U.S. patent application number 11/364514 was filed with the patent office on 2007-08-30 for healthcare debit card linked to healthcare-related and non-healthcare-related financial accounts.
Invention is credited to John P. Dibiasi, Jimmie L. Lindsey, Douglas L. Norman.
Application Number | 20070203757 11/364514 |
Document ID | / |
Family ID | 38445145 |
Filed Date | 2007-08-30 |
United States Patent
Application |
20070203757 |
Kind Code |
A1 |
Dibiasi; John P. ; et
al. |
August 30, 2007 |
Healthcare debit card linked to healthcare-related and
non-healthcare-related financial accounts
Abstract
A healthcare financial payment system and method are disclosed
in which a debit card which may be used by a cardholder to pay for
medical products and services is linked with a healthcare-related
financial account associated with the cardholder as well as with a
non-healthcare-related financial account belonging to the
cardholder. The healthcare-related financial account associated
with the cardholder may be a Flexible Spending Arrangement (FSA), a
Health Savings Account (HSA), or a health reimbursement arrangement
(HRA), and the non-healthcare-related financial account associated
with the cardholder may be a bank checking or savings account or a
credit card. Any expenses for medical goods and services which are
not covered by the cardholder's medical insurance may be paid from
the cardholder's healthcare-related financial account if the
medical goods or services are eligible and if there are funds
remaining in the healthcare-related financial account, with any
remaining costs being paid for from or charged to the cardholder's
non-healthcare-related financial account.
Inventors: |
Dibiasi; John P.; (Sedona,
AZ) ; Norman; Douglas L.; (Brookfield, WI) ;
Lindsey; Jimmie L.; (Milwaukee, WI) |
Correspondence
Address: |
REINHART BOERNER VAN DEUREN S.C.;ATTN: LINDA KASULKE, DOCKET COORDINATOR
1000 NORTH WATER STREET
SUITE 2100
MILWAUKEE
WI
53202
US
|
Family ID: |
38445145 |
Appl. No.: |
11/364514 |
Filed: |
February 28, 2006 |
Current U.S.
Class: |
705/4 |
Current CPC
Class: |
G16H 10/65 20180101;
G06Q 40/02 20130101; G06Q 40/08 20130101; G06Q 20/10 20130101; G06Q
20/34 20130101; G16H 40/20 20180101; G06Q 10/10 20130101 |
Class at
Publication: |
705/004 |
International
Class: |
G06Q 40/00 20060101
G06Q040/00 |
Claims
1. A system for making payments for medical products and services,
said system comprising: a healthcare card associated with a
cardholder and a medical insurance plan, said healthcare debit card
also being associated with first and second financial accounts of
the cardholder, said first financial account being a
healthcare-related financial account and said second financial
account being a non-healthcare-related financial account; a data
input station associated with a medical product and/or service
provider, said data input station being operable to acquire first
data and second data, said first data comprising information
associated with said healthcare card and said second data
comprising information related to a medical product and/or service
provided or to be provided to the cardholder or a dependant of the
cardholder covered by said medical insurance plan; a medical
insurance processor that receives said first and second data, and
in response determines whether said medical insurance plan offers
coverage for said medical product and/or service and pays or
arranges for the payment of any amount due from said medical
insurance plan for said medical product and/or service, a
determination as to whether a balance is due for said medical
product and/or service being made following the determination by
said medical insurance plan; a first financial processor that, if a
non-zero balance is due for said medical product and/or service
following consideration by said medical insurance processor,
ascertains whether said first financial account allows payment for
said medical product and/or service and has sufficient funds
available and, if so, pays or arranges for the payment of all or
part of the balance due for said medical product and/or service
from said first financial account; and a second financial processor
that, if a non-zero balance is due for said medical product and/or
service following consideration by said first financial processor,
ascertains whether said second financial account has sufficient
funds available and, if so, pays or arranges for the payment of all
or part of the balance due for said medical product and/or service
from said second financial account.
2. A system as defined in claim 1, wherein said healthcare card
contains a healthcare card number, cardholder information, medical
insurance provider information, and information regarding copay
amounts which are required for various medical products and/or
services under said medical insurance plan, all of which are
printed and/or embossed onto said healthcare card.
3. A system as defined in claim 1, wherein said healthcare card
also functions as a conventional credit or debit card for use in
financial transactions including financial transactions which are
unrelated to healthcare.
4. A system as defined in claim 1, wherein said healthcare card
comprises: a radio frequency ("RF") communication and storage
device containing said first and second data; and wherein said data
input station comprises: a reader which operates with said
healthcare card to cause said RF communication and storage device
to transmit said first and second data to said data input station
in a touch-less communication mode.
5. A system as defined in claim 1, wherein said healthcare card
comprises: a data storage element for storing electronic data
including cardholder information, medical insurance provider
information, and information regarding said second financial
account.
6. A system as defined in claim 5, wherein said data storage
element comprises: a magnetic stripe located on said healthcare
card.
7. A system as defined in claim 5, wherein said data storage
element comprises: an electronic chip located in said healthcare
card.
8. A system as defined in claim 1, wherein said data input station
comprises: a terminal located a place of business of said medical
product and/or service provider.
9. A system as defined in claim 8, wherein said data input station
additionally comprises: a card reader which is operatively
connected to said terminal, said healthcare card being scanned by
said card reader to derive said first information.
10. A system as defined in claim 8, wherein said terminal is used
to enter said second data, said second data comprising: data
identifying said medical product and/or service with sufficient
specificity to allow said medical insurance processor and said
first financial processor to determine eligibility of said medical
product and/or service for payment; and data regarding the cost of
said medical product and/or service established by said medical
product and/or service provider.
11. A system as defined in claim 8, wherein said terminal allows
the entry of said cardholder's personal identification umber
("PIN"), wherein said PIN is required by said second financial
processor to access funds in said second financial account.
12. A system as defined in claim 1, wherein said medical insurance
processor comprises: a medical insurance storage medium containing
data regarding said medical insurance plan; and a medical insurance
server that determines whether said medical insurance plan offers
coverage for said medical product and/or service based upon said
first data, said second data, and said data from said medical
insurance storage medium.
13. A system as defined in claim 1, wherein said first financial
processor comprises: a first financial storage medium containing
data regarding eligibility of medical products and/or services and
the balance of said first financial account; and a first financial
server that ascertains whether payment for a balance due for said
medical product and/or service may be made from said first
financial account based upon said second data and said data from
said first financial storage medium.
14. A system as defined in claim 1, wherein said second financial
processor comprises: a second financial storage medium containing
data regarding the balance of said second financial account; and a
second financial server that ascertains whether payment for a
balance due for said medical product and/or service may be made
from said second financial account based upon said second data and
said data from said second financial storage medium.
15. A system as defined in claim 1, additionally comprising: a
cardholder administrator processor that enrolls, disenrolls, and
changes information for employees or other cardholders serviced by
said medical insurance plan.
