AU2017204901A1 - Computer-implemented system and method for processing healthcare transactions - Google Patents

Abstract

The present invention relates to processing service transactions, in particular, healthcare transactions involving a healthcare provider, patient and a patient health fund. 771!7 User API Web Server (Mobile App) (PHP Script) 20 Internet Connectivity to User Interface Healthlinked Web Server (Mobile App): Healthlinked API Server My Gap Payments .-- Lbdwd 2 @® G My ddr MyHealth d 5 Financial Institution Private Health Fund I Web Server Web Server Fiaure I

Description

COMPUTER-IMPLEMENTED SYSTEM AND METHOD FOR PROCESSING

HEALTHCARE TRANSACTIONS

FIELD OF THE INVENTION

[0001] The present invention relates to processing service transactions, in particular, healthcare transactions involving a healthcare provider, patient and a patient health fund.

BACKGROUND OF THE INVENTION

[0002] Healthcare providers are paid for services provided to their patients. If the patient is a member of a health fund, the health fund will typically offer a rebate to members whereby a portion of the total charge associated with a healthcare transaction is covered by the health fund rebate. The portion of the charge that is not covered by the health fund rebate, combined with any other applicable benefits such as Medicare®, is referred to, in Australia at least, as the “gap”.

[0003] Existing systems of processing healthcare transactions, including receiving approval for a health fund rebate and paying the gap, are antiquated. The hardware typically used involves a device specifically set up to read both Health Industry Claims and Payment Service (HICAPS) cards, which are issued by Health Funds to their members for identification purposes, and Electronic Funds Transfer at Point of Sale (EFTPOS) cards, which are issued by financial institutions to their account holders to enable electronic payments.

[0004] The healthcare provider will typically operate a desktop computer running purpose built software that enables data relating to the healthcare transaction to be entered by healthcare provider personnel, and to which the HICAPS / EFTPOS reader is connected. The software is used to bill the charge, and the HICAPS / EFTPOS machine registers the charge. The patient then swipes (or taps or inserts) their HICAPS card, and the machine communicates with the relevant health fund server to approve or decline the claim. If the claim is approved, the device will print out a customer copy and a provider copy of the transaction receipt.

[0005] The software is then used to bill the gap portion of the total bill, and the HICAPS / EFTPOS machine registers the gap charge. The patient then swipes (or taps or inserts) their EFTPOS card, and the machine communicates with the relevant financial institution to approve or decline the transaction. If the transaction is approved, another set of receipts is printed for the provider and customer as a record of this second part of the transaction.

[0006] Accordingly, a technical problem exists in that the current hardware used to process healthcare transactions requires at least two card transactions when paying for a health care service, and paper receipts are printed which need to be physically retained or filed. The existing technical hardware and method of processing is known to be very slow and non-user friendly, and does not provide opportunities for broad based revenue generation.

[0007] It is therefore an object of the present invention to overcome at least some of the aforementioned problems or to provide the public with a useful alternative. Reference is made throughout this specification to “insurance” funds which is intended to be an overarching reference to any type of fund involving a user, a service provider and a benefit afforded to members of the fund that results in a reduced amount payable to the service provider in relation to services provided to the user by the service provider.

SUMMARY OF THE INVENTION

[0008] According to an aspect, the present invention provides a computer-implemented method for processing service transactions, the method including receiving, by a remote central server, transaction data transmitted from a service provider device, the transaction data relating to a service transaction and including information relating to a user receiving a service relating to the service transaction from the service provider, an insurance fund of the user, and a monetary amount that is reflective of a charge of the service provider for providing said service, transmitting, from the remote central server to a handheld device of the user, at least part of the transaction data associated with the service transaction, wherein the handheld device includes a user interface that enables the user to view the transmitted transaction information and authorise payment of at least a portion of said monetary amount, in response to receiving a user authorisation, transmitting, from the handheld device to the remote central server, user-authorised transaction data, in response to receiving the user-authorised transaction data from the handheld device, transmitting the user-authorised transaction data from the remote central server to an insurance fund server associated with the insurance fund of the user.

[0009] In an embodiment, in response to receiving the user-authorised transaction data from the remote central server, the insurance fund server performs operations including comparing the transaction information against stored identifiers associated with the user, based upon determining that the transaction information matches the stored identifiers, authenticating the user-authorised transaction data, and transmitting, to a financial institution associated with the insurance fund, instructions to process said payment of at least a portion of said monetary amount to a financial institution of the service provider.

[0010] In an embodiment, the transaction data further includes information relating to the service provider, and the service provided by the service provider.

[0011] In an embodiment, the monetary amount includes a first portion that is equivalent to an insurance rebate or benefit available to the user by the insurance fund and a second portion reflective of a remaining balance after the first portion and any additional available rebate is subtracted from the monetary amount.

[0012] In an embodiment, the method further includes determining, by the insurance fund server, that the transaction information matches the stored identifiers further includes determining that the insurance fund associated with the user includes sufficient available rebate funds or benefits to pay the first portion of the monetary amount.

[0013] In an embodiment, the method further includes transmitting, to a financial institution associated with the insurance fund, instructions to process said payment of at least a portion of said monetary amount to a financial institution of the service provider, includes transmitting, from the insurance fund server to the financial institution associated with the insurance fund, instructions to process payment reflective of the first portion of the monetary amount to the financial institution of the service provider.

[0014] In an embodiment, the method further includes transmitting the user-authorised and authenticated transaction data from the insurance fund server to the remote central server, and storing, in the remote central server or an associated database, the user-authorised and authenticated transaction data.

[0015] In an embodiment, the method further includes determining, by a computer associated with the remote central server, the second portion of the monetary amount that is payable to the service provider.

[0016] In an embodiment, the method further includes transmitting, from the remote central server to the handheld device, the user-authorised and authenticated transaction data including the calculated second portion of the monetary amount that is payable to the service provider, and in response to receiving the user-authorised and authenticated transaction data, transmitting, from the handheld device to a financial institution associated with the user, instructions to process payment reflective of the second portion of the monetary amount to the financial institution of the service provider.

[0017] In an embodiment, the user interface of the handheld device enables the user to view one or more payment options for payment of the second portion of the monetary amount and to input account verification information associated with the user’s financial institution.

[0018] In an embodiment, the method further includes storing, by the insurance fund server, the transaction data relating to the service transaction selected for payment.

[0019] In an embodiment, the remote central server communicates with the insurance fund server to poll information relating to the user insurance fund, including the transaction data stored by the insurance fund server.

[0020] In an embodiment, the method further includes transmitting, from the handheld device to the remote central server, a request for a listing of previous transactions associated with the user, and in response to receiving said request, transmitting, from the remote central server to the handheld device, a listing of previous transactions polled from the insurance fund server.

[0021] In an embodiment, the listing of previous transactions includes at least information relating to the service provider and a date associated with the service transaction.

[0022] In an embodiment, the user interface of the handheld device enables the user to view the listing of previous transactions, and sort the listing by date or service provider.

[0023] In an embodiment, the method further includes transmitting, from the handheld device to the remote central server, a request for a insurance fund benefits summary associated with the user, and in response to receiving said request, transmitting, from the remote central server to the handheld device, a benefits summary polled from the insurance fund server, wherein the user interface of the handheld device enables the user to view the benefits summary.

[0024] In an embodiment, the benefits summary includes one or more progress bars which displays how much of any one insurance fund benefit has been used and how much is remaining.

[0025] In an embodiment, when the information polled from the insurance fund server includes an update to the benefits summary associated with the user, the remote central server transmits the transaction data including the update to the handheld device, and the user interface of the handheld device enables the user to view an updated benefits summary.

[0026] In an embodiment, when the update indicates that an upper limit of a insurance fund benefit has been reached, the remote central server transmits the transaction data including the update to the handheld device, and the user interface of the handheld device enables the user to view the update and apply for an upgrade to an existing insurance fund policy.

[0027] In an embodiment, the information polled from the insurance fund server includes updates or information in relation to one or more of additional insurance options offered by the insurance fund, a policy assessment tool, and general messages or reports from the insurance fund to insurance fund members, and the user interface of the handheld device enables the user to view the updates and select additional options or links associated with same.

[0028] In an embodiment, the method further includes transmitting, from the handheld device to the remote central server, a request for signing in as an existing user, and in response to receiving said request, transmitting, from the remote central server to the handheld device, a request for existing user credentials.

[0029] In an embodiment, the user interface of the handheld device enables the existing user to enter the credentials and transmit the credentials from the handheld device to the remote central server for approval.

[0030] In an embodiment, the method further includes transmitting, from the handheld device to the remote central server, a request for registering as a new user, and in response to receiving said request, transmitting, from the remote central server to the handheld device, a request for information from the new user including the user’s insurance fund and insurance fund membership number.

[0031] In an embodiment, the user interface of the handheld device enables the new user to enter the information and transmit the information from the handheld device to the remote central server for storing and for use in subsequent approval of user credentials.

[0032] In an embodiment, the user interface of the handheld device enables an existing user to edit their credentials and personalise settings of the user interface.

[0033] In an embodiment, the service transaction is a healthcare transaction, the service provider is a healthcare provider, the user is a patient of the healthcare provider, and the insurance fund is a health fund of the patient.

