Automated Configuration of Medical Practice Management Systems

Abstract

A user (e.g., medical office manager, medical office insurance administrator, doctor) utilizes a medical practice configuration interface (e.g., web page) to input information about the user's medical practice (e.g., address, insurance plans, doctors, hospitals that the doctors utilize). Based on this information and/or rules associated with the insurance plans accepted at the user's medical practice, additional information is requested from the user about the user's medical practice (e.g., information needed for an insurance plan, information needed for a hospital). The user inputs the requested additional information utilizing the medical practice configuration interface. Configuration information for the user's medical practice is generated based on the information and/or the additional information inputted by the user. A user interface (e.g., web pages interfacing with the medical practice management server) and/or rules for the medical practice can be generated based on the configuration information.

1 . A method for automated computerized configuration of a medical practice management system, the method comprising:
 receiving first information associated with a medical practice;   generating one or more requests for second information based on the first information, one or more insurance rules that apply to one or more payor servers, which are associated with the medical practice based on the first information, or both;   receiving second information, which comprises information for submission of medical claims to the one or more payor servers, based on the one or more requests for second information; and   generating configuration information for the medical practice management system based on the first information, the second information, or both.   
     
     
         2 . The method of  claim 1  wherein the configuration information comprises information utilized to select third information for submission to a payor server, information utilized to format the selected third information for submission to the payor server, or both. 
     
     
         3 . The method of  claim 1  further comprising merging the configuration information with stored configuration information for the medical practice. 
     
     
         4 . The method of  claim 1  further comprising replacing stored configuration information for the medical practice with the configuration information. 
     
     
         5 . The method of  claim 1  further comprising:
 determining whether to request additional information based on the first information, the second information, the one or more insurance rules that apply to the one or more payor servers, or both;   generating one or more requests for additional information based on the first information, the second information, the one or more insurance rules that apply to the one or more payor servers, or both;   receiving additional information, which comprises information for submission of medical claims to the one or more payor servers, based on the one or more requests for additional information; and   generating configuration information for the medical practice management system based on the first information, the second information, the additional information, or any combination thereof.   
     
     
         6 . The method of  claim 1  wherein the first information and the second information being received from a user. 
     
     
         7 . The method of  claim 1  further comprising dynamically updating a user interface based on the first information, the second information, or both. 
     
     
         8 . The method of  claim 1  wherein the first information comprises medical group information, tax information, provider information, legal information, department information, patient information, medical office information, hospital information, place of service information, signature information, user information, user permission information, or any combination thereof. 
     
     
         9 . The method of  claim 1  wherein the second information comprises payor information, information associated with an insurance rule, or any combination thereof. 
     
     
         10 . The method of  claim 1  wherein the first information is different from the second information. 
     
     
         11 . The method of  claim 1  further comprising storing the first information, the second information, the configuration information, or any combination thereof in a medical practice information database. 
     
     
         12 . The method of  claim 1  further comprising generating one or more user interfaces for one or more users of the medical practice based on the configuration information. 
     
     
         13 . The method of  claim 12 , wherein the one or more users are healthcare professionals associated with the medical practice. 
     
     
         14 . The method of  claim 1  further comprising generating one or more rules for the medical practice management system based on the configuration information. 
     
     
         15 . The method of  claim 1  further comprising checking the first information, second information, or both to determine if one or more errors are associated with the first information, second information, or both. 
     
     
         16 . The method of  claim 15  wherein the one or more errors comprise incorrect information, missing information, or both. 
     
     
         17 . The method of  claim 15  further comprising:
 generating one or more requests for correct information; and   receiving correct information based on the one or more requests for correct information.   
     
     
         18 . The method of  claim 15  wherein the checking further comprises utilizing one or more rules associated with one or more payor servers to check the first information, the second information, or both. 
     
     
         19 . The method of  claim 1  wherein the configuration information comprises medical claim processing information associated with the medical practice, medical claim processing information associated with one or more payor servers, medical claim information utilized to generate medical claims for submission to one or more payor server, or any combination thereof. 
     
     
         20 . A computer program product, tangibly embodied in an information carrier, the computer program product including instructions being operable to cause a data processing apparatus to:
 receive first information associated with a medical practice;   generate one or more requests for second information based on the first information, one or more insurance rules that apply to one or more payor servers, which are associated with the medical practice based on the first information, or both;   receive second information, which comprises information for submission of medical claims to the one or more payor servers, based on the one or more requests for second information; and   generate configuration information for the medical practice management system based on the first information, the second information, or both.   
     
     
         21 . A system for automated computerized configuration of a medical practice management system, the system comprising:
 a medical practice module configured to receive first information associated with a medical practice and receive second information, which comprises information for submission of medical claims to one or more payor servers, based on one or more requests; and   a server configuration module configured to generate the one or more requests for the second information based on the first information, one or more insurance rules that apply to the one or more payor servers, which are associated with the medical practice based on the first information, or both, and generate configuration information for the medical practice management system based on the first information and the second information.   
     
     
         22 . The system of  claim 21  further comprising a medical practice information database configured to store the first information, the second information, the configuration information, or any combination thereof. 
     
     
         23 . The system of  claim 21  wherein the server configuration module being further configured to check the first information, second information, or both to determine if one or more errors are associated with the first information, second information, or both. 
     
     
         24 . The system of  claim 23  wherein the server configuration module being further configured to:
 generate one or more requests for correct information; and   receive correct information based on the one or more requests for correct information.   
     
     
         25 . A system for automated computerized configuration of a medical practice management system, the system comprising:
 a means for receiving first information associated with a medical practice and receiving second information, which comprises information for submission of medical claims to one or more payor servers, based on one or more requests; and   a means for generating the one or more requests for the second information based on the first information, one or more insurance rules that apply to the one or more payor servers, which are associated with the medical practice based on the first information, or both, and generating configuration information for the medical practice management system based on the first information and the second information.