIG. 2.
102331 Then, the method continues at step 1110 with the processor 604
determining, if a patient
lifecycle event is detected based on. the updated patient medical data. The
processor 604 executes the
process 1200, depicted by FIG.. 12 and described herein, to determine if a
patient lifecycle event is
detected. The processor .604 may determine if a patient lifecycle event is
detected based. on accessing
and storing patient,. practice, or condition data using, for example, any of
customer profile database
114a, practice group profile database 114c, or condition information database
114f, depicted in FIG.. 2.
102341 Then, the method continues at step 1115 with the -processor 604
performing a test to determine
if a patient. lifecycle event is detected, based on the execution of process
1200 by the processor 604 at
step 1110. Upon a determination by the processor 604 at step 1115 that a
patient- lifecycle event has
not been detected, -the method continues at step 1105 with the processor- 604
receiving an electronic
message coMptisi rig a. patient medical data update.
102351 Upon a determination by the processor 604 at step 1115 that. a patient
lifecycle event has been
detected, the method continues at step 1120 with the processor 604 executing
the process 1300,
depicted by FIG. 13 and described herein, to determine a medical service
bundle to be offered. The.
processor 604- may -determine the medical service bundle based on accessing
and storing medical
service, data using any of customer profile database 114a, physician profile
database 114b, practice
group profile database 114eõ condition information database 114f, or available
service database 114g,
depicted in FIG. 2.
1.02361 Then, the. Method -continues at step 11.25 with the processor 604
executing the process 1400,
depicted by FIG. 14 and described- herein, to offer the medical service bundle
for eelectien and
prepayment. For example, the processor 604 may offer the medical service
bundle for selection and
payment through the customer portal 120 (depicted by FIG. 2), using techniques
similar to. those
described herein with reference to the account management service 1.22 and
purchasing. service 126
(both depicted by FIG. 2).
102371 Then, the method continues at step 1130 with the processor 604
performing a testto determine
if payment' for the medical service bundle has been received. Upon a
determination by the processor
604. At step 1130 payment has not been received, the method eontinues at step
1105 with the processor
604 receiving an electronic message comprising a patient medical data update.
192381 Upon a determination by the processor 604 at step 1130 payment was
received, the method
continues at step 1135 with the processor Ofei...seliedelita the paid
services. In various embodiments,
the method may repeat. In some designs, the method may end.
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102391 FIG, 12 is a process flow illustrative of an example aspect of patient
lifecycle event triggered
Shopping cart provisioning design. The method depicted in Ha 12 is given from
the perspective of an
exemplary patient lifecycle event triggered shopping cart provisioning engine
(SCPE) implemented via
processor-executable program instructions executing on the SCPE processor
604., depicted in FIG.. 5.
In. various embodiments, the processor 604 implementing the process 1200 may
be configured in an
-exemplary system 100 as described herein with reference to any of FIG's. 1,
6, and O. In various
embodiments, the method depicted in. FIG. 12 may also be understood as from
the perspective of
processor-executable program instructions executing on a mobile device
operably coupled with the
network 150, depicted-at least in FIGs. 1,.6, and 9. :For example, the
depicted process may execute as
processor executable program instructions on processor 604- configured in the
application server 116,
depicted in .FIGs. 1, 6, and:. in theillustrated embodiment, the SCPE executes
as program instructions
on the processor 604, depicted in .FIG. 5. In some embodiments, the SCPE may
execute as a cloud
,scrvice.; coruntinica.tively and operatively coupled. with system. services,,
hardware resources, or
software elements local to and/or external to the. SCPE processor 6.04. The
depicted method 1200
begins at step 1205 with the processor 604 performing a test to determine if
the patient is a new patient.
