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;   associating one or more payor servers with the medical practice based on the first information;   generating a request for second information based on (a) the first information and (b) one or more insurance rules stored in an insurance rules database that apply to one or more payor servers, wherein the one or more insurance rules apply to the one or more payor servers associated with the medical practice;   in response to the request, receiving second information which comprises information for submission of medical claims to the one or more payor servers;   generating configuration information for the medical practice management system based on the first information and the second information; and   configuring the medical practice management system for one or more users at the medical practice based on the configuration information.   
     
     
         2 . The method of  claim 1  further comprising dynamically generating a user interface for one or more users of the medical practice based on the configuration information, the user interface comprising one or more fields including information from the configuration information. 
     
     
         3 . The method of  claim 1  further comprising updating stored configuration information for the medical practice stored in a medical practice information database with the configuration information. 
     
     
         4 . The method of  claim 1  further comprising:
 determining whether to request additional information based on the first information, the second information, and the one or more insurance rules;   generating a request for additional information based on the first information, the second information, and the one or more insurance rules;   receiving additional information, which comprises information for submission of medical claims to the one or more payor servers, based on the request for additional information; and   generating configuration information for the medical practice management system based on the first information, the second information, and the additional information.   
     
     
         5 . The method of  claim 1  wherein the configuration information comprises medical claim processing information, medical claim information utilized to generate medical claims for submission to one or more payor server, or both, the method further comprising:
 generating one or more rules for the medical practice management system based on the configuration information; and   storing the one or more rules in the insurance rules database.   
     
     
         6 . The method of  claim 1  further comprising:
 determining one or more errors are associated with the first information, second information, or both based on one or more rules associated with one or more payor servers;   generating a request for correct information; and   receiving correct information based on the request for correct information.   
     
     
         7 . The method of  claim 1  further comprising selecting third information for submission to a payor server based on the configuration information. 
     
     
         8 . The method of  claim 7  further comprising formatting the third information for submission to the payor server based on the configuration information. 
     
     
         9 . 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;   associate one or more payor servers with the medical practice based on the first information;   generate a request for second information based on (a) the first information and (b) one or more insurance rules stored in an insurance rules database that apply to one or more payor servers, wherein the one or more insurance rules apply to the one or more payor servers associated with the medical practice;   in response to the request, receive second information which comprises information for submission of medical claims to the one or more payor servers;   generate configuration information for the medical practice management system based on the first information and the second information; and   configure the medical practice management system for one or more users at the medical practice based on the configuration information.   
     
     
         10 . 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 a request; and   configure the medical practice management system for one or more users at the medical practice based on the configuration information;   a server configuration module in communication with the medical practice module configured to:   associate one or more payor servers with the medical practice based on the first information;   generate the request for the second information based on (a) the first information and (b) one or more insurance rules that apply to the one or more payor servers, wherein the one or more insurance rules apply to the one or more payor servers associated with the medical practice; and   generate configuration information for the medical practice management system based on the first information and the second information; and   an insurance rules database in communication with the server configuration module configured to store the one or more insurance rules.