Intelligent Patient Billing Communication Platform For Health Services

Abstract

A system for generating customized patient billing communications includes software executing on a server which receives patient billing data indicative of a patient visit and further indicative of a balance. The software accesses a storage to determine patient visit context data indicative of one or more visit codes associated with the billing data. The software generates a communication for a user based on the patient visit context data with message content altered from a standard message based on the one or more visit codes, the communication including a bill for the balance and being a first communication to the user with the bill.

What is claimed is: 
     
         1 . A method of patient communications comprising:
 providing software executing on a computer and providing patient user access thereto via a network, the software providing a patient portal with a scheduling module which allows the patient user to schedule an appointment and receives appointment information from the patient user, wherein the appointment information includes information indicative of a nature of a visit associated with the appointment;   providing a storage accessible by the software;   with the software, determining from the appointment information visit services information and determines one or more insurance adjudication codes associated with the appointment;   with the software, determining expected costs associated with the appointment from the visit services information by a comparison to data in the storage, the data indicative of services recently used by another patient and costs associated with those services recently used by another patient to generate an estimate of costs, the software presenting the estimate of costs to the patient user;   with the software, sending a bill communication to the patient user indicative of an amount associated a bill associated with the bill communication based on insurance adjudication of visit codes associated with the appointment and information associated with the bill is stored in the storage as part of the data;   after the sending step, with the software, providing patient user access to one or more second patient users via the patient portal which allows the one or more second patient users to schedule one or more appointments and further receives appointment information from the one or more second patient users;   next, determining, with the software, expected costs associated with the one or more appointments appointment from the visit services information associated with the one or more second patient users by a comparison to the data in the storage including costs associated with those services recently used by other patients and patient users to generate an estimate of costs for each of the one or more appointments, the software presenting the estimate of costs for each of the one or more appointments to a corresponding one of the one or more second patient users.   
     
     
         2 . The system of  claim 1  further comprising:
 upon presenting the estimate of costs said software generating an authorization form for presentation to one or more of the patient user and the one or more second patient users which authorization form is indicative of the estimate of costs associated with the corresponding user and receiving payment information and authorization for payment prior to the appointment. 
 
     
     
         3 . A method of patient communication comprising:
 providing a storage containing contact data related to the plurality of patients, the contact data indicative of communications habits of the plurality of patients as related to bill collection success;   providing software executing on a computer wherein the software comprises a machine learning program which determines how to communicate with a patient user, the machine learning program receives patient data indicative of contact, insurance and demographic information for a plurality of patients, one of which is associated with the patient user;   with the machine learning program, querying the contact data and patient data to and determining a rank order of communications methodologies based on the communications habits of the plurality of patients as compared to the demographic information;   with the machine learning program, further querying the storage by the patient user to determine modifications to the rank order of communications based bill collection success for the patient user   the machine learning program further generating a bill communication for the patient user to transmit a bill to the patient user;   wherein the software sends the bill communication to the patient user using a first communications methodology from the rank order of communications and the software updating the storage based on if the bill is paid in response to the communication so that based on bill collection success and when accessing the storage to determine communication methodology for future communications, the software gives greater weight to the communication methodology which is associated with actual bill collection success so that the software learns for future communications based on data in the storage indicative of bill collection success in response to the first communication methodology for the patient user.   
     
     
         4 . The method of  claim 3  wherein if the bill is not paid, sending the bill communication to the patient user using a second communications methodology from the rank order of communications and updating the storage by the software based on if the bill is paid following communication of the bill to the second communications methodology and the storage is updated by the software based on the first communications methodology being unsuccessful. 
     
     
         5 . The method of  claim 3  wherein the software is in communication with a plurality of external billing systems, the data module extracting data from the plurality of external billing systems and transforming the extracted data to a unified format. 
     
     
         6 . The method of  claim 5  wherein the data extracted to the unified format is stored in the storage. 
     
     
         7 . The method of  claim 6  wherein the contact data and the data extracted is stored in the storage in the unified format. 
     