The processor 604 may implement. the test to determine if the patient is a new
patient: based on patient
medical data encoded by an MIR,
102401 Upon a determination by the processor 604 at step 1205 the patient is a
new patient, the
method continues at step 1245 with the processor 604 indicating th the
invoking process that a patient
lifecycle event occurred,
102411 Upon a determination by the processor 604 at step 1205 the patient is
not a new patient, the
method continues at step 121.0 with the processor .604 determining the
patient's historical patient
lifecycle state based on patient medical data. The historical patient
lifecycle state may be the patient's
lifecycle state. preVits4othe lcutrentalvocation of proeeas 1200. The
historical patient lifecycle 'state
may be administratively assigned. The historical patient lifecycle stale may
be programmatically
determined by the processor 604 as .a function of patient .medical data
encoded by an EHR. The.
processor 604 may determine the historical patient- lifecycle state - based
on, for example, patient
medical data encoded by a previously processed EHR, administratively
configured patient medical
data, or an administratively configured lifecycle state. In -illustrative
examples, the EHR may encode
patient physiological data such. as, for example, a laboratory test report
indicating the concentration of
a substance in the patient'sbody, or a test result indicating a measured
patient physiological parameter
such as blood .pressure, 'heart. rate, weight, or height. The processor 604
may programmatically
determine the historical patient lifecycle state based on, for example,,
operations such as comparing,. or
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correlating, patient medical data encoded by an EHR with one. or more range of
similar data to
determine the patient lifecycle state. In an illustrative example, the
processor 604 may determine, the
patient lifecycle state to be new patient, well patient, acute care patient,
chronic care patient, or
recovering patient. Other patient aifeeyele states may be determined by the
processor 604 based on.
programmatically -analyzing patient medical data such as laboratory results
and measurements to
determine correspondence with standardized or administratively determined
medical data ranges. For
at step 1210 the processor 604 may determine a patient with a blood pressure
hi a.
predetermined range is an acute care patient based on patient. medical data
encoded by an ElaR.
102421 Then, the method continues at step 1215 With the processor 604
determining the current
patientlifecycle state based on updated patient-medical data. The processor
604 may programmatically.
determine the current patientlifecycle state based on updated patient medical
data encoded by an .EHR.
The ERR encoding updated patient medical data may be provided as input to the
system as a result of
a patient's examination by a medical professional.. The. EHR. encoding updated
patient. medical data
may be provided as input to the system as a result of a measurement by a
doctor during a patient visit.
The UM encoding updated patient medical data may be provided as input to the
system as a result of.
a measurement remotely performed. by a patient in a care context such as
telemedicirre, or self-care by
the patient in the patient's home. The operations perfeemed by the processor
604 to detenuine the
current patient lifecycle state at step 1215 are in. line with the operations
performed by the processor
604 at step 1210 to determine thehittOrical patient lifecycle state. in any
ease, the processor 604 at step
1215 determines the current patient lifecycle state based on evaluating
patient medical data. that has
been updated. In this example, the patient medical data has been updated.
relative to the patient medical
data analyzed by the processor 604 at step .1210 to determine the historical
patient lifecycle state.
102431 Then, the method, continues at step. 1220 with the processor 604
comparing the historical
patient lifocycle State determined by the processor 604 at step '1210 with the
current patient lifecycle
state determined 'IV tbe pittiKSOttinis: at step 1215, to determine if a.
patient lifecycle event occurred
based on the comparison. In an illustrative example, -the processor 604 may
compare the historical and
current lifecycle states based on comparing archived patient medical data-With
updated patient medical
data.
102441 Thee, the Method continues at Step 1225 with the processor 604
performing a test to determine
if the patient condition changed. The processor 604 may determine if the
patient condition changed
based on comparing -archived patient medical data, such as, for example, a
previous blood pressure
measurement or laboratory test result, with patient medical data updated by a.
more recent measurement
or result. For example, the prucessor -6-04 may determine patient condition
changed if a more recent
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test result or measurement is in a different range than a previous test result
or measurement. Upon, a
determinatiOn at step 1225 by the processor-604 patient condition' changed,
the method continues at
step 1245 with the processor 604 indicating to the invoking process that a
patient lifecycle event
occurred.
