WO2019010502A1

WO2019010502A1 - Automated system and method for managing billing/invoicing and medical payments, including insurance payments and copays

Info

Publication number: WO2019010502A1
Application number: PCT/US2018/048529
Authority: WO
Inventors: John Russell; Jordan Kelley
Original assignee: Enter, Inc.
Priority date: 2017-07-07
Filing date: 2018-08-29
Publication date: 2019-01-10

Abstract

A system and method for automatically reconciling and paying healthcare insurance claims to healthcare providers via an intermediary system. The system and method involve a third-party advance payment of a claim by a healthcare provider to an insurance carrier. Once the insurance carrier pays the provider on the claim, the third- party recoups the advance payment and associated fee. The system is automated and involves communicatively connecting the third-party system to a provider's electronic medical records (EMR) and/or practice management software and provider's bank account.

Description

AUTOMATED SYSTEM AND METHOD FOR MANAGING

BILLING/INVOICING AND MEDICAL PAYMENTS, INCLUDING

INSURANCE PAYMENTS AND COPAYS

CROSS-REFERENCE

[0001] This application claims priority to U.S. Patent Application No. 15/644,671 filed July 7, 2017, and to U.S. Patent Application No. 15/979,150, filed May 14, 2018, each of which is incorporated herein for all purposes.

FIELD OF INVENTION

[0002] The embodiments of the present invention relate to a system and method for automating medical billing/invoicing and payