Patents
US 10546098 B2: Claim reimbursement valuation and remittance validation
- Granted
- 2020-01-28
- Filed
- 2014-12-19 application 14577562
- Type
- Utility · 7 claims
- Elsewhere
- Google Patents ↗ · USPTO patent document ↗ · USPTO Patent Center record ↗
Abstract
A claim valuation engine is provided. The claim valuation engine enables a healthcare provider to accurately value an expected reimbursement of a claim from a payer based on a contract between the healthcare provider and the payer. Contract terms, code sets, fee schedules, and other valuation data is input into the engine. The engine receives a claim from a healthcare provider information system, locates a contract applicable for valuing the claim, correlates the claim attributes with the contract terms according to a hierarchy, and determines an expected reimbursement for each claim attribute or group of attributes. The claim valuation engine is further operable to determine contractual allowances, determine under and overpayments by validating remittances, and to simulate valuation of a contract by valuing a claim based on multiple sets of contract terms. The engine is further operable to generate output reports and post results to the healthcare provider information system.
Source: PVGPATDIS, file of 2026-04-10 (ipg200128.xml).
Assignees
| Assignee | Type | Place | Also on furp.org | Source |
|---|---|---|---|---|
| Passport Health Communications, Inc. 17 patents | US company or organization | Franklin, TN | PASSPORT HEALTH COMMUNICATIONS, INC. State business registration EXACT high confidence: identical full name and state | PVGPATDIS, file of 2026-04-10 |
Inventors
| Inventor | Place | Patents | Person page | Source |
|---|---|---|---|---|
| Richard Frank Derer | Westmont, IL | 2 | PVGPATDIS, file of 2026-04-10 |
CPC categories
| Subclass | Category | First group | Source |
|---|---|---|---|
| G06Q | Information and communication technology [ict] specially adapted for administrative, commercial, financial, managerial or supervisory purposes; systems or methods specially adapted for administrative, commercial, financial, managerial or supervisory purposes, not otherwise provided for | G06Q40/08 | PVGPATDIS, file of 2026-04-10 |
| G16H | Healthcare informatics, i.e. information and communication technology [ict] specially adapted for the handling or processing of medical or healthcare data | G16H40/20 | PVGPATDIS, file of 2026-04-10 |
Cooperative Patent Classification, as currently assigned (one row per subclass).
Assignments and security interests
| Recorded | What | From | To | Reel/frame | Source |
|---|---|---|---|---|---|
| 2020-05-20 | Name change Change of name | PASSPORT HEALTH COMMUNICATIONS, INC signed 2015-12-14 | EXPERIAN HEALTH, INC FRANKLIN, TN | 52709/502 | ECORSEXC, file of 2026-09-25 |
| 2014-12-19 | Assignment Assignment of assignor's interest | DERER, RICHARD FRANK signed 2014-12-19 | PASSPORT HEALTH COMMUNICATIONS, INC. FRANKLIN, TN | 34560/212 | ECORSEXC, file of 2026-09-25 |
Documents recorded with the USPTO Assignment Recordation Branch that list this patent. A security interest is a lender’s claim on the patent as collateral; a release ends it.
USPTO bulk data: PatentsView granted patents, disambiguated (PVGPATDIS) for patents, assignees, inventors, places and CPC categories; the USPTO Patent Assignment Dataset (ECORSEXC) for assignments and security interests. Patents filed in the last 20 years. No claims or full text. Links to other records are by name (and state): EXACT means the identical full name and state; FUZZY means a looser name match, with the confidence shown.