Payment Card Reconciliation by Authorization Code

Abstract

A payment processor acting on behalf of a third party administrator to make payment on an adjudicated claim makes a straight through payment to an acquirer for a health care provider's merchant account. Via the authorization process, the payment processor generates an authorization code which is returned to the health care provider on its merchant statement for the payment. Concurrently, the remittance advice from the third party administrator is linked to the same authorization code as the payment by the payment processor which sends the advice in an 835 -formatted transmission to the health care provider. Thus, the remittance advice may be linked (reconciled) with the payment on the merchant statement by the common authorization code.

What is claimed is: 
     
         1 . A computer-implemented method of facilitating claims and virtual payment card transaction reconciliation for a healthcare provider, the method comprising the steps of:
 receiving a data file by a payment processor computing system operating on a computing device from a remote administrator computer to pay an adjudicated claim in an authorized amount to the healthcare provider having a tax identification number, the data file including remittance advice for the claim previously submitted by the healthcare provider;   electronically requesting by the payment processor computing system a virtual payment card account from a card issuing application in an amount equal to the authorized amount for payment of the claim to the healthcare provider;   sending from the payment processor computing system to a payment card acquirer for the healthcare provider of the claim the healthcare provider tax identification number and virtual card account data wherein the payment card acquirer electronically requests authorization from a card network for the virtual payment card data in an amount equal to the authorized amount for the claim;   generating at the direction of the payment processor computing system, an authorization code for the virtual payment card authorization request; and   sending an  835 -format remittance advice file from the payment processor computing system to the healthcare provider, the remittance advice file including the authorization code, whereby the authorization code links funds received through the virtual payment card transaction to the  835  file wherein the healthcare provider may reconcile the payment received through the virtual payment card transaction with the  835  remittance advice file.   
     
     
         2 . The method of  claim 1  wherein the  835 -format remittance advice file is computer readable and electronically sent to the healthcare provider from the payment processor computing system. 
     
     
         3 . A computer-implemented method of facilitating claims and virtual payment card transaction reconciliation for a healthcare provider, the method comprising the steps of:
 receiving a data file by a payment processor computing system operating on a computing device from a remote administrator computer to pay an adjudicated claim in an authorized amount to the healthcare provider, the data file including remittance advice for the claim previously submitted by the healthcare provider as an  837  transaction set, the transaction set including a claim identifier value and a requested amount for payment and wherein the remittance advice includes a tax identification number for the healthcare provider, an explanation of benefits and an authorized amount for payment;   electronically requesting by the payment processor computing system a virtual payment card account from a card issuing application in an amount equal to the authorized amount for payment of the claim to the healthcare provider, the virtual payment card account having an account number, an expiration date and a CVV code;   sending from the payment processor computing system to a payment card acquirer for the healthcare provider of the claim the healthcare provider tax identification number, virtual card account number, expiration date, and CVV code wherein the payment card acquirer electronically requests authorization from a card network for the virtual payment card data in an amount equal to the authorized amount for the claim;   generating at the direction of the payment processor computing system, an authorization code for the virtual payment card authorization request and setting the authorization code to the claim identifier value; and   sending an  835 -format remittance advice file from the payment processor computing system to the healthcare provider, the remittance advice file including the authorization code, whereby the authorization code links funds received through the virtual payment card transaction to the  837  and  835  files wherein the healthcare provider may reconcile the payment received through the straight through virtual payment card transaction with the  835  remittance advice file and bill a patient for the difference between the requested amount in the  837  file and the authorized amount enumerated in the  835  file.   
     
     
         4 . The method of  claim 3  wherein the  835 -format remittance advice file is computer readable and electronically sent to the healthcare provider from the payment processor computing system. 
     
     
         5 . A computer-implemented method of facilitating claims and payment card transaction reconciliation for a healthcare provider, the method comprising the steps of:
 receiving a data file by a payment processor computing system operating on a computing device from a remote administrator computer to pay an adjudicated claim in an authorized amount to the healthcare provider, the data file including remittance advice for the claim previously submitted by the healthcare provider as an  837  transaction set, the transaction set including a claim identifier value and a requested amount for payment and wherein the remittance advice includes a tax identification number for the healthcare provider, an explanation of benefits and an authorized amount for payment;   electronically requesting by the payment processor computing system a virtual payment card account from a card issuing application in an amount equal to the authorized amount for payment of the claim to the healthcare provider, the virtual payment card account having an account number, an expiration date and a CVV code;   sending from the payment processor computing system to the healthcare provider the virtual card account number, expiration date, CVV code and remittance advice wherein the healthcare provider enters the virtual card account number, expiration date and CVV code in a merchant account terminal device in an amount equal to the authorized amount for the claim whereby an authorization request is sent to a card issuing authority;   generating at the direction of the payment processor computing system, an authorization code for the virtual payment card authorization request and setting the authorization code to the claim identifier value whereby the authorization response sent by the card issuing authority includes the claim identifier value as the authorization code; whereby the authorization code links funds received through the virtual payment card transaction to the  837  file data wherein the healthcare provider may reconcile the payment received through the virtual payment card transaction and bill a patient for the difference between the requested amount in the  837  file and the authorized amount received through the virtual payment card transaction.   
     
     
         6 . The method of  claim 5  wherein the  835 -format remittance advice file is computer readable and electronically sent to the healthcare provider from the payment processor computing system.