16. A system as defined in claim 15, wherein said cardholder
administrator processor comprises: a cardholder administrator
storage medium containing data regarding cardholders; and a
cardholder administrator server that is used to enter and modify
said data from said cardholder administrator storage medium.
17. A system as defined in claim 1, wherein said medical insurance
processor, said first financial processor, and said second
financial processor operate substantially in real time to provide
said data input station with an indication of payment(s) for said
medical product and/or service and any amount which remains due
which said medical product and/or service provider must collect
from said cardholder.
18. A system as defined in claim 1, additionally comprising: a
system administrator processor that interacts with said data input
station, said medical insurance processor, said first financial
processor, and said second financial processor, said system
administrator processor sequentially routing data: first, to said
medical insurance processor for a determination of coverage by said
medical insurance plan and payment if there is coverage by said
medical insurance plan; second, if there is a balance due following
consideration by said medical insurance processor, to said first
financial processor for a determination of eligibility and funds
availability and payment if there is eligibility and funds are
available; and third, if there is a balance due following
consideration by said first financial processor, to said second
financial processor for a determination of funds availability and
payment if funds are available.
19. A system as defined in claim 18, wherein said system
administrator processor comprises: a system administrator storage
medium containing data regarding said cardholder; and a system
administrator server that interacts with said data input station,
said medical insurance processor, first financial processor, and
said second financial processor, said system administrator server
accessing data regarding said cardholder in said system
administrator storage medium.
20. A system as defined in claim 1, additionally comprising: at
least one network that facilitates communication between said data
input station, said medical insurance processor, said first
financial processor, and said second financial processor.
21. A system as defined in claim 20, wherein said network comprises
the Internet.
22. A system as defined in claim 1, wherein said healthcare debit
card is also associated with a third financial account of the
cardholder, said third financial account being a secondary
healthcare-related financial account, said system additionally
comprising: a third financial processor that, if a non-zero balance
is due for said medical product and/or service following
consideration by said first financial processor and before
consideration by said second financial processor, ascertains
whether said third financial account allows payment for said
medical product and/or service and has sufficient funds available
and, if so, pays or arranges for the payment of all or part of the
balance due for said medical product and/or service from said third
financial account.
23. A system as defined in claim 1, wherein said healthcare debit
card is also associated with a third financial account of the
cardholder, said third financial account being a secondary
non-healthcare-related financial account, additionally comprising:
a third financial processor that, if a non-zero balance is due for
said medical product and/or service following consideration by said
second financial processor, ascertains whether said third financial
account has sufficient funds available and, if so, pays or arranges
for the payment of all or part of the balance due for said medical
product and/or service from said third financial account.
24. A system for making payments for medical products and services,
said system comprising: a healthcare card associated with a
cardholder and a medical insurance plan, said healthcare debit card
also being associated with first and second financial accounts of
the cardholder; a data input station associated with a medical
product and/or service provider and operable to acquire first data
from said healthcare card and second data related to a medical
product and/or service provided or to be provided; a medical
insurance processor that receives said first and second data and
pays or arranges for the payment of any amount due from said
medical insurance plan for said medical product and/or service; a
first financial processor that, if a balance for said medical
product and/or service remains, pays or arranges for the payment of
all or part of the balance due from said first financial account if
said medical product and/or service is eligible and sufficient
funds are available; and a second financial processor that, if a
balance for said medical product and/or service remains, pays or
arranges for the payment of all or part of the balance due from
said second financial account if sufficient funds are
available.
25. A system for making payments for medical products and services,
said system comprising: a healthcare card associated with a
cardholder and a medical insurance plan, said healthcare debit card
also being associated with a healthcare-related financial account
of the cardholder and a non-healthcare-related financial account of
the cardholder; a data input station associated with a medical
product and/or service provider, said data input station being
operable to acquire first data and second data, said first data
comprising information associated with said healthcare card and
said second data comprising information related to a medical
product and/or service provided or to be provided to the cardholder
or a dependant of the cardholder covered by said medical insurance
plan; a medical insurance processor that receives said first and
second data, and in response determines whether said medical
insurance plan offers coverage for said medical product and/or
service and pays or arranges for the payment of any amount due from
said medical insurance plan for said medical product and/or service
to said medical product and/or service provider, a determination as
to whether a balance is due for said medical product and/or service
being made following the determination by said medical insurance
plan; a healthcare-related financial processor that, if a non-zero
balance is due for said medical product and/or service following
consideration by said medical insurance processor, ascertains
whether said healthcare-related financial account allows payment
for said medical product and/or service and has sufficient funds
available and, if so, pays or arranges for the payment of all or
part of the balance due for said medical product and/or service
from said healthcare-related financial account to said medical
product and/or service provider; a non-healthcare-related financial
medical processor that, if a non-zero balance is due for said
medical product and/or service following consideration by said
healthcare-related financial medical processor, ascertains whether
said non-healthcare-related financial account has sufficient funds
available and, if so, pays or arranges for the payment of all or
part of the balance due for said medical product and/or service
from said non-healthcare-related financial account to said medical
product and/or service provider; and a system administrator
processor that interacts with said data input station, said medical
insurance processor, said first financial processor, and said
second financial processor, said system administrator processor
sequentially routing data to said medical insurance processor,
first financial processor, and said second financial processor.
26. A method of making payments for medical products and services,
said method comprising: providing a cardholder with a healthcare
card associated with a medical insurance plan, said healthcare card
being linked to a first financial account and a second financial
account, said first financial account being a healthcare-related
financial account and said second financial account being a
non-healthcare-related financial account; acquiring first data and
second data with a data input station associated with a medical
product and/or service provider, said first data comprising
information associated with said healthcare card and said second
data comprising information related to a medical product and/or
service provided or to be provided to the cardholder or a dependant
of the cardholder covered by said medical insurance plan; in
response to said first and second data, determining whether said
medical insurance plan offers coverage for said medical product
and/or service and paying or arranging for the payment of any
amount due from said medical insurance plan for said medical
product and/or service, a determination as to whether a balance is
due for said medical product and/or service being made following
such payment; if a non-zero balance is due for said medical product
and/or service following said determining step, ascertaining
whether said first financial account allows payment for said
medical product and/or service and has sufficient funds available
and, if so, paying or arranging for the payment of all or part of
the balance due for said medical product and/or service from said
first financial account; and if a non-zero balance is due for said
healthcare product and/or service following said ascertaining step,
establishing whether said second financial account has sufficient
funds available and, if so, paying or arranging for the payment of
all or part of the balance due for said medical product and/or
service from said second financial account.
Description
BACKGROUND OF THE INVENTION
[0001] Field of the Invention--The present invention relates
generally to healthcare financial payment systems and methods, and
more particularly to a novel system and method in which a
healthcare debit card used by a cardholder to pay for medical
products and services is linked with a healthcare-related financial
account associated with the cardholder as well as with a
non-healthcare-related financial account belonging to the
cardholder.