[0034] According to another aspect, the present invention provides a system for processing service transactions, the system including a service provider device, a remote insurance fund server associated with an insurance fund of the user, a handheld device including a user interface, a financial institution server associated with the insurance fund, a financial institution server associated with the service provider, and a remote central server having instructions stored thereon, or on an associated storage means, which, when executed by the remote central server, cause the remote central server to perform operations including receiving transaction data transmitted from the service provider computer, the transaction data relating to a service transaction and including information relating to a user receiving a service relating to the service transaction from the service provider, an insurance fund of the user, and a monetary amount that is reflective of a charge of the service provider for providing said service, transmitting, from the remote central server to the handheld device of the user, at least part of the transaction data associated with the service transaction, wherein the user interface of the handheld device enables the user to view the transmitted transaction information and authorise payment of at least a portion of said monetary amount, receiving, from the handheld device, user-authorised transaction data, and transmitting the user-authorised transaction data to the remote insurance fund server.

[0035] In an embodiment, the remote insurance fund server compares the transaction information against stored identifiers associated with the user, and based on a determination that the transaction information matches the stored identifiers, authenticates the user-authorised transaction data, and transmits, to the financial institution server associated with the insurance fund, instructions to process said payment of at least a portion of said monetary amount to the financial institution server associated with the service provider.

[0036] According to another aspect, the present invention provides a computer-readable medium storing instructions for processing a healthcare transaction which are executable by a remote central server and which, upon such execution, cause the remote central server to perform operations including receiving transaction data transmitted from a service provider device, the transaction data relating to a service transaction and including information relating to a user receiving a service relating to the service transaction from the service provider, an insurance fund of the user, and a monetary amount that is reflective of a charge of the service provider for providing said service, transmitting to a handheld device of the user, at least part of the transaction data associated with the service transaction, wherein the user interface of the handheld device enables the user to view the transmitted transaction information and authorise payment of at least a portion of said monetary amount, receiving, from the handheld device, user-authorised transaction data, and transmitting the user-authorised transaction data to a remote insurance fund server associated with an insurance fund of the user.

[0037] In an embodiment, the remote insurance fund server compares the transaction information against stored identifiers associated with the user, and based on a determination that the transaction information matches the stored identifiers, authenticates the user-authorised transaction data, and transmits, to a financial institution server associated with the insurance fund, instructions to process said payment of at least a portion of said monetary amount to a financial institution server associated with the service provider.

BRIEF DESCRIPTION OF THE DRAWINGS

[0038] Features of the present disclosure are illustrated by way of example and not limited in the following figure(s), in which like numerals indicate like elements, in which:

Figure 1 illustrates a flow diagram of a system and method for processing a healthcare transaction according to an embodiment of the present invention;

Figure 2 illustrates exemplary user interfaces that enable a user to authorise a rebate and gap payment to a health care provider;

Figure 3 illustrates a flow diagram illustrating data flow processes that enable a user to access historical healthcare transaction information according to an embodiment;

Figure 4 illustrates exemplary user interfaces that enable a user to view historical healthcare transaction information;

Figure 5 illustrates exemplary user interfaces that enable a user to view a health fund benefits summary including usage information associated with each health fund benefit;

Figure 6 illustrates exemplary user interfaces that enable a user to view additional insurance products of the health fund provider;

Figure 7 illustrates exemplary user interfaces that enable a user to view and partake in a policy assessment and upgrade the existing health fund policy;

Figure 8 illustrates exemplary user interfaces that enable a user to view messages and information issued by the health fund provider;

Figure 9 illustrates exemplary user interfaces that enable a user to view and confirm an appointment with a healthcare provider using their handheld device; and

Figure 10 illustrates exemplary user interfaces that enable a user to register and set up their health fund, as well as edit their credentials and general settings.

DETAILED DESCRIPTION OF THE EMBODIMENT(S) OF THE INVENTION

[0039] For simplicity and illustrative purposes, the present disclosure is described by referring mainly to an example thereof, in particular, an example relating to a healthcare transaction involving a healthcare provider, a patient, and the patient’s healthcare insurance fund. In the following description, numerous specific details are set forth in order to provide a thorough understanding of the present disclosure. It will be readily apparent however, that the present disclosure may be practiced without limitation to these specific details and that the present invention may well be applied to other insurance-based transactions. In other instances, some methods and structures have not been described in detail so as not to unnecessarily obscure the present disclosure. As used herein, the terms “a” and “an” are intended to denote at least one of a particular element, the term “includes” means includes but not limited to, the term “including” means including but not limited to, and the term “based on” means based at least in part on.

