Invention Grant
- Patent Title: Method and system for managing appeals
- Patent Title (中): 管理上诉的方法和制度
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Application No.: US14016166Application Date: 2013-09-02
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Publication No.: US08694343B2Publication Date: 2014-04-08
- Inventor: Olakunle Olaniyan
- Applicant: Olakunle Olaniyan
- Agency: Im IP Law PLLC
- Agent C. Andrew Im
- Main IPC: G06Q40/00
- IPC: G06Q40/00 ; G06Q10/00 ; G06Q50/00

Abstract:
A system and method for managing insurance claim denials. The system and method reviews a denial of claim from an insurer and a patient medical record received from a healthcare provider to determine if an appeal should be filed for the denial. It prepares an appeal to the denial comprising an appeals overturn letter and supporting document and submits the appeal to the insurer if it determines that an appeal should be filed. The system then tracks and monitors the progress of the appeal and process the appeal determination received from the insurer. The system utilizes these tracking and monitoring information to streamline and improve the insurance claim process of the healthcare provider, such as developing and implementing claim denial reduction program.
Public/Granted literature
- US20140006065A1 METHOD AND SYSTEM FOR MANAGING APPEALS Public/Granted day:2014-01-02
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