[0002] With the widespread use of medical insurance has come the
necessity of establishing that a particular individual has medical
insurance coverage and arranging for the payment of medical
products and services which are provided to the individual. At
physicians' offices, hospitals, and pharmacies, the established
policy has become that unless proof of coverage is provided at the
time of provision of medical services or purchase of medical
products, the consumer must pay, or make arrangements to pay, for
the cost of the medical products or services at the time of their
delivery. At physicians' offices at the time of service, consumers
having medical insurance are typically required to present a card
evidencing proof of the consumer's medical insurance plan and
information regarding the plan including the copay amount required
for an office visit, and pay the copay amount.
[0003] At hospitals, consumers having medical insurance typically
present the card evidencing proof of the consumer's medical
insurance plan and information regarding the plan prior to delivery
of medical services (other than in the case of an emergency). At
pharmacies, consumers having medical insurance are required to
present the card evidencing proof of the consumer's medical
insurance plan and information regarding the plan including the
copay amount required for the prescription(s) being obtained, and
pay the copay amount. In each of these situations, the consumer is
required to either pay a copay amount prior to the delivery of
medical services or a prescription, or, in the case of a hospital,
to agree to pay the hospital for the amount which is not covered by
the consumer's medical insurance.
[0004] This system of payment for medical services and products
operated as described above until federal laws were passed to allow
a participant and eligible dependents to save a considerable amount
of money in taxes through a Flexible Spending Arrangement ("FSA").
FSA programs allow participants to deduct a predetermined amount of
money from the participant's before-tax income. This predetermined
amount of money is set aside in the participant's
healthcare-related financial account, which is sometimes referred
to as a flexible spending account or a flex account. The money then
can be used toward paying for expenses incurred for certain
eligible products and services specified by the IRS. Because the
money is deducted from the employee's before-tax income through
payroll deductions, the amount of tax that is actually paid by the
employee is reduced. Further, the employer's FICA payment is
reduced based on the applicable amount of pre-tax contributions
made by their employees. As FSA plan is not portable.
[0005] A Health Savings Account ("HSA") is a tax-advantaged trust
or custodial healthcare-related financial account created for the
benefit of an individual (not limited to employees) who is covered
under a high deductible health plan ("HDHP"). The HSA provider need
not require proof of HDHP coverage but may desire to do so for
purposes of its recordkeeping and reporting. If an employer sets up
an HSA for an employee, however, the employer must verify that the
employee is enrolled in an HDHP offered by the employer.
Contributions may be made by an employer, the individual, or a
family member (subject to the gift tax). Contributions are
deductible if made by an individual and are excludable from income
and wages if they are made by an employer. Earnings grow tax-free
and distributions for qualified medical expenses are tax-free.
Nonqualified withdrawals are subject to income and penalty taxes,
and excess contributions are subject to a six percent excise tax.
Like an IRA, the HSA is owned by the individual and is
portable.
[0006] A health reimbursement arrangement ("HRA") is an arrangement
funded solely by an employer. An HRA may be offered to employees or
former employees. Amounts in the HRA healthcare-related financial
account must be used for qualified medical expenses, and balances
may be carried forward. Depending upon the terms of the HRA,
coverage may (or may not) continue if the employee terminates
service. An HRA is not portable.
[0007] The operation of a healthcare provider in conjunction with
such healthcare-related financial accounts (any of an FSA, an HSA,
or an HRA) typically involves three entities which each have a
predefined function. The first of these entities is a cardholder
administrator that enrolls employees or other cardholders serviced
by a particular healthcare program. The cardholder administrator,
in the process of enrolling employees or cardholders, obtains
information from the employees or cardholders and their dependants
and provides that information to the second and third entities.
[0008] The second entity is a medical insurance program
administrator that administers the claims of cardholders under the
medical insurance of the healthcare program. The medical insurance
program administrator typically establishes payment schedules and
deductibles for medical products and services and informs providers
of such medical products and services of the amounts which will
they be paid by the medical insurance portion of the healthcare
program. The medical insurance program administrator also typically
provides healthcare cards to the employees or cardholders, which
they can present to providers of medical products and services as
proof of enrollment in the medical insurance program.
[0009] The third entity is a healthcare-related financial account
administrator, which administers the healthcare-related financial
accounts which are owned by the employees or cardholders. The
healthcare-related financial account administrator reviews the
eligibility of medical products and services which are submitted by
employees or cardholders in order to determine whether the medical
products and services are eligible for payment from the
healthcare-related financial accounts. If the medical products and
services are eligible, the healthcare-related financial account
administrator then determines whether the cardholders have
sufficient funds left in their healthcare-related financial
accounts. If the medical product or services in question are
eligible, and if there are sufficient funds, the healthcare-related
financial account administrator sends payment, typically to the
employee or cardholder.
[0010] In all healthcare systems involving medical insurance,
whether or not the employees or cardholders have healthcare-related
financial accounts, the cardholders generally complete each
transaction involving obtaining medical products or services by
paying a remaining amount directly to the medical product or
service providers. Additionally, in many healthcare systems there
is uncertainty about the final cost to the employee or cardholder
since the approval and payment systems do not operate in real time.
Finally, since there is no central coordination of the various
aspects of the healthcare program, each of the entities often
operates without any interaction with the other entities.
[0011] It is accordingly the primary objective of the present
invention that it provide a system and method for linking a
healthcare debit card to both a healthcare-related financial
account and a non-healthcare-related financial account in addition
to linking the healthcare debit card to a medical insurance
program. It is a related objective of the present invention that
the healthcare debit card contain sufficient information, either in
printed form or in electronic form, or in both forms, to enable
medical product and service providers to ascertain that the
healthcare debit card provides for payment from the three sources.
It is another related objective of the present invention that it be
capable of working which any of a plurality of different
healthcare-related financial accounts, including FSA, HSA, and HRA
healthcare-related financial accounts.
[0012] It is an additional objective of the present invention that
it provide coordination between the submissions for payment of
medical products and services to a medical insurance provider, the
healthcare-related financial account, and the
non-healthcare-related financial account to ensure that the
submissions to these three entities are made quickly and in the
proper sequence. It is a related objective that the system and
method of the present invention be capable of operation in real
time or in near-real time, thereby enabling complete resolution of
payment for the medical products and services at the time of
delivery. It is a further objective that the healthcare debit card
used in the system and method of the present invention may
optionally be used as a conventional credit or debit card for use
in purchasing non-medical products and services.
[0013] The system and method of the present invention must also be
flexible of design and robust in operation, and once established it
should require little or no effort to maintain it other than to
keep the employee or cardholder data current. In order to enhance
the market appeal of the system of the present invention, it should
also be relatively inexpensive to implement and to operate to
thereby give it a high perceived value-to-cost ratio to afford it
the broadest possible market. Finally, it is also an objective that
all of the aforesaid advantages and objectives of the system and
method of the present invention be achieved without incurring any
substantial relative disadvantage.