102.451 Upon a determination by the processor 604 atstep 1.225 the patient
condition did not change,
the method continues at :step 1230 with the processor 604 performi nu. a test
to determine-if the' patient-
status changed. The processor 604 may determine if patient Status changed
based on adminiSkatively
configured or programmatically determined patient.statits. The processor 604
may determine if patient
status changed based on comparing archived patient data With updated patient
data. The patient data
used by the processor 604 to determine patient status may be medical, billing,
payment, insurance, or
other data. In an illustrative example, patient status may be new patient,
activepatient, inactive patient,
former patient, referral patient, or referred patient. For example, the
processor 604 may determine
patient status changed from active to inactive if the patient has not kept. an
appointment for at: least a
predetermined time period. The processor 604 may determine the patient is a
new patient if patient
records were not previously accessible to the system. A referral patient may
have been referred from
another medical practice, and in view of this, patient care of such a patient
may benefit from customized
consideration, in line with what 'may be known by one of skill in the art.. A.
referred patient may have
specific goals resulting in. the patient's referral to another medical.
practice, or to a specialist, for
example. In an illustrative example, the referred patient May benefit from
optional services offered
through the specialist's practice. JP any case, upon a determination by the
processor 604 at step 1230
the patient status changed, the method continues at step 1245 With the
processor 604 indicating to the
invoking process that a:patient lifecycle event occurrect
102461 Upon a determination by the processor 604 at step 1.230 the patient
status did not change; the
method Continues ...'step 1235 with the processor 604 performing a test to
determine if another patient
lifecycle event occurred. The operations petfortned by the processor 604 at
step 1235 to determine if
another patient lifecyele event has occurred may include. comparing archived
patient data with updated
patient- data encoded. by an .EIIR received with a notification or
administratively configured. in the
system. In any case-the processor 604 may determine a patient lifecycle -event
other than: a Change in
patient condition or Status has occurred, based on comparing the archived. and
updated patient data, to
determine if a Change has occurred based on the comparison. The change
detected by the processor 604
may be any change in patient data that has. not been identified previously.
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102471 Upon a determination by the processor 604 at step 1235 another patient
lifecycle event has
not occurred, the method Continues at step 1250 with the processor 604
indicating to the invoking
process that. no patient lifecycle event occurred.
102481 Upon a determination by the processor 604 at. step 1235. another
patient. lifecycle event has
occurred-, the method continues at step 1240 With the processor604 determining
the patient lifecycle
event that did occur, based on the patient lifecycle state .compari son
performed by the processor 604. at
step 1220. The operations performed by the processor 604 to determine the
patient lifecycle event at
step 1240 are in line with the operations performed. by the processor 604 at
step .1225 and step 1230
with deeper analysis of the patient data at: -step 1240. The patient data
analysis performed by the
processor 604- at step 1240 may include lifecycle event determination based on
patient data input to a
predictive analytic,, machine learning, or artificial intelligence model
trained with patient data.
102491 Then, the method continues at step 1245 with the processor 664
indicating to the invoking
process that. a patient lifecycle event- occurred. In various embodiments, the
method may repeat. In
some designs, the method may end.
102501 FIG. 13 is a process flow illustrative of an example aspect of patient
lifecycle event triggered
shopping cart. provisioning design. The method depicted in 'FIG. 13 is given
from the perspective of an
exemplary patient lifecycle event niggered.shopping cart provisioning engine
(SCPE) imPlemented via
processor-executable program instructions executing on the SCPE processor 604,
depicted in. FIG. 5.
In VIITi011S embodiments, the processor 604 implementing the proetSs 1300 May
be configured in an
exemplary system 100 as described. herein with reference to any of .FIGs. 1,
6, and 9. For (maniple, the
depicted. process may .execute as processor executable program instructions on
processor 604
configured in the application server 116, depicted in FIGs. 1, .6, and -9. In
various embodiments, the
method depicted in FIG. 13 may also be understood as from the perspective of
processor-executable
program inStructiOns executing on a mobile device operably coupled with the
netWork 150, depicted at
least in FIGs. I., 6, and-9.. In the illustrated embodiment, the SCPE executes
as. program instructions on
the processor 604, depicted in FIG. 5. In some embodiments, the SCPE..may
execute as a eloud-serviee
communicatively and operatively coupled with system services, 'hardware
resources; or software
elements local to. and/or .external tothe SCPE processor 604. The depicted
method 1300 begins at step
1305 With the processor 604 creating:a default service bundle. Th.e.default
service bundle created by
the processor 604 may include a service for which a patient is already
registered. The service for which
the patient is already registered may be a primary serviceõ The default
service bundle may include a
service: window parameter related to a bundled service, such as, for example,
location., facility, time
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slot, or doctor. The processor 604 may create the default service bundle as an
empty bundle with no
service, Or no setvice-Window.