[0040] According to an embodiment, the present invention provides a computer-implemented method, system and computer-readable medium for processing healthcare transactions. It will become apparent that the method, system and computer-readable medium may utilise a smart phone application (also referred to herein as an “app”) which allows users (customers or patients) to pay for visits to their health care providers, including payment of any gap, in a single transaction and without the need for HICAPS, EFTPOS or other swipe cards. The healthcare transaction may be completed by the customer bringing their handheld device, such as a mobile phone device, with them to their appointment for quick and efficient processing of the healthcare transaction following their consultation.

[0041] In an embodiment, the system 10 may include a health care provider desktop computer and associated interface 12, a remote central server 14, which by way of example may be an Amazon™ web server. The remote central server 14 may be any server having web connectivity and the ability to communicate with device applications through an Application Programming Interface (API). In this embodiment, the system 10 may further include a remote health fund server 16 (which again may be any server having web connectivity and API functionality), and a patient’s handheld device 18, which may be an IOS / Android device or any other device with internet connectivity and having the ability to run an application. Any user interfaces described herein and/or shown in the drawings are interfaces of an app according to an exemplary embodiment. It is to be understood that other software applications including different interfaces may provide the same or similar functionality and the present invention is not limited to any one example presented in the Figures.

[0042] The remote central server 14 may have instructions stored thereon or on an associated database (not shown), which, when executed by the remote central server 14, may cause the remote central server to perform operations including receiving transaction data related to a healthcare transaction entered into and transmitted using the health provider computer interface 12. The health provider computer may have internet connectivity to enable transmission of data to the server 14. The healthcare transaction data may include information relating to a patient receiving healthcare from the healthcare provider and to whom the transaction relates, data identifying a health fund of the patient (having an associated health fund server 16), and a monetary amount that is reflective of a total charge of the healthcare provider for providing their services to the patient. The healthcare provider computer 12 may utilise existing software for creating the transaction data, such as Smartsoft Front Desk®, Capable 21C®, or Cliniko®, an example of which is shown in the interface of Figure 1.

[0043] The operations may further include transmitting the transaction data to a handheld device 18 of the patient that may include a user interface 20 that enables the patient to view the transaction information and authorise payment of at least a portion of the monetary amount by selecting the transaction for payment. The flow diagram of Figure 1 illustrates the above process in arrows 1 and 2.

[0044] Also shown in Figure 1 by arrow 3 is an embodiment of transmitting, in response to a patient selecting the transaction for payment, from the handheld device 18 to the remote central server 14, confirmation that the transaction has been selected for payment. The confirmation may be in the form of user-authorised transaction data.

[0045] Arrow 4 of Figure 1 reflects the process of the remote central server 14, in response to receiving the user-authorised transaction data from the handheld device 18, transmitting the user-authorised transaction data to the remote health fund server 16. The remote health fund server 16 may be configured to perform operations including comparing the transaction information against stored identifiers associated with the user (for example, membership data, remaining benefit allocation and provider eligibility), authenticating the user-authorised transaction data (for example, based on determining that the transaction information matches the stored identifiers or satisfies certain requirements), and transmitting instructions to a financial institution (not shown) associated with the insurance health fund instructions to process payment of at least a portion of the monetary amount to a financial institution server (not shown) of the healthcare provider. Whilst a financial institution server 21 is shown in Figure 1, this is a server associated with the patient’s financial institution and not that of the health fund.

[0046] Accordingly, once a patient logs into the system 10 (a login procedure according to an embodiment is described in more detail below), and accepts the transaction sent to their phone, their handheld device 18 effectively becomes linked to their health fund membership. This then enables (1) an authorization by the user of transaction data transmitted to the user device 18 by the central server 14, and (2) an authentication of the user-authorised transaction data by the health fund server 16. Multiple devices may be linked to a single private health fund membership, for example, mobile devices belonging to family members included in the same health fund policy.

[0047] An example of a user interface 20 is shown in Figure 2 as well as an example of a new bill notification 22 and a “Pay Bill” interface 24 which allows the user to accept 26 or decline 28 payment of the transaction. The notification 22 will appear after the remote central server 14 communicates with the handheld device 18 to identify the transaction. The transaction data may further include details 30 of the health care provider, and services provided by the health care provider as part of the healthcare transaction, and the “Pay Bill” interface 24 may display the monetary amount that is reflective of individual or total charges of the health care provider for providing said services.