SUMMARY OF THE INVENTION
[0014] The disadvantages and limitations of the background art
discussed above are overcome by the present invention. With this
invention, a healthcare debit card is provided which has the
cardholder's name, a healthcare debit card number, and healthcare
plan information typically including deductible amounts printed
thereon. The healthcare debit card also has a magnetic stripe used
to store data including information about the card, the cardholder,
a healthcare plan, and financial account information on the back
side of the healthcare debit card. Alternately, the healthcare
debit card may instead be a standard size card which contains an
electronic chip which may be used to store the same type of
information. Such cards, commonly referred to as "smartcards," have
a built-in microprocessor and memory used for identification and/or
financial transactions.
[0015] The system of the present invention is used to link the
healthcare debit card to a medical insurance provider and to a
healthcare-related financial account, as well as to a
non-healthcare-related financial account. The healthcare-related
financial account may be a Flexible Spending Arrangement (FSA), a
Health Savings Account (HSA), or a Health Reimbursement Arrangement
(HRA). The non-healthcare-related financial account may be a bank
checking or savings account or a credit card, or any other type of
non-healthcare-related financial account.
[0016] The system of the present invention links together a number
of entities which each have a predefined function in the operation
of the system. The first entity is a cardholder administrator that
enrolls employees or other cardholders serviced by a particular
healthcare program. The function of the cardholder administrator is
to provide information regarding cardholders to the system,
typically by entering that information into a computer terminal.
The second entity is a medical insurance program administrator that
administers the claims of cardholders under the medical insurance
of the healthcare program. These two entities have existed
historically, and the medical insurance program administrator has
informed providers of medical products and services of the amounts
which will be paid by the medical insurance of the healthcare
program.
[0017] A third entity is a healthcare-related financial account
administrator, which administers healthcare-related financial
accounts which are owned by cardholders. The healthcare-related
financial account can be any one of a Flexible Spending Arrangement
(FSA), a Health Savings Account (HSA), or a Health Reimbursement
Arrangement (HRA). This entity has also existed historically, and
the healthcare-related financial account administrator has reviewed
the eligibility of medical products and services which are
submitted by cardholders in order to determine whether the medical
products and services are eligible for payment from the
healthcare-related financial accounts. If they are eligible, the
healthcare-related financial account administrator then pays for
them if the cardholders have sufficient funds left in their
healthcare-related financial accounts.
[0018] The system and method of the present invention adds two
additional entities, and also provides a mechanism for medical
product and service providers to obtain essentially instant payment
for all medical products and services. The first additional entity
may be a financial institution in which a cardholder has a
financial account, which may for example be any of a conventional
checking or savings account or a credit card. The second additional
entity is a system administrator, which serves to coordinate the
operations performed under the system and method of the present
invention between all of the other entities.
[0019] In addition, each of the medical product and service
providers is provided with a system interface to allow them to
electronically communicate with the other entities in the system.
This may be coordinated through the system administrator, or the
interfaces of each of the entities may be configured to communicate
with each other to the extent necessary and/or desirable. In the
preferred embodiment, each of the medical product or service
providers utilizes a facility terminal having a card reader to read
the data stored on the healthcare debit card so that it may be
transmitted to the various entities in the system that need the
data. In the embodiment discussed herein, the communication between
the various entities and providers may be provided by the Internet.
Alternately, some or all of the network links between the various
entities could be private networks as well.
[0020] In operation, a cardholder presents the healthcare debit
card to a medical product or service provider. The healthcare debit
card is scanned and information relating to the medical product or
service together with the data from the healthcare debit card is
provided to the system of the present invention. The medical
insurance program administrator reviews the information relating to
the medical product or service and the data from the healthcare
debit card and determines whether the medical product or service is
covered and what the deductible amount is. Information relating to
coverage and the remaining amount which is due for the medical
product or service is then provided by the medical insurance
program administrator to the system of the present invention.
[0021] Next, the healthcare-related financial account administrator
reviews the information relating to the medical product or service,
the data from the healthcare debit card, and the remaining amount
which is due for the medical product or service and determines
whether the medical product or service is covered and whether the
cardholder has sufficient funds in the healthcare-related financial
account. Information relating to eligibility, payment of the
remaining amount which is due for the medical product or service,
and any resulting remaining amount due for the medical product or
service is provided by the healthcare-related financial account
administrator to the system of the present invention.
[0022] If there is any remaining unpaid amount, the
non-healthcare-related financial account administrator (which may
be a DDA deposit bank or a credit card administrator) determines
whether the cardholder has sufficient funds in the DDA deposit
account or on the credit card. If there are sufficient funds in the
non-healthcare-related financial account, the remaining amount due
for the medical product or service is taken from the
non-healthcare-related financial account, and the medical product
or service provider is notified that the medical product or service
is paid for. If there are not sufficient funds in the
non-healthcare-related financial account, the medical product or
service provider is notified that it must collect the remaining
amount due for the medical product or service from the
cardholder.
[0023] In operation, the system can operate rapidly to provide a
transaction which is essentially accomplished in real time even
though there are a plurality of entities involved in each
transaction. The perception to both the cardholder and the medical
product or service provider is that there is a single transaction
which results either in the entire cost of the medical product or
service being paid or in the requirement that the cardholder must
pay some or all of the cost of the medical product or service at
that time. optionally, the healthcare debit card may also function
as a conventional charge card (credit or debit) as well for use in
transactions other than for the purchase of medical products or
services. In this case, the healthcare debit card can also be the
non-healthcare-related financial account if desired.
[0024] In the preferred embodiment, the system administrator is the
interface between the other entities in the system of the present
invention. Thus, the flow of information passes through the system
administrator, thereby enabling the system administrator to
ascertain the status of each transaction. Optionally, the system
administrator's role can be reduced, but those skilled in the art
will recognize that one of the entities in the system serves to
route the various operations to ensure that they are all carried
out in the proper order.
[0025] It may therefore be seen that the present invention teaches
a system and method for linking a healthcare debit card to both a
healthcare-related financial account and a non-healthcare-related
financial account in addition to linking the healthcare debit card
to a medical insurance program. The healthcare debit card used in
the system and method of the present invention contains sufficient
information, either in printed form or in electronic form or in
both forms, to enable medical product and service providers to
ascertain that the healthcare debit card provides for payment from
the three sources. The system and method of the present invention
is capable of working which any of a plurality of different
healthcare-related financial accounts, including FSA, HSA, and HRA
healthcare-related financial accounts.