(02511 Then, the method :continues at step 1 MO with the processor 604
identifying. appropriate
optional services to offer to the patient based on patient medical data..
Theprocessor 604 may determine
an optional service is appropriate to a patient if the optional service
considered is not contraindicated.
by medical care -standards, in view of the patient's medical- condition. The
patients medical .condition
may be determined by the pi-oceSsor 604 using. techniques similar to those
described herein with
reference to process 1200,:depi eted by FIG. 12.
102521 Then, the method continues at step 1315 with the processor 604
determining if any
optional services determined at step 1310 by the processor 604 as appropriate
are medically indicated
for the patient based on the current patient lifecycle event and. patient
medical data. The processor 604
may determine an optional service is .medically indicated for a patient if the
service is related by medical
care standards to the. patient condition, for example, f a medical care
standard suggests a doctor
treating a patient with a given condition should also. consider treatment with
a particular class of drug
or screening by a particular test for another condition, the processor 604 may
determine that
consideration of the drug treatment or screening test may be medically
indicated for the patient based
on the current. patient lifecycle. event and patient medical data.. The
current patient lifecyCle event may
be determined by the processor 604 using techniques similar to those.
described herein with reference
to process 1200, depicted by FIG. 12.
102$31 Then, the method continues at step 1320 with the processor 604
performing a test to determine
if medically indicated procedures should be added to the default service
bundle, based on the
determination by the processor 604 at step 1315, as to whether appropriate
optional services may be
medically indicated. Upon a determination at step 1320 by the processor 604
some appropriate optional
service-is medically indicated, the method continues at step 1325 with the
processor 604 addingat- least
one medically, indicated appropriate optional service, to the default service
bundle. The service, added
to the service bundle.: by the processor 604 may include a. service window
parameter related to -the added
service, such as, for example, location, facility, time slot,- or doctor.
102541 Upon a determination at- step 1320 by the processor 604 no appropriate
optional service is
medically indicated, the method continues at step 1330 with the processor 604
performing a: tea to
determine if a follow-up service may be added to the service bundle. A follow-
up service may: be, for
example, mandatory,auch as a post-surgical visit for suture removal. In
sotnecases, a follow-up service
may be optional. A candidate fellow-up service: considered by the processor
604 for addition to the
service, bundle may be a follow-up service to a primary service, or a follow-
up service to an optional
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service.. Upon a determination by the processor 604 at step_ 1330 some follow-
up-Service may be added
to the Service bundle, the method continues at step 133:5 with the processor
604 adding: at least one
follow-up service to the.:service bundle.
1025.9 Upon a determination by the processor 604 at step 1330 no follow-up
service may be added
to the service bundle, the method continues at step 1340 with the processor
604 determining if
additional optional services are available within the same service window (for
example, location,
facility, time slot, or doctor) as a piiirnary service.
[02561 Then, the method continues at step 1345 with the processor 604
performing .a test.to determine
if an -optional service available in the. same service window as a primary
service may he added to the
service bundle. Upon a determination at step 1345 by the processor 604 an
optional service available
in the same service window as a primary service may be added to the service
bundle, the method
continues at step 1350 with the processor 604 adding to the service bundle an
optional service available
within -the same service window as a -printery service.
102571 Upon a determination at step 1345 by the processor 604 no optional
service available in the
same service window as a primary service may be added. to the service bundle,
the method continues
at step 1355 with the processor 604 determining if performing bundled services
in another optional
service window (that is, a service window different from, or alternative-to,
the Ornery service window)
would improve resource.utilization. The resource utilization data evaluated by
the processor 604 at step
1355 May include facility, equipment,. or medical -professional cost per unit
time, percent idle time, or
percent active time, The processor 604 may determine..if resource utilization
may be improved based
on comparing calculated projected utilization of one or more resource based on
the resource utilization
data for more than one service window. The processor .604 may determine the
relative cost to provide
service in various service windoWs,; to. facilitate offering a discount
determined by the processor 604
as a function of relative resource utilization between the service Window's.