[0048] In an embodiment, the total monetary amount may include a first portion that is covered by a rebate or benefit available to the patient through the patient’s health fund and a second portion that is not covered by the rebate or benefit. In this regard, the operations may further include, in response to receiving the user-authorised transaction data from the handheld device, determining that the insurance fund associated with the user includes sufficient available rebate funds or benefits to pay the first portion of the monetary amount. In this regard, the instructions that are transmitted to the financial institution (not shown) associated with the insurance health fund may be to process payment of the first portion of the monetary amount to the financial institution (not shown) of the healthcare provider.

[0049] Arrow 5 of Figure 1 reflects a step of transmitting the user-authorised and authenticated transaction data from the remote health fund server 16 to the remote central server 14. In response to receiving this data, the remote central server 14 may store the data and further calculate a second portion of the monetary amount that is left to be paid. For example, in the case of health insurance, this second portion is often referred to as the “gap”. The user-authorised and authenticated transaction data, including the determined second portion of the monetary amount that is yet to be paid, may be transmitted to the handheld device 18. In respect of the second portion, the operations may further include transmitting, from the handheld device 18 to a financial institution server 21 associated with the patient, instructions to process payment reflective of the second portion of the monetary amount to the financial institution server (not shown) of the health care provider, as illustrated by the broken line arrow of Figure 1. Accordingly, payment approval may be pushed via the handheld device 18. This general communication of data and instructions from the remote central server 14 to the patient’s financial institution 21 via the handheld device 18 of the patient is indicated by arrow 6 in Figure 1.

[0050] Accordingly, once a user authorizes a transaction on their handheld device, the health fund may authenticate the authorization, and then once authenticated, funds may be released from the patient’s health fund for allocation to the first portion of the monetary amount, and from the patient’s nominated bank account, credit card or Paypal™ account for allocation to the second portion of the monetary amount, and transferred to the healthcare provider’s bank account to compensate the healthcare provider the total monetary amount. Payment of the second portion may be made in a modified phone / internet banking protocol. Data relating to transfer of the second portion of the monetary amount to the healthcare provider’s bank account may be transferred from the financial institution server 21 of the patient to the remote central server 14 where a record of all transaction data may be stored, as indicated by arrow 7 in Figure 1.

[0051] An example of a “My Gap Payments” user interface 32 of the handheld device 18 that enables the patient to view one or more payment options 34 and to input account verification information 36 associated with the patient’s financial institution 21 is also shown in Figure 2. This interface may also enable the user to choose a favourite or default account. Alternatively, the account verification information associated with the patient’s financial institution 21 may be stored in the handheld device 18 after being entered previously, as described in more detail below. Such stored information may autopopulate the account verification fields.

[0052] In an embodiment, after receiving the transaction data from the remote central server 14, the health fund server 16 may store the transaction data relating to the healthcare transaction that was selected by the patient for payment. In this regard, healthcare providers are often required to verify transactions and this often involves a health fund auditing the transaction records of the healthcare provider. In storing transaction data both at the remote central server and the health fund server, this verification and auditing process is simplified and does not require a health fund representative visiting the premises of a healthcare provider to audit paper receipt archives. The remote central server 14 may also communicate and re-synchronise with the health fund server 16 at any time to poll the most up to date information relating to the patient health fund and benefit usage, including the transaction data stored by the health fund server 16. Figure 3 shows an example flow diagram of a request for data being transmitted from the handheld device 18 to the remote central server 14, and the requested data being polled from the remote health fund server 16 for subsequent transmission to the handheld device 18.

[0053] An example of data that is stored by the health fund server 16 and may be polled by the remote central server before being transmitted to the handheld device 18 is a listing of previous transactions associated with the patient. Figure 4 shows exemplary “Transaction History” interfaces 38 and 40 which display the listing of previous transactions by date and by provider respectively.

[0054] Another example of information that can be polled from the remote health fund server 16 is a summary of benefits provided by the patient’s health fund and their status. For example, if a user seeks to access such information, a request for a health fund benefit summary may be transmitted from the handheld device to the remote central server, and in response to receiving the request, the remote central server may poll the information from the health fund server 16 and transmit same to the handheld device 18. Figure 5 shows exemplary “My Providers” and “My Benefit Summary” interfaces 42 and 44 respectively, wherein the “My Providers” interface 42 (which appears when the “My Providers” icon in interface 20 is selected) enables a user to select a “My Benefit Summary” icon to view the benefit summary and display the summary respectively. In an embodiment, and as shown in interface 44, the benefits summary may include one or more progress bars 46 which displays how much of any one health fund benefit has been used and how much is remaining. The progress bars may display information as a percentage of annual benefit or pursuant to some other factor.

[0055] In an embodiment, when the information polled from the health fund server 16 includes an update to the benefits summary associated with the user, the remote central server 14 may transmit the transaction data including the update to the handheld device 18, and the user interface of the handheld device may alert the user and enable the user to view an updated benefits summary. In this regard, the interface 20 may include an update notification 48.