[0026] The system and method of the present invention provide
coordination between the submissions for payment of medical
products and services to a medical insurance provider, the
healthcare-related financial account, and the non-
healthcare-related financial account to ensure that the submissions
to these three entities are made quickly and in the proper
sequence. The system and method of the present invention are
capable of operation in real time or in near-real time, thereby
enabling complete resolution of payment for the medical products
and services at the time of delivery. The healthcare debit card
used in the system and method of the present invention can
optionally be used as a conventional credit or debit card for use
in purchasing non-medical products and services.
[0027] The system and method of the present invention are flexible
of design and robust in operation, and once established the system
requires little or no effort to maintain it other than to keep the
employee or cardholder data current. The system of the present
invention is also relatively inexpensive to implement and to
operate to give it a high perceived value-to-cost ratio to enhance
its market appeal and to thereby afford it the broadest possible
market. Finally, all of the aforesaid advantages and objectives of
the system and method of the present invention are achieved without
incurring any substantial relative disadvantage.
DESCRIPTION OF THE DRAWINGS
[0028] These and other advantages of the present invention are best
understood with reference to the drawings, in which:
[0029] FIG. 1 is a front side plan view of a healthcare debit card
which may be linked to healthcare-related and
non-healthcare-related financial accounts;
[0030] FIG. 2 is a back side plan view of the healthcare debit card
illustrated in FIG. 1;
[0031] FIG. 3 is a functional schematic diagram of a system for
linking the healthcare debit card illustrated in FIGS. 1 and 2 to a
medical insurance provider and to healthcare-related and
non-healthcare-related financial accounts each of which may be used
to pay for medical services and products;
[0032] FIG. 4 is a flow diagram showing the process used to add,
delete, or change employee or cardholder users of the system
illustrated in FIG. 3;
[0033] FIG. 5 is a flow diagram showing exemplary uses of the
healthcare debit card illustrated in FIGS. 1 and 2 in the system
illustrated in FIG. 3;
[0034] FIG. 6 is a flow diagram showing further exemplary uses of
the healthcare debit card illustrated in FIGS. 1 and 2 in the
system illustrated in FIG. 3; and
[0035] FIG. 7 is a flow diagram showing still further exemplary
uses of the healthcare debit card illustrated in FIGS. 1 and 2 in
the system illustrated in FIG. 3.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
[0036] The preferred embodiment of the present invention utilizes a
healthcare debit card 20 which is illustrated in FIGS. 1 and 2. The
healthcare debit card 20, which includes a front side as shown in
FIG. 1 and a rear side as shown in FIG. 2, is preferably made of
plastic material as is conventional. Referring first to the front
side of the healthcare debit card 20 as shown in FIG. 1, a medical
insurance provider name 22 is prominently located near the top of
the healthcare debit card 20. A cardholder name 24 is located near
the bottom of the healthcare debit card 20.
[0037] Prominently located on the healthcare debit card 20 is a
healthcare debit card number 26, and below the healthcare debit
card number 26 near the left side of the healthcare debit card 20
is a four digit verification number 28. Located above the
cardholder name 24 and below the healthcare debit card number 26 is
a healthcare debit card expiration date 30. Located just to the
right of the healthcare debit card expiration date 30 is a
financial network symbol 32, which may be used to identify a
financial network which may be used to facilitate part of the
payment process, as will become apparent later in conjunction with
a description of the operation of the system and method for linking
the healthcare debit card 20 to healthcare-related and
non-healthcare-related financial accounts of the present invention.
In the preferred embodiment, the cardholder name 24, the healthcare
debit card number 26, the healthcare debit card expiration date 30,
and 32 are all both printed and embossed on the healthcare debit
card 20.
[0038] Also located on the healthcare debit card 20 is healthcare
plan information indicated generally by the reference numeral 34.
The healthcare plan information 34 may include, for example, a
subscriber identification number, the effective date of the
healthcare plan, the healthcare plan group name, the healthcare
plan group identification number, and the copay amounts which are
required for various medical services under the healthcare plan.
Located near the right side of the healthcare debit card 20 is a
holographic logo 36, and located below the holographic logo 36 is a
financial network logo 38, which may be used to identify the
financial network which is used to facilitate part of the payment
process.
[0039] Referring now to the back side of the healthcare debit card
20 shown in FIG. 2, a magnetic stripe 40 is located across the
healthcare debit card 20 near the top thereof. The magnetic stripe
40 may be used to store information about the card, the cardholder,
the healthcare plan, and financial account information as well.
Located below the magnetic stripe 40 is a cardholder signature area
42, where the cardholder typically must sign the healthcare debit
card 20 in order for the healthcare debit card 20 to be valid.
[0040] Located on the left side of the healthcare debit card 20 is
healthcare plan service information 44, which can include telephone
numbers, an Internet address, and a mailing address used by the
healthcare plan. Located below the healthcare plan service
information 44 is healthcare financial account service information
46, which may be used to provide telephone numbers and an Internet
address for the administrator of a healthcare financial account
such as an FSA/HSA/HRA financial account. Located near the bottom
of the healthcare debit card 20 is healthcare service information
48 relating to specific services which may be provided by the
healthcare plan service provider.
[0041] Located on the healthcare debit card 20 below the cardholder
signature area 42 is additional healthcare plan information 50,
which may include, for example, information relating to the
healthcare plan system administrator, terms and conditions
governing the use of the healthcare debit card 20, and information
relating to the financial network which is used to facilitate part
of the payment process. Located below the additional healthcare
plan information 50 are a medical network logo 52 and a healthcare
plan provider logo 54, which may respectively be used to identify a
health maintenance organization ("HMO") and/or the healthcare
provider.
[0042] Instead of or in addition to the magnetic stripe 40 located
across the healthcare debit card 20 near the top thereof, a smart
chip 56 may be embedded into the healthcare debit card 20 as shown
in FIG. 1. The smart chip 56 may be used to store information about
the card, the cardholder, the healthcare plan, and financial
account information as well. The smart chip 56 may typically be a
thin and flat integrated circuit assembly which includes a
microprocessor and memory. When the healthcare debit card 20
containing the smart chip 56 is inserted into a reader (not shown),
it wirelessly transfers data to and from the reader via radio
frequency ("RF"). The smart chip 56 needs no internal power source
since it is powered by the signal from the reader.
[0043] An integrated circuit assembly suitable for use as the smart
chip 56 is disclosed in U.S. Pat. No. 5,600,175, and the operation
of a transponder circuit contained in the smart chip 56 is
disclosed in U.S. Pat. No. 5,053,774. Both U.S. Pat. No. 5,600,175
and U.S. Pat. No. 5,053,774 are hereby incorporated herein by
reference in their entirety. A healthcare debit card 20 containing
the smart chip 56 is more secure than if only the magnetic stripe
40 was used. The smart chip 56 can be programmed to self-destruct
if the wrong password is entered too many times.