102581 Then the method. continues at step 1360 with the processor 604
performing a test to determine
if offering service in an alternative. service window would improve resource
utilization, based on the.
evaluation of resource utilization in optional service windows performed by
the processor 604 at step
1355. Upon a-determination by the processor 604 at. step 1360 offering service
in an alternaiiveservice
window would. improve resource utilization, the method continues at step 1365
with the processor 604
adding an optional service window to the service bundle.
102591 Upon a determination by the processor 604 at step 1360 Offering service
in an alternative
service window would not improve resource utilization; the method continues at
step 1370 with the
processor 604 adding a prepayment discount determined as a function of
relative, service window
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resource utilization to the service bundle offer. In various embodiments, the.
method may repeat. In
some designs, the method May end.
102601 FIG. 14 is a process flow illustrative of an example aspect of patient
lifecycle event triggered
shopping cart provisioning design.. The method depicted in FIG.. 14 is given
from the perspective of an
exemplary patient lifecycle event triggered-shopping cart provisioning engine
(SCPE) implemented via
processor-exeeutattle program -iestructions executing on the SCPE processor
604, depicted in FIG, Si.
In various enibodimenta, the processor 604 iniplementing the process 1400 may
be configured in an
exemplary system WO as described herein with reference to any. of FIGs. 1, 6,
and 9. For example, the
depicted process may execute as processor executable program instruetions on
process.ot 604
configured in the application server 116, depicted in FIGs. 1, 6, and 9. In
various embodiments, the
method depicted in FIG. 14 may also be understood as from the perspective of
processor-executable
program instructions executing on a mobile device operably coupled with the
network ISO, depicted at
least in FIGs. 1, 0, and 9., In the illustrated embodiment, the SOT executes
as program instructionson
the processor 604, depicted in FIG. 5. In some embodiments, the SCPE may
execute as a cloud service
communicatively and operatively coupled with system services, hardware
resources, or software
elements local to and/or external to the SCPE processor 604 The depicted
method 1400 begins at step
1405 with the 'processor 604 constiuuting a shopping. cart based on the
service bundle offer
predetermined by the processor 604 executing the process 1300, depicted by
FIG. 13.
101611 Then, the Method continues Ai Step 1410 with the processor 604
presenting the shopping cart
of bundled services to a patient as a function of service. window (for
example, a service window may
include location, facility, time slot, doctor, or othervariables) and a
prepayment discount. The shopping
cart of bundled services may be presented to the patient in an email, text
message, mobile app, web
page, chat window, or automated phone call. Various designs may enable the
patient-to select, from
among the offered services presented in the shopping cart. In an illustrative
example, the shopping cart
may offer a choice of service window with some services. For example, given an
offered service such
as a particular medical procedure; a service window choice. presented to the.
patient with:the medical
procedure may include a -choice of location; facility; time slot, doctor, or
other optional procedures
available within the service window. in some -CaStgy more than one service
window may be presented
to a patient for selection. The service 'window *choice may include a
prepayment discount. More than
one prepayment discount amount or prepayment discount percentage may be
offered to a patient. The
prepayment discount may vary as a function of the service window. The
prepayment discount may be
determined, as a. function of medical practice resource utilization, medical
practice cost per unit time to
provide a service in the service window, or medical professional availability
during the service. window.
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The prepayment discount may be a prepayment discount valid for prepayment
before. a predetermined
date.
102621 Then, the method continues at step 1415 with the processor 604
receiving an indication of
patient. service selection from the shopping cart of bundled services
presented to the patient by the
processor 604 at. step 141Ø The. indication-of patient. service selection
may be an indication the .patient.
did not select an offered service after a predetermined time period. The
indication of patient:service
selection may be art indiCatiOn the patient rejected the oMred ser-vices.
102631 Then, the method continues at step 1420 with the processor 604
performing.a testto determine
if the patient selected a service. Upon a determination by the processor-604
at step.1420 the patient did.
not select a service, the method continues at step 1425 with the processor 604
optionally adjusting the
prepayment discount, and the method continues at step 1405 with the processor
604 constructing a
shopping cart based on a. service bundle .offer.
102.641 Upon a determination by the processor 604 at step 1420 the patient.
selected, a service, the
method continuesat step. 14.50 with the processor 604 applying the prepayment
discount to the -seeded
services, and the method continues at step 1435 with the processor 604
accepting payment In various
embodiments, the method may repeat.. In some designs, the method may end.