[0056] When the update indicates that an upper limit of a health fund benefit has been reached, the remote central server 14 may transmit the transaction data including the update to the handheld device 18, and Figure 5 also illustrates an example of a user interface 50 that may identify 52 the health fund benefit in question, and may enable the patient to view the update and apply 54 for an upgrade to an existing health fund policy.

[0057] In an embodiment, the information polled from the health fund server 16 may include additional updates and information relating to, for example, one or more of additional insurance options offered by the health fund (car insurance, health insurance, travel insurance, etc) as shown in the exemplary interface 56 of Figure 6, a policy assessment tool as shown in the exemplary interfaces 58 and 60 of Figure 7, and general messages or reports from the health fund to health fund members as shown in the exemplary interfaces 62 and 64 of Figure 8. Where appropriate, notifications 66 may also be used, and the user interfaces enables the patient to view the updates and select additional options or links associated with same.

[0058] In an embodiment, the patient may make appointments with the healthcare provider using their handheld device 18. An example of an appointment user interface 67 of the handheld device 18 that enables the patient to view available appointment times of the healthcare provider is shown in Figure 9. This interface may enable the patient to search for and select available appointments and for selected appointments to be saved into a calendar that is viewable on the user interface of the patient’s handheld device 18. Accordingly, settings can be arranged to import appointments directly into the handheld device calendar, with appropriate automatic reminders.

[0059] The healthcare provider computer 12 may store information relating to available appointment times of the healthcare provider, and such information may form part of the transaction data that is transmitted to the remote central server 14. This data may include information relating to existing appointments of the patient. The healthcare provider computer 12 may also be programmed to enable a user to make an appointment and automatically transmit the information to the remote central server for access by the patient’s handheld device 18.

[0060] As discussed earlier, users (customers, patients, etc.) may be required to sign in to access the system 10. For example, once the application software has been downloaded onto the user’s device, they may be prompted to register their details which may include their health fund name and membership number, and credit card details for example. In this regard, Figure 10 illustrates exemplary interfaces 68, a welcome screen which may appear the first time the application is accessed after download, 70, requesting that the user enter a security pin to access the application, 72, requesting that the user enter the health fund name and membership number, and 74, indicating the initial setup has been completed successfully. The operations may further include transmitting, from the handheld device 18 to the remote central server 14, a request for registering as a new user, and in response to receiving the request, the remote central server 14 may transmit to the handheld device 18 a request for this information.

[0061] In an embodiment, the operations may further include transmitting, from the handheld device 18 to the remote central server 14, a request for signing in as an existing user. In response to receiving such a request, the remote central server 14 may transmit, from the remote central server 14 to the handheld device 18, a request for previously entered user credentials.

[0062] In an embodiment, a user interface 76 of the handheld device 18 may enable an existing user to edit their credentials and personalise settings of the application software, as also shown in Figure 10.

[0063] The skilled addressee should now appreciate the benefits afforded by the present invention. Customers no longer need to carry their health care membership cards with them to appointments, and their wait time will be minimised since all information may be securely stored in their handheld device 18. To ensure security, the application software may allow a 5 minute time limit, for example, for the customer to authorise the transaction to ensure transactions are completed whilst the customer is physically in the health care provider’s premises. If a customer leaves their handheld device at home, then solutions are available including a one-time override code being issued to the customer to completer the transaction outside of the designated time limit.

[0064] Health fund providers may also benefit from implementing the present invention in that the software application utilised by customers provides a means by which health fund providers may advertise and promote offerings to their customer base. In addition, because usage (and exhaustion) of a health fund benefit is displayed to the customer in virtually real-time, the opportunity exists for customers to immediately upgrade their health fund policy for the following year.

[0065] The ability for health fund providers to inform customers that other insurance products are available provides a competitive advantage in that the health fund provider may offer a real-time discount if the customer agrees to purchase multiple policies through the same health fund provider. As described earlier, the application software may be used by the health fund provider to provide to customers a product assessment tool and also a product recommendation based on responses to, for example, a lifestyle assessment quiz. In this regard, options may be presented to the customer via the user interface that enable the customer to distinguish between their current policy and the one recommended for them. This may be based on their needs and responses, and the interface may further include a tap button to arrange contact from a staff member of the health fund provider.

[0066] The application software may also provide secure messaging and a forum for communication between the health fund provider and the customer that is more fast and efficient as compared with traditional communication methods.

[0067] Throughout this specification and claims which follow, unless the context requires otherwise, the word “comprise”, and variations such as “comprises” and “comprising”, will be understood to imply the inclusion of a stated integer or step, or group of integers or steps, but not the exclusion of any other integer or step, or group of integers or steps.

