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Competitive Health Receives Patent for Real-Time Medical Payments
MyHealthGuide Source: Competitive Health (CH), 4/7/08, www.competitivehealth.com
Mission Viejo, CA --- The U.S. Patent and Trademark Office has granted Competitive Health (CH) an important patent for its breakthrough technology used in the repricing of healthcare transactions at the time of service. The company’s patent, U.S. Patent 7,346,522, titled "Medical Payment System," refers to the system and method CH developed for real time repricing and auto-adjudication of healthcare transactions prior to authorizing payment.
This patented process ensures that the true "net" payment is made only after eligibility, PPO pricing, scheduled benefits and/or deductible history are determined real-time and eliminates the need for the patient to pay gross billed charges, reduce receivables for providers and reduces the need to file a paper claim.
Real-Time System Features
- 100% electronic repricing of transactions like physician office visits, lab, dental, and other ancillary providers.
- Real-time transmission of Payment information for Limited Benefit Programs, Health Reimbursement (HSA) and Health Reimbursement Accounts (HRAs)
- On-demand ID cards and PPO network identification
- On-demand out of network claims negotiation
"Competitive Health has made substantial investments in developing auto-repricing and auto-adjudication technologies for the prepaid card and insurance industries and we are pleased that the U.S. Patent Office has recognized the novelty of our approach. This patent validates our position as the technology leader in electronic repricing and auto-adjudication services," said Kimberly Darling, founder and CEO of Competitive Health. "consumer-directed benefit programs, limited benefit programs, hospital indemnity programs, and healthcare providers all benefit from our advanced technology. CH’s patented real-time, auto-adjudication technology validates the insureds’ transaction prior to payment, providing maximum cardholder convenience, savings and lower administrative costs for carriers," she said.
About Competitive Health
Competitive Health, Inc., headquartered in Mission Viejo, California, began operation in 1996 with a mission to provide innovative and intelligent payment
solutions for the limited benefit and consumer-directed benefits marketplace. Its primary product, First Access™ repricing solution, applies eligibility,
PPO fee schedule repricing, deductible history, indemnity office visit benefits, patient and/or carrier payment, multiple fee schedule hierarchy technology
including percentage of Medicare fee schedule repricing, real-time secondary PPO network identification and patented auto-adjudication technologies to the
limited benefit, indemnity, and non-logo secondary PPO and HSA marketplace.. CH’s have other patents that are pending. Competitive Health intelligently
routes data and provides real-time solutions to more than 35 managed care and administrative services organizations. Contact Kimberly Darling, Founder &
CEO, at 949-888-2511, kdarling@competitivehealth.com and visit www.competitivehealth.com.
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