102651 Although various embodiments have been described with reference to the
Drawings, other
embodiments are possible.
102661 In the Summary above. and. in this Detailed Description,, and the.
Claims below, and in the
-accompanying drawings, reference is -made to particular features of various
embodiments of. the
invention. It is to be understood that the disclosure Ofembodiments of the
inventiOn in this specification
includes all possible combinations of such particular features. For example,
where a particular feature
is disclosed in the conteit of a particular aspeet or embodiment of the
invention, or a particular claim,
that feature can also. be used .. to the extent possible
............................... in combination with and/or in: the context of
other particular aspects and embodiments of the-invention, and in the
invention generally.
102671 In the present disclosure, various features may be described as being
optional, for example,
through the use of the verb "may;"; or; through the use of any of the phrases:
"in some embodiments,"
"in some implementations," "in some designs,' "in various embodiments," "in.
various.
implementationµ", "M various designs," "in an illustrative. example," or "for
example;" or,. through.the
use of parentheses. For the sake of brevity and legibility, the present
disclosure does not explicitly
recite each and every permutation that may be obtained by choosing from the
set of optional features.
However, the present disclosure is to be interpreted as explicitly disclosing
all such permutations. For
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example, a system described as having three optional features may be embodied
in sewn different
ways, namely With just One of the-three possible features, with any two of the
three possiblefeatures
or with all three of the three possible features.
102681 In Various embodiments, elements described herein as coupled or
connected may have an
effectual relationship realizable by a direct connection or indirectly with
one or more other intervening
elements.
102691 The phrases "connected to," "coupled to" and "in communication with"
refer to any form of
interaction between two or moreentitiesõ including mechanical, electrical,
magnetic, electromagnetic,
fluid, and thermal interaction. Two components may be functionally coupled to
each other even though
they are not. in direct contact with each. other. The -term "abutting" refers
to items that. are in direct
Physical contact with each other, although the items may not necessarily be
attached together.
102701 In the present disclosure, the term "any" may be understood as
number of the
respective elements, i.e. as designating one, at least one, at least two, each
or all of the respective.
elements. Similarly, the term "any" may be understood as designating any
collection(s) of .the
respective elements, i.e. as designating one or more collections of the
respective elements,: a collection
comprising one, at least one, at least two, each or all Of the respective
elements. The respective
collections need not comprise the same number of elements.
102711 While various. embodiments of the present invention have been disclosed
and described in
detail herein, it will be apparent to those skilled in the art that. various
changes may be made to the
configuration, operation, and form of the invention without departing from the
spirit and scope thereof.
In particular, it is: noted that the respective features of embodiments of the
invention, even those
disclosed solely in combination with other features of embodiments of the
invention, may be combined
in any configuration excepting those readily apparent to the person skilled in
the an as nonsensical.
Likewise, use of the singular and plural is solely for the sake of
illustration and is not to be interpreted
as limiting..
101721 The Abstract is provided to comply with 37 C. F. R. I.72(b), to allow
the reader-to quickly
ascertain the nature of the technical disclosure and is submitted with the
understanding that it-will not
be Used to interpretor-litnit the Scope or meaning of the claims.
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102731 In the present disclosure, any method or apparatus embodiment may be
devoid of one or more.
process steps or cOmponents, In the present disclosure, embodiments employing
negative. limitations
.are -expressly disclosed and considered a part of this disclosure.
102741 The term "comprises" and grammatical equivalents thereof are used
herein to mean that. -other
components, ingredients, steps, among others, are optionally present.. For
example, an embodiment
"comprising" (or "whieh comprises") oompOrtents A, B and C can consist of
(i.e., contain only)
components A. B and C. or can contain not only components A, B, and C but also
contain .one or more
other components.
102751 Where reference is made -herein to .a method comprising two or more
defined steps, the
defined steps can be earned out. in any order or simultaneously (except Where
the context. excludes that
possibility), and the method can include one or more other steps -which are
carried out before any of
the defined steps, between two of the defined steps, or after all the defined
steps (except where the
context excludes that possibility).
102761 Recitation. in a claim, of the term "first" with respect to a feature
or element does not
necessarily imply the. existence of a second or additional such feature or
element.