     
         8 . The method of  claim 3  wherein the patient user is one of the plurality of patients. 
     
     
         9 . The method of  claim 3  wherein when the one or more codes indicates denial of a claim based on expired or incorrect insurance information, the bill communication includes message content with a request for updated insurance information from the patient user. 
     
     
         10 . The system of  claim 1  wherein the software modifies a communications methodology for the bill communication based on the one more patient treatment codes. 
     
     
         11 . A method of patient communications comprising:
 providing software executing on a computer and providing patient user access thereto via a network, the software providing a patient portal with a scheduling module which allows the patient user to schedule an appointment and receives appointment information from the patient user, wherein the appointment information includes information indicative of a nature of a visit associated with the appointment;   providing a storage accessible by the software;   with the software, determining from the appointment information visit services information and determines one or more insurance adjudication codes associated with the appointment;   with the software, determining expected costs associated with the appointment from the visit services information by a comparison to data in the storage, the data indicative of services recently used by another patient and costs associated with those services recently used by another patient to generate an estimate of costs, the software presenting the estimate of costs to the patient user;   wherein the storage further contains contact data related to the plurality of patients, the contact data indicative of communications habits of the plurality of patients as related to bill collection success;   wherein the software comprises a machine learning program which determines how to communicate with the patient user, the machine learning program receives patient data indicative of contact, insurance and demographic information for the plurality of patients, one of which is associated with the patient user;   with the machine learning program, querying the contact data and patient data to and determining a rank order of communications methodologies based on the communications habits of the plurality of patients as compared to the demographic information;   with the machine learning program, further querying the storage by the patient user to determine modifications to the rank order of communications based bill collection success for the patient user   with the software, sending a bill communication to the patient user indicative of an amount associated a bill associated with the bill communication based on insurance adjudication of visit codes associated with the appointment and information associated with the bill is stored in the storage as part of the data;   wherein the software sends the bill communication to the patient user using a first communications methodology from the rank order of communications and the software updating the storage based on if the bill is paid in response to the communication so that based on bill collection success and when accessing the storage to determine communication methodology for future communications, the software gives greater weight to the communication methodology which is associated with actual bill collection success so that the software learns for future communications based on data in the storage indicative of bill collection success in response to the first communication methodology for the patient user.   
     
     
         12 . The method of  claim 11  further comprising:
 after the sending step, with the software, providing patient user access to one or more second patient users via the patient portal which allows the one or more second patient users to schedule one or more appointments and further receives appointment information from the one or more second patient users; 
 next, determining, with the software, expected costs associated with the one or more appointments appointment from the visit services information associated with the one or more second patient users by a comparison to the data in the storage including costs associated with those services recently used by other patients and patient users to generate an estimate of costs for each of the one or more appointments, the software presenting the estimate of costs for each of the one or more appointments to a corresponding one of the one or more second patient users. 
 
     
     
         13 . The method of  claim 11  wherein if the bill is not paid, sending the bill communication to the patient user using a second communications methodology from the rank order of communications and updating the storage by the software based on if the bill is paid following communication of the bill to the second communications methodology and the storage is updated by the software based on the first communications methodology being unsuccessful. 
     
     
         14 . The method of  claim 13  wherein the software is in communication with a plurality of external billing systems, the data module extracting data from the plurality of external billing systems and transforming the extracted data to a unified format. 
     
     
         15 . The method of  claim 14  wherein the data extracted to the unified format is stored in the storage. 
     
     
         16 . The method of  claim 15  wherein the contact data and the data extracted is stored in the storage in the unified format. 
     
     
         17 . The method of  claim 11  wherein the patient user is one of the plurality of patients. 
     
     
         18 . The method of  claim 11  wherein when the one or more codes indicates denial of a claim based on expired or incorrect insurance information, the bill communication includes message content with a request for updated insurance information from the patient user. 
     
     
         19 . The system of  claim 11  wherein the software modifies a communications methodology for the bill communication based on the one more patient treatment codes.