[0068] The reference to any prior art in this specification is not, and should not be taken as, an acknowledgement or any suggestion that the prior art forms part of the common general knowledge in Australia.

Claims (30)

1. The claims defining the invention are as follows:

   1. A computer-implemented method for processing service transactions, the method including: receiving, by a remote central server, transaction data transmitted from a service provider device, the transaction data relating to a service transaction and including information relating to: a user receiving a service relating to the service transaction from the service provider; an insurance fund of the user; and a monetary amount that is reflective of a charge of the service provider for providing said service; transmitting, from the remote central server to a handheld device of the user, at least part of the transaction data associated with the service transaction, wherein the handheld device includes a user interface that enables the user to view the transmitted transaction information and authorise payment of at least a portion of said monetary amount; in response to receiving a user authorisation, transmitting, from the handheld device to the remote central server, user-authorised transaction data; in response to receiving the user-authorised transaction data from the handheld device, transmitting the user-authorised transaction data from the remote central server to an insurance fund server associated with the insurance fund of the user.
2. 2. A method according to claim 1, further including: in response to receiving the user-authorised transaction data from the remote central server, the insurance fund server performs operations including: comparing the transaction information against stored identifiers associated with the user; based upon determining that the transaction information matches the stored identifiers, authenticating the user-authorised transaction data; and transmitting, to a financial institution associated with the insurance fund, instructions to process said payment of at least a portion of said monetary amount to a financial institution of the service provider.
3. 3. A method according to claim 2, wherein the transaction data further includes information relating to the service provider, and the service provided by the service provider.
4. 4. A method according to either claim 2 or claim 3, wherein the monetary amount includes a first portion that is equivalent to an insurance rebate or benefit available to the user by the insurance fund and a second portion reflective of a remaining balance after the first portion and any additional available rebate is subtracted from the monetary amount.
5. 5. A method according to claim 4, further including: determining, by the insurance fund server, that the transaction information matches the stored identifiers further includes determining that the insurance fund associated with the user includes sufficient available rebate funds or benefits to pay the first portion of the monetary amount.
6. 6. A method according to either claim 4 or claim 5, further including: transmitting, to a financial institution associated with the insurance fund, instructions to process said payment of at least a portion of said monetary amount to a financial institution of the service provider, includes transmitting, from the insurance fund server to the financial institution associated with the insurance fund, instructions to process payment reflective of the first portion of the monetary amount to the financial institution of the service provider.
7. 7. A method according to any one of claims 4 to 6, further including: transmitting the user-authorised and authenticated transaction data from the insurance fund server to the remote central server, and storing, in the remote central server or an associated database, the user-authorised and authenticated transaction data.
8. 8. A method according to any one of claims 4 to 7, further including: determining, by a computer associated with the remote central server, the second portion of the monetary amount that is payable to the service provider.
9. 9. A method according to claim 8, further including: transmitting, from the remote central server to the handheld device, the user-authorised and authenticated transaction data including the calculated second portion of the monetary amount that is payable to the service provider, and in response to receiving the user-authorised and authenticated transaction data, transmitting, from the handheld device to a financial institution associated with the user, instructions to process payment reflective of the second portion of the monetary amount to the financial institution of the service provider.
10. 10. A method according to claim 9, wherein the user interface of the handheld device enables the user to view one or more payment options for payment of the second portion of the monetary amount and to input account verification information associated with the user’s financial institution.
11. 11. A method according to any one of the preceding claims, further including: storing, by the insurance fund server, the transaction data relating to the service transaction selected for payment.
12. 12. A method according to claim 11, wherein the remote central server communicates with the insurance fund server to poll information relating to the user insurance fund, including the transaction data stored by the insurance fund server.
13. 13. A method according to claim 12, further including: transmitting, from the handheld device to the remote central server, a request for a listing of previous transactions associated with the user, and in response to receiving said request, transmitting, from the remote central server to the handheld device, a listing of previous transactions polled from the insurance fund server.
14. 14. A method according to claim 13, wherein the listing of previous transactions includes at least information relating to the service provider and a date associated with the service transaction.
15. 15. A method according to either claim 13 or claim 14, wherein the user interface of the handheld device enables the user to view the listing of previous transactions, and sort the listing by date or service provider.
16. 16. A method according to any one of the preceding claims, further including: transmitting, from the handheld device to the remote central server, a request for a insurance fund benefits summary associated with the user, and in response to receiving said request, transmitting, from the remote central server to the handheld device, a benefits summary polled from the insurance fund server, wherein the user interface of the handheld device enables the user to view the benefits summary.