102771 Reference throughout this, specification to "an.embodiinent" or "the
embodiment" means. that
a particular feature, . Structure, Or characteristie described in connectiOn
with that embodiment is
included in at least one embodiment. Thusõ the quoted phrases, Or variations
thereof; as recited
throughout this specification are not necessarily all referring to the same
embodiment.
102781 -Similarly, it. should be=appreciated that in the above .description of
embodiments, various
features are sometimes grouped together in a single embodiment,. Figure, or
description thereof for the
purpose of streamlining the disclosure. This method. of disclosure, however,
is not to be interpreted as
reflecting an intention that any, claim in this:or any application claiming
priority to- this application
require more features than those expressly recited in that claim. Rather, as
the following elairris.reflect,
inventive aspects- may lie in a combination of fewer than all features of any
single foregoing disclosed
embodiment. Thus, the claims following this Detailed Description are hereby
expressly incorporated
into this Detailed Description, With each claim standing on its own as a
separate. embodiment. This
-disclosure includes all permutations of the independent: elainiSwith their
dependent daints.
102791 Aspects of exemplary embodiments of the present invention described
herein .can be
implemented using One or more program modules and data storage units. As Used
herein, the 'term
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"modules", "program modules", "components", "systems", "tools", "utilities",
and the. like, include.
routines, programs, Objects, components, data :stnictures, and instructions,,
or instructions sets, and so
forth that perform particular tasks or implement particular abstract data
types. As can be. appreciated,
the, modules, refer to computer-related entities that can be implemented as
software, hardware,
firmware, and/or other suitable components that provide the described
functionality, and which may
be loaded into memory of a machine embodying an. exemplary embodiment of' the
present invention.
Aspects of the modules may be written in a variety of programming languages,
such as C, C++, Java,
etc. The functionality provided by modules used for aspects of exemplary
embodiments described
herein can. b.c combined.and/or further partitioned..
102801 As used "herein, the terms "data storage unit,* "data store", "storage
unit", and the like can
refer to any suitable. memory -device that may be. used for storing data,
including Manual files, machine
readable files, and databases. The modules and/or storage units can all he
implemented and run on the
same computing system (for example, the exemplary computer system illustrated
in FIG. 5 and
described below) or they can be implemented and run on different computing
systems. For example,
one or modules can be implemented on a personal computer operated by a user
while other modules
can be implemented on a remote server and accessed via a network.
102811 According to an embodiment of the. present invention, the system and
method may: be
accomplished through. the use a one or Mote Computing devices. As depicted,
for example, at least in
Ms. 1, 2 5, 6, and .9, one of -ordinary skill in the aft would. appreciate
that an exemplary system
appropriate for use with embodiments in .accordance with the present appl
'cation may generally include
one or more of a Central processing Unit (CPU), Random Access Memory (RAM), a
storage medium
(eg:, hard disk drive, solid state drive,: flash memory, cloud- storage), an
operating system. (OS), :one or
more application software, a. -display element, one or more communications
moans, or one or more
input/output devices/means. Examples of computing. devices usable with
embodiments of the present
invention include, but are not limited to, proprietary computing devices,
personal_ computers mobile
computing devices, tablet PCs, mini-PCs, servers, or any combination thereof.
The term computing
device may also describe two or more computing-devices communicatively linked
in a manner as to
distribute and share one or more resources, such as clustered computing
devices and server
banks/farms. One of ordinary skill in the art would understand that any number
of computing devices
could be used, and embodiments of the present invention are contemplated for
use with any computing
device.
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102.821 Throughout this disclosure and elsewhere, block diagrams and.
flowchart illustrations depict
methods, apparatuses (i.e,, -systems), and computer program products: Each
element of the block
diagrams and flowchart illustrations, as well as each respective combination
of elements in the block
diagrams and flowchart illustrations, illustrates a function of the methods,
apparatuses; and computer
program products. Any and all such functions ("depicted functions") can be
implemented by computer
program instructions; by special-puipose, hardware-based computer systems; by
combinations of
special purpose hardware -and computer instructions; by 'combinations of
general purpose hardware and
computer instructions; and so on --- any and all of which may be generally
referred to herein as a
"circuit'- "module," or "system.'