[0044] Referring next to FIG. 3, a system for using the healthcare
debit card 20 (illustrated in FIGS. 1 and 2) to establish payment
to medical service and/or product providers from a
healthcare-related financial account and a non-healthcare-related
financial account is illustrated. While in FIG. 3 all of the
entities shown are depicted as being connected with a single
network 60, it will be understood by those skilled in the art that
multiple networks may be used instead, and that some or all of
these networks may be private, dedicated networks in addition to
(or instead of) the use of public networks such as the
Internet.
[0045] The healthcare debit card 20 can be made of a variety of
different materials, including conventional PVC stock with an
integrated magnetic stripe 40, a plastic-laminated paper or
cardstock with an integrated magnetic stripe 40, PVC with an
integrated smart chip 56 (the smart chip 56 having the same
information which would otherwise have been included in a magnetic
stripe 40), or PVC with both an integrated magnetic stripe 40 and
an integrated smart chip 56.
[0046] FIG. 3 depicts two medical product providers and three
medical service providers, all of which are connected to the
network 60. These five medical product and medical service
providers are typical of the types of providers which may be
accommodated by the system and method for linking a healthcare
debit card to healthcare-related and non-healthcare-related
financial accounts of the present invention. A drug store 62 which
is a provider of such medical products as prescription drugs,
nonprescription drugs and supplements, and other medical goods has
a card reader 64 which is connected to a facility terminal 66,
which in turn is connected to the network 60. A provider of other
medical products 68 has a card reader 70 which is connected to a
facility terminal 72, which in turn is connected to the network
60.
[0047] A physician office 74 which is most typically a provider of
medical services has a card reader 76 which is connected to a
facility terminal 78, which in turn is connected to the network 60.
A hospital 80 which is also predominantly a provider of medical
services has a card reader 82 which is connected to a facility
terminal 84, which in turn is connected to the network 60. A
provider of other medical services 86 which may be a provider of
medical services such as chiropractic services, various types of
physical therapy, or mental health services has a card reader 88
which is connected to a facility terminal 90, which in turn is
connected to the network 60.
[0048] It may be noted in passing that the card readers 64, 70, 76,
82, and 88 can each be either or both of a magnetic stripe reader
or a smart chip reader. The facility terminals 66, 72, 78, 84, and
90 in conjunction with the card readers 64, 70, 76, 82, and 88 can
be personal computers having wedge reader/pin pads connected
thereto, Internet-enabled point-of-sale terminals, or
Internet-enabled retail cash register/sales systems with an
integrated or stand alone card reader/pin pad.
[0049] FIG. 3 also depicts three administrators which are connected
to the network 60, each of which administrators is a key player in
the operation of typical healthcare systems. A cardholder
administrator 92 that enrolls employees or other cardholders
serviced by a particular healthcare program has a storage medium 94
which is connected to a facility server 96, which in turn is
connected to the network 60. The storage medium 94 is used to store
data regarding the employees or other cardholders.
[0050] A medical insurance program administrator 98 which
administers the healthcare program (typically having defined
healthcare benefits, payment costs, and preferred providers with
which it has fee agreements) has a storage medium 100 which is
connected to a facility server 102, which in turn is connected to
the network 60. The storage medium 100 is used to store data
regarding the medical insurance program, including eligibility
information, coverage information, and copay amounts. A
healthcare-related financial account administrator 104 which
administers employee or cardholder healthcare financial accounts
(such as FSA, HAS, and HRA accounts) has a storage medium 106 which
is connected to a facility server 108, which in turn is connected
to the network 60. The storage medium 106 is used to store data
regarding the healthcare-related financial accounts, including
eligibility information and account balances.
[0051] FIG. 3 also shows two other entities which are included in
the system and method for linking a healthcare debit card to
healthcare-related and non-healthcare-related financial accounts of
the present invention, the first of which is a DDA deposit bank 110
having a non-healthcare-related financial account which belongs to
the employee or cardholder. The employee or cardholder's account at
the DDA deposit bank 110 can be a checking account, a savings
account, or a credit card account, and need not be a dedicated
account which is used only by the system and method for linking a
healthcare debit card to healthcare-related and
non-healthcare-related financial accounts. The DDA deposit bank 110
has a storage medium 112 which is connected to a facility server
114, which in turn is connected to the network 60. The storage
medium 112 is used to store data regarding the
non-healthcare-related financial accounts, including personal
identification numbers ("PIN's") and account balances.
[0052] While the non-healthcare-related financial accounts used by
the system and method for linking a healthcare debit card to
healthcare-related and non-healthcare-related financial accounts of
the present invention are preferably DDA deposit accounts such as
checking or savings accounts, they could also be any of debit
accounts, a dynamic lines of credit, revolving lines of credit,
gift card financial accounts (including incentive-based accounts),
and HSA investment accounts. Additionally, there could be more than
one healthcare-related financial account and/or more than one
non-healthcare-related financial account associated with a single
healthcare debit card 20. Theoretically there could be a relatively
large number of financial accounts associated with a single
healthcare debit card 20, with the system of the present invention
being capable of handling at least twenty different financial
accounts associated with a single healthcare debit card 20.
[0053] The remaining entity shown in FIG. 3 is a system
administrator 116 which is the heart of the system for linking a
healthcare debit card to healthcare-related and
non-healthcare-related financial accounts of the present invention,
since the system administrator 116 functions to coordinate
communications from and between all of the other entities shown in
FIG. 3. The system administrator 116 has a facility server 118
which is connected to the network 60. The facility server 118
accesses a customer database 120 in which information relating to
the system of the present invention is stored. A terminal 122 is
connected to the facility server 118, and a printer 124 and a card
printer 126 are used to respectively provide paper communications
regarding the system of the present invention and cards which may
be used by employees or cardholders having a healthcare program
administered by the system of the present invention.
[0054] Referring now to FIG. 4, a process which may be used to add,
delete, or change employees or cardholders participating in the
system for linking a healthcare debit card to healthcare-related
and non-healthcare-related financial accounts of the present
invention is illustrated. The process begins at a process
initiation step 130 in which the cardholder administrator 92
(illustrated in FIG. 3) provides information to the system
administrator 116 (also illustrated in FIG. 3) relating to the
addition or deletion of an employee or cardholders or relevant
updated data regarding an employee or cardholder.
[0055] The process then moves to a new employee determination step
132 in which it is determined whether or not the information
provided by the cardholder administrator 92 is for a new employee
or cardholder. If the information is for a new employee or
cardholder, the process moves to an add employee to database and
print card step 134 where the data regarding the employee or
cardholder is added to the database contained in the customer
database 120 (illustrated in FIG. 3) and a healthcare debit card 20
(illustrated in FIGS. 1 and 2) is printed and mailed to the new
employee or cardholder. If, on the other hand, the information is
not for a new employee or cardholder, the process moves instead to
a delete employee determination step 136.