17. 17. A method according to claim 16, wherein the benefits summary includes one or more progress bars which displays how much of any one insurance fund benefit has been used and how much is remaining.
18. 18. A method according to either claim 16 or claim 17, wherein when the information polled from the insurance fund server includes an update to the benefits summary associated with the user, the remote central server transmits the transaction data including the update to the handheld device, and the user interface of the handheld device enables the user to view an updated benefits summary.
19. 19. A method according to claim 18, wherein when the update indicates that an upper limit of a insurance fund benefit has been reached, the remote central server transmits the transaction data including the update to the handheld device, and the user interface of the handheld device enables the user to view the update and apply for an upgrade to an existing insurance fund policy.
20. 20. A method according to any one of claims 16 to 19, wherein the information polled from the insurance fund server includes updates or information in relation to one or more of additional insurance options offered by the insurance fund, a policy assessment tool, and general messages or reports from the insurance fund to insurance fund members, and the user interface of the handheld device enables the user to view the updates and select additional options or links associated with same.
21. 21. A method according to any one of the preceding claims, further including: transmitting, from the handheld device to the remote central server, a request for signing in as an existing user, and in response to receiving said request, transmitting, from the remote central server to the handheld device, a request for existing user credentials.
22. 22. A method according to claim 21, wherein the user interface of the handheld device enables the existing user to enter the credentials and transmit the credentials from the handheld device to the remote central server for approval.
23. 23. A method according to any one of claims 1 to 20, further including: transmitting, from the handheld device to the remote central server, a request for registering as a new user, and in response to receiving said request, transmitting, from the remote central server to the handheld device, a request for information from the new user including the user’s insurance fund and insurance fund membership number.
24. 24. A method according to claim 23, wherein the user interface of the handheld device enables the new user to enter the information and transmit the information from the handheld device to the remote central server for storing and for use in subsequent approval of user credentials.
25. 25. A method according to any one of claims 21 to 24, wherein the user interface of the handheld device enables an existing user to edit their credentials and personalise settings of the user interface.
26. 26. A method according to any one of the preceding claims, wherein the service transaction is a healthcare transaction, the service provider is a healthcare provider, the user is a patient of the healthcare provider, and the insurance fund is a health fund of the patient.
27. 27. A system for processing service transactions, the system including: a service provider device; a remote insurance fund server associated with an insurance fund of the user; a handheld device including a user interface; a financial institution server associated with the insurance fund; a financial institution server associated with the service provider; and a remote central server having instructions stored thereon, or on an associated storage means, which, when executed by the remote central server, cause the remote central server to perform operations including: receiving transaction data transmitted from the service provider computer, the transaction data relating to a service transaction and including information relating to: a user receiving a service relating to the service transaction from the service provider; an insurance fund of the user; and a monetary amount that is reflective of a charge of the service provider for providing said service; transmitting, from the remote central server to the handheld device of the user, at least part of the transaction data associated with the service transaction, wherein the user interface of the handheld device enables the user to view the transmitted transaction information and authorise payment of at least a portion of said monetary amount; receiving, from the handheld device, user-authorised transaction data; and transmitting the user-authorised transaction data to the remote insurance fund server.
28. 28. A system according to claim 27, wherein the remote insurance fund server compares the transaction information against stored identifiers associated with the user, and based on a determination that the transaction information matches the stored identifiers, authenticates the user-authorised transaction data, and transmits, to the financial institution server associated with the insurance fund, instructions to process said payment of at least a portion of said monetary amount to the financial institution server associated with the service provider.
29. 29. A computer-readable medium storing instructions for processing a healthcare transaction which are executable by a remote central server and which, upon such execution, cause the remote central server to perform operations including: receiving transaction data transmitted from a service provider device, the transaction data relating to a service transaction and including information relating to: a user receiving a service relating to the service transaction from the service provider; an insurance fund of the user; and a monetary amount that is reflective of a charge of the service provider for providing said service; transmitting to a handheld device of the user, at least part of the transaction data associated with the service transaction, wherein the user interface of the handheld device enables the user to view the transmitted transaction information and authorise payment of at least a portion of said monetary amount; receiving, from the handheld device, user-authorised transaction data; and transmitting the user-authorised transaction data to a remote insurance fund server associated with an insurance fund of the user.
30. 30. A computer-readable medium according to claim 29, wherein the remote insurance fund server compares the transaction information against stored identifiers associated with the user, and based on a determination that the transaction information matches the stored identifiers, authenticates the user-authorised transaction data, and transmits, to a financial institution server associated with the insurance fund, instructions to process said payment of at least a portion of said monetary amount to a financial institution server associated with the service provider.