102831 While the foregoing datwingS and description may set forth functional
aspects of the disclosed
wstems, no particular arrangement of software, for implementing these
functional aspects shOuld be
inferred from .thcsc descriptions -unless explicitly stated. or otherwise
clear from the context:
102841 Each element' in flowchart illustrations may depict a step, or group of
steps, of a computer-
implemented method. Further, each step may contain one or more sub-steps. For
the purpose of
illustration, these steps (as well as any and all other steps identified and
described above) are presented
in order. It will be understood that an embodiment can contain an alternate
order of the steps adapted
to a particular application of a technique disclosed herein. All such
variations and modifications are
intended to fall within the scope of this ditclosure. The depiction and
description of steps in any
particular order is not intended to exclude embodiments having the steps in a
different order, unless
required by a particular application, explicitly stated, or otherwise Clear
from the context.
[02851 Traditionally, .a computer program Consists- cif a sequence of
COMpUtational Instructions or
program instructions. It will be appreciated that a programmableapparattis
computing device) can
receive such a computer program and, by processing the computational
instructions thereof, produce a
further technical effect.
102861 .A programmable apparatus may include one or more microprocessors,
microcontrollers,
embedded microcontrollers, programmable digital signal. processors,
programmable devices,
programmable gate arrays, programmable array logic, memory devices,
application specific integrated
circuits, or the like, which can be suitably employed or configured to process
computer program
instructions, execute computer logic, store computer data, and so on.
Throughout this disclosure and
elsewhere a computer can include any and all suitable combinations of at least
one general purpose
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computer, special-purpose computer, programmable data processing apparatus,
processor, processor
architecture; and so on.
102871 it will be understood that a computer can include a computer-readable
storage medium and
that this medium may be 'internal or external, removable, and replaceable, or
fixed. It Will also be
understood that a computer can include a Basic Input/output System (BIOS),
firmware, an operating
system, a database, or the like that can include, interface with, or support
the software and hardware
described herein.
102881 Regardless of the type of computer program or computer involved, a
computer program can
be loaded onto a computer to produce a particular machine that can perform any
and all of the depicted
functions. This particular machine provides a means for carrying out any and
all of the depicted
functions.
102891 The elements depicted in flowchart illustrations and block diagrams
throughout the figures
imply logical boundaries between the. elements. However, according to software
or 'hardware
engineering practices, the-depicted elements and the-functions thereof may he
implemented as parts of
a monolithic software structure, as standalone software modules, or as modules
that employ external
routines, code, services, and se forth, or any combinatiOn ofthese. All such
implementations are within
the scope of the present disclosure.
102901 Unless explicitly stated or otherwise clear from the context, the verbs
"execute" and "processr
are used interchangeably to indicate execute, process, interpret, compile,
assemble, link, load; any and
all combinations of the foregoing; or the like. Therefore, embodiments that
execute or process computer
program instructions, computer-executable code, or the like can suitably act..
upon the insmdfwe
code in. any and all of' the ways just-described.
102911 While the invention has been described in detail with reference. to
exemplary embodiments,
it will be understood by those skilled in the art that various changes arid
alternations may be made and
equivalents may be substituted for elements thereof without .departing fron
the scope of the invention
as-defined by the appended -claims. In addition, many modifications. may be
made to adapt a particular
application or material to the teachings of the invention without departing
from the. essential scope
thereof.
102921 -Variations described for exemplary .emboditnents of the present
invention can be realized in
any -combination desirable for each particular application. Thus particular
limitations, end/or
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embodiment enhancements described herein, which may have particular
limitations need be
implemented in methods, systems, and/or apparatuses including one or more
concepts describe with
relation to exerriplaty embodiments of the present invention,
102931 Therefore, it is intended that the invention not be limited to the
particular embodiments
disclosed as the best mode contemplated for carrying out this invention, but
that the invention will
include all embodiments falling within the scope of the present application as
set forth in the following
claims, wherein reference to an element in the singular, such tts by use of
the article "a" c/r. -"an" is not
intended to mean "one and only one" unless specifically so stated, but rather
one or more." Moreover,
no claim element is to be construed under the oroYisions of 35 U.S.C. 112,
sixth paragraph, unless
the element is expressly recited using the phrak "means for or -"step for.
These following claims
should be Mutt ____ -Lied to maintain the proper protection for thepresent
invention.
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