[0056] In the delete employee determination step 136, it is
determined whether or not the information provided by the
cardholder administrator 92 is for an employee or cardholder who is
to be deleted from the system of the present invention. If the
information is for an employee or cardholder to be deleted from the
system, the process moves to a delete employee from database step
138 where the specified employee or cardholder is deleted from the
database contained in the customer database 120. If, on the other
hand, the information is not for an employee or cardholder to be
deleted from the system, the process moves instead to a change
employee information determination step 140.
[0057] In the change employee information determination step 140,
it is determined whether or not the information provided by the
cardholder administrator 92 is a change in information regarding an
employee or cardholder participating in the system of the present
invention. If the information is a change in information for an
employee or cardholder participating in the system, the process
moves to a change employee information step 142 where the
information regarding the employee or cardholder is updated in the
database contained in the customer database 120. If, on the other
hand, the information is not for a change in information for an
employee or cardholder participating in the system, the process
moves instead to manual review step 144 where the information is
manually reviewed by a service employee who takes appropriate
action as necessary.
[0058] Referring next to FIGS. 5 through 7, a flow diagram which
shows by way of example the operation of the system for linking a
healthcare debit card to healthcare-related and
non-healthcare-related financial accounts of the present invention
is illustrated. Referring first primarily to FIG. 5, the operation
of the system begins with the employee or cardholder using the
healthcare debit card 20 (illustrated in FIGS. 1 and 2) to purchase
a medical product or service. With regard first to the purchase of
a medical product from a medical product provider 150 which may be
a drug store or some other medical product provider, the process
begins with the employee or cardholder purchasing a medical product
in a cardholder purchases medical product step 152.
[0059] At the time of purchase of the medical product, the employee
or cardholder presents the healthcare debit card 20 to an employee
of the medical product provider 150 in a cardholder presents card
step 154. The employee of the medical product provider 150 then
either scans the card with a card reader or manually enters the
healthcare debit card number 26 (illustrated in FIG. 1) using a
terminal in a scan card or enter card number step 156. Optionally,
the system of the present invention may require the employee's or
cardholder's personal identification number (a "PIN") which is
associated with the healthcare debit card 20. If it does, the
employee or cardholder enters the PIN in a cardholder enters PIN
number step 158.
[0060] Following this step, the medical product information (which
is typically derived by scanning code on the medical product or by
manually entering information regarding the medical product), the
healthcare debit card number 26, and the employee's or cardholder's
PIN (optional) are transmitted in a transmit information step 160
to a system administrator 162, where the transmitted data is
received in a receive information step 164.
[0061] A similar process is followed by the employee or cardholder
to use the healthcare debit card 20 to purchase a medical service
(or a medical product) from a medical service provider 166 which
may be a physician's office, a hospital, or some other medical
service provider. This process begins with the employee or
cardholder receiving a medical service (or a medical product) in a
cardholder receives medical service step 168. In consideration for
the receipt of the medical service (or a medical product), the
employee or cardholder presents the healthcare debit card 20 in a
cardholder presents card step 170. The employee of the medical
service provider 166 then either scans the card through a card
reader or manually enters the healthcare debit card number 26 in a
scan card or enter card number step 172.
[0062] Optionally, the system of the present invention may require
the employee's or cardholder's personal identification number (a
"PIN") which is associated with the healthcare debit card 20. If it
does, the employee or cardholder enters the PIN in a cardholder
enters PIN number step 174. Following this step, the medical
service (or medical product) information (which is typically
derived by manually entering information regarding the medical
service), the healthcare debit card number 26, and the employee's
or cardholder's PIN are transmitted in a transmit information step
176 to the system administrator 162, where the transmitted data is
received in the receive information step 164.
[0063] For either a medical product or a medical service, following
the receive information step 164 the process then moves to a send
claim information step 178 in which the medical product or service
information, the healthcare debit card number 26, and the
employee's or cardholder's PIN (optional) are provided to the
medical insurance program administrator 180. The medical insurance
program administrator 180 analyzes the medical product or service
information, the healthcare debit card number 26, and the
employee's or cardholder's PIN (optional) in a product or service
coverage determination step 182.
[0064] If it is determined in the product or service coverage
determination step 182 that the medical product or service is
covered by the employee's or cardholder's medical insurance, the
process moves to a pay claim for product or service step 184 where
the medical insurance program administrator 180 pays the
appropriate amount for the medical product or service. In addition,
the pay claim for product or service step 184 also provides
information regarding any amounts which will be written off by the
provider, and the remaining amount which is due for the medical
product or service to the system administrator 162, where this
information is received in a receive claim coverage information
step 186.
[0065] If, on the other hand, it is determined in the product or
service coverage determination step 182 that the medical product or
service is not covered by the employee's or cardholder's medical
insurance, information indicating that the medical product or
service is not covered by the employee's or cardholder's medical
insurance (as well as information regarding any amounts which will
be written off by the provider pursuant to contract) is provided to
the system administrator 162, where this information is received in
the receive claim coverage information step 186.
[0066] Referring primarily now to FIG. 6, from the receive claim
coverage information step 186, the process next moves to a send
unpaid claim information step 188 in which information relating to
the remaining amount which is due for the medical product or
service is forwarded to a healthcare-related financial account
administrator 190. At the healthcare-related financial account
administrator 190, a determination is made as to whether the
medical product or service is a covered medical product or service
in a coverage determination step 192. If it is determined in the
coverage determination step 192 that the medical product or service
is covered by the employee's or cardholder's healthcare-related
financial account, the process moves to an account fund sufficiency
determination step 194.
[0067] In the account fund sufficiency determination step 194, it
is determined whether or not there are sufficient funds in the
employee's or cardholder's healthcare-related financial account to
pay the remaining amount which is due for the medical product or
service. If there are sufficient funds (or if the financial account
can advance funds), the process moves to a pay balance for product
or service step 196 where the coverage determination step 192 pays
the remaining amount which is due for the medical product or
service to the provider of the medical product or service. The
process them moves to a receive payment information step 198 where
the system administrator 162 is provided with information from the
healthcare-related financial account administrator 190 which
indicates that the remaining amount which is due for the medical
product or service has been paid. In this event, the process then
terminates in a transaction complete step 200.
[0068] If, on the other hand, it is determined in the account fund
sufficiency determination step 194 that there are not sufficient
funds in the employee's or cardholder's healthcare-related
financial account to pay the remaining amount which is due for the
medical product or service, the process moves instead to a pay
remaining funds to provider step 202. In the pay remaining funds to
provider step 202, the remaining funds (if any) in the employee's
or cardholder's healthcare-related financial account are paid to
the provider of the medical product or service. The process them
moves to a receive amount due information step 204 where the system
administrator 162 is provided with information from the
healthcare-related financial account administrator 190 which
indicates the remaining amount which is due for the medical product
or service.
[0069] Returning now to the coverage determination step 192, if on
the other hand it is determined that the medical product or service
is not covered by the employee's or cardholder's healthcare-related
financial account, the process moves instead directly to the
receive amount due information step 204, where the system
administrator 162 is informed that the medical product or service
is not covered and of the remaining amount which is due for the
medical product or service. Thus, the process will include the
receive amount due information step 204 whenever there is a
remaining amount which is due for the medical product or service.
