Medical benefits payment system

Abstract

A method of facilitating payment of health care benefits to on behalf of a payer comprising the step of electronically transmitting a stored-value card account payment of the authorized benefit amount concurrently with an explanation of benefits.

What is claimed is: 
     
       1. A method of facilitating payment of adjudicated health care benefits to a health care provider on behalf of a payer comprising the steps of:
 loading a unique, single-use, stored-value card account with an amount equal to a single, authorized benefit payment, the card account only chargeable through a medical services terminal;   generating an explanation of benefits associated with the payment;   creating a computer-generated image file containing the stored-value card account number, the amount, a card verification value code, an expiration date, and the explanation of benefits;   transmitting the image file by fax to the health care provider; and   reconciling the charged card account to confirm that the health care provider has received payment.   
     
     
       2. A method of facilitating payment of adjudicated health care benefits to a health care provider comprising:
 identifying the health care provider that renders medical services in anticipation of payment;   identifying a payer that has agreed to pay the health care provider on behalf of a patient subject to preselected conditions;   identifying an administrator that determines whether the medical services conducted by the service provider meet the preselected conditions by the payer, generates an explanation of benefits, and authorizes payment of the service provider for an authorized amount;   intercepting the explanation of benefits and payment information transmitted from the administrator to the health care provider;   acquiring a single-use, stored-value card account number and loading it with funds equal to the authorized amount;   merging the stored-value card account number, the authorized amount, a card verification value code, and an expiration date with the explanation of benefits into a computer-generated image file; and   transmitting the image file to the health care provider via a computer-implemented transmission.   
     
     
       3. The method of  claim 2  wherein the image file is transmitted by fax. 
     
     
       4. The method of  claim 2  further comprising the step of reconciling the charge incurred against the stored-value card account number to confirm the health care provider has been paid for the services approved by the administrator. 
     
     
       5. The method of  claim 2  wherein the stored-value card account number is chargeable only through a medical services terminal. 
     
     
       6. A method of facilitating payment of adjudicated health care benefits to a health care provider on behalf of a payer comprising the steps of:
 loading a unique, single-use, stored-value card account with an amount equal to a single, authorized benefit payment, the card account only chargeable through a medical services terminal;   generating an explanation of benefits associated with the payment;   creating a computer-generated image file containing the stored-value card account number, the amount, a card verification value code, an expiration date, and the explanation of benefits;   transmitting the image file by a computer-implemented electronic transmission medium selected from the group consisting of fax, SMTP, SMS, MMS, HTTP, HTTPS, and FTP to the health care provider wherein the electronic transmission includes a computer-generated image of a physical card; and   reconciling the charged card account to confirm that the health care provider has received payment.   
     
     
       7. A method of facilitating payment of adjudicated health care benefits to a health care provider on behalf of a payer comprising the steps of:
 adjudicating a benefit payment by evaluating a benefit claim under the terms of an applicable medical benefits policy and calculating an amount of a payable benefit;   creating a unique stored-value card account by one or more computers, the stored-value card account being chargeable only up to an authorized amount;   allocating funds within an account designated by a payer to the stored-value card account by one or more computers in the amount of the adjudicated benefit payment;   generating an explanation of benefits associated with the payment;   creating a file containing the stored-value card account number, the adjudicated benefit payment amount, a card verification value code, an expiration date, and the explanation of benefits by one or more computers; and   sending the file to the health care provider.   
     
     
       8. The method of claim 7 further comprising the step of reconciling the charged card account to confirm that the health care provider has received payment. 
     
     
       9. The method of claim 7 further comprising the step of providing a computer-generated image of a physical card in the transmitted file. 
     
     
       10. The method of claim 7 wherein the stored-value card account is only chargeable through a medical services terminal. 
     
     
       11. The method of claim 7, wherein the stored-value card is a debit card. 
     
     
       12. The method of claim 7, wherein the stored-value card is a credit card. 
     
     
       13. A system for payment of health care benefits combining payment terms and an explanation of benefits, the system comprising:
 an explanation of benefits describing medical services provided to a patient by a health care provider, an amount billed by the health care provider and an amount paid by the patient's insurance company; and   a payment mechanism associated with the explanation of benefits, the payment mechanism merging a stored-value card account number, an adjudicated benefit payment amount, a card verification value code, and an expiration date with the explanation of benefits into a document by one or more computers;   wherein funds in the amount of a single, adjudicated benefit payment are allocated within an account designated by the insurance company to a unique, single-use, stored-value card account, the stored-value card account being chargeable only up to an authorized amount, and wherein the document is sent to the health care provider as payment for the medical services.   
     
     
       14. The system of claim 13 wherein the charged card account is reconciled to confirm that the health care provider has received payment. 
     
     
       15. The system of claim 13 wherein a computer-generated image of a physical card is provided in the transmitted document. 
     
     
       16. The system of claim 13 wherein the stored-value card account is only chargeable through a medical services terminal. 
     
     
       17. The method of claim 13, wherein the stored-value card is a debit card. 
     
     
       18. The method of claim 13, wherein the stored-value card is a credit card. 
     
     
       19. A computer implemented method for combining payment of health care benefits with an associated explanation of benefits, the method comprising:
 receiving an explanation of benefits related to medical services provided by a health care provider;   receiving authorization to pay at least a portion of submitted charges associated with the explanation of benefits and the associated funds for payment;   allocating funds within an account designated by a payer to a unique, stored-value card account in an amount equal to the adjudicated benefit payment by one or more computers, the stored-value card account being chargeable only up to the authorized amount; and   merging the explanation of benefits with the stored-value card account number, the adjudicated benefit amount of payment, a card verification value code, and an expiration date in a file.   
     
     
       20. The media of claim 19 wherein the charged card account is reconciled to confirm that the health care provider has received payment. 
     
     
       21. The media of claim 19 wherein a computer-generated image of a physical card is provided in the merged file. 
     
     
       22. The media of claim 19 wherein the stored-value card account is only chargeable through a medical services terminal. 
     
     
       23. The method of claim 19, wherein the stored-value card is a debit card. 
     
     
       24. The method of claim 19, wherein the stored-value card is a credit card. 
     
     
       25. A system for payment of health care benefits to a health care provider, the system comprising:
 an administration system operable to receive a benefit claim from the health care provider and to generate an explanation of benefits for the benefit claim along with an approved payment, wherein the amount of approved payment is adjudicated by evaluating the benefit claim under the terms of an applicable medical benefits policy; and   a card processing system operable to allocate funds within an account designated by a payer to a stored-value card account in an amount equal to the approved payment by one or more computers, the card processing system also operable to merge the explanation of benefits with the stored-value card account number by one or more computers, the adjudicated amount of payment, a card verification value code, and an expiration date in a file and to send the file to the health care provider as payment for the benefit claim.   
     
     
       26. The system of claim 25 wherein the charged card account is reconciled to confirm that the health care provider has received payment. 
     
     
       27. The system of claim 25 wherein a computer-generated image of a physical card is provided in the file. 
     
     
       28. The system of claim 25 wherein the stored-value card account is only chargeable through a medical services terminal. 
     
     
       29. The system of claim 25, wherein the stored-value card is a debit card. 
     
     
       30. The system of claim 25, wherein the stored-value card is a credit card.