It is from the receive amount due information step 204 where the
system and method for linking a healthcare debit card to
healthcare-related and non-healthcare-related financial accounts of
the present invention are focused.
[0070] As previously mentioned, it is possible to have more than
one healthcare-related financial account associated with a
healthcare debit card 20. If there is more than one
healthcare-related financial account associated with a healthcare
debit card 20, they will be sequentially accessed by the system
administrator 116 to determine coverage and the availability of
funds in each account. Thus, the coverage determination step 192,
the account fund sufficiency determination step 194, and the pay
balance for product or service step 196 or the pay remaining funds
to provider step 202 will be performed in conjunction with each
healthcare-related financial account administrator 190 until the
healthcare-related financial accounts associated with a healthcare
debit card 20 have been exhausted.
[0071] Referring primarily now to FIG. 7, from the receive amount
due information step 204, the process moves to a send amount due
information to DDA account bank step 206 in which information
relating to the remaining amount which is due for the medical
product or service is forwarded to a non-healthcare-related
financial account administrator 208. The non-healthcare-related
financial account administrator 208 is typically a bank or other
financial institution, and the non-healthcare-related financial
account may be either a conventional savings account, a checking
account, or a credit card account at the bank (it need not be a
special or dedicated financial account). The send amount due
information to DDA account bank step 206 also forwards information
held by the system administrator 162 relating to the account number
of the employee's or cardholder's account at the
non-healthcare-related financial account administrator 208, as well
as the PIN for the financial account.
[0072] A determination is made by the non-healthcare-related
financial account administrator 208 as to whether the information
provided from the system administrator 162 identifies a valid
financial account and includes all of the information required to
perform a financial transaction from that financial account in a
account authorization determination step 210. If it is determined
in the account authorization determination step 210 that the
account authorization information is not valid, the system
administrator 162 is informed in a receive failure to pay
notification step 212. Following such a notification, the process
moves to a notify product or service provider to collect from
cardholder step 214, where the provider is notified of the
remaining amount which is due for the medical product or service.
In this event, the process then terminates in a transaction
complete step 216.
[0073] If, on the other hand, it is determined in the account
authorization determination step 210 that the account authorization
information is valid, the process moves instead to a sufficient
funds in account determination step 218. If it determined in the
sufficient funds in the account determination step 218 that there
are insufficient funds in the non-healthcare-related financial
account, the system administrator 162 is informed in the receive
failure to pay notification step 212. In this event, the process
then again moves to the notify product or service provider to
collect from cardholder step 214 and the transaction complete step
216.
[0074] If, on the other hand, it is determined in the sufficient
funds in account determination step 218 that there are sufficient
funds in the non-healthcare-related financial account to pay the
remaining amount which is due for the medical product or service,
the process moves to a pay balance for product or service step 220.
In the pay balance for product or service step 220, the
non-healthcare-related financial account administrator 208 pays the
remaining amount which is due for the medical product or service to
the system administrator 162. The process them moves to a receive
payment information step 222 where the system administrator 162 is
provided with information from the non-healthcare-related financial
account administrator 208 which indicates that the remaining amount
which is due for the medical product or service has been paid to
the system administrator 162.
[0075] As previously mentioned, it is possible to have more than
one non-healthcare-related financial account associated with a
healthcare debit card 20. If there is more than one
non-healthcare-related financial account associated with a
healthcare debit card 20, they will be sequentially accessed by the
system administrator 116 to determine the availability of funds in
each account. Thus, the account authorization determination step
210 and the sufficient funds in account determination step 218 or
the pay balance for product or service step 220 will be performed
in conjunction with each non-healthcare-related financial account
administrator 208 until the non-healthcare-related financial
accounts associated with a healthcare debit card 20 have been
exhausted.
[0076] Following an indication that the remaining amount which is
due for the medical product or service has been paid to the system
administrator 162, the process then moves to a transfer funds to
provider step 224 in which the system administrator 162 transfers
the remaining amount which is due for the medical product or
service to the medical product or service provider. Next, in a
notify provider of payment step 226, the system administrator 162
notifies the medical product or service provider that the remaining
amount which was due for the medical product or service has been
paid. Finally, the process terminates in a transaction complete
step 228.
[0077] It may therefore be appreciated from the above detailed
description of the preferred embodiment of the present invention
that it teaches a system and method for linking a healthcare debit
card to both a healthcare-related financial account and a
non-healthcare-related financial account in addition to linking the
healthcare debit card to a medical insurance program. The
healthcare debit card used in the system and method of the present
invention contains sufficient information, either in printed form
or in electronic form or in both forms, to enable medical product
and service providers to ascertain that the healthcare debit card
provides for payment from the three sources. The system and method
of the present invention is capable of working which any of a
plurality of different healthcare-related financial accounts,
including FSA, HSA, and HRA healthcare-related financial
accounts.
[0078] The system and method of the present invention provide
coordination between the submissions for payment of medical
products and services to a medical insurance provider, the
healthcare-related financial account, and the non-
healthcare-related financial account to ensure that the submissions
to these three entities are made quickly and in the proper
sequence. The system and method of the present invention are
capable of operation in real time or in near-real time, thereby
enabling complete resolution of payment for the medical products
and services at the time of delivery. The healthcare debit card
used in the system and method of the present invention can
optionally be used as a conventional credit or debit card for use
in purchasing non-medical products and services.
[0079] The system and method of the present invention are flexible
of design and robust in operation, and once established the system
requires little or no effort to maintain it other than to keep the
employee or cardholder data current. The system of the present
invention is also relatively inexpensive to implement and to
operate to give it a high perceived value-to-cost ratio to enhance
its market appeal and to thereby afford it the broadest possible
market. Finally, all of the aforesaid advantages and objectives of
the system and method of the present invention are achieved without
incurring any substantial relative disadvantage.
[0080] Although the foregoing description of the system and method
of the present invention has been shown and described with
reference to particular embodiments and applications thereof, it
has been presented for purposes of illustration and description and
is not intended to be exhaustive or to limit the invention to the
particular embodiments and applications disclosed. It will be
apparent to those having ordinary skill in the art that a number of
changes, modifications, variations, or alterations to the invention
as described herein may be made, none of which depart from the
spirit or scope of the present invention. The particular
embodiments and applications were chosen and described to provide
the best illustration of the principles of the invention and its
practical application to thereby enable one of ordinary skill in
the art to utilize the invention in various embodiments and with
various modifications as are suited to the particular use
contemplated. All such changes, modifications, variations, and
alterations should therefore be seen as being within the scope of
the present invention as determined by the appended claims when
interpreted in accordance with the breadth to which they are
fairly, legally, and equitably entitled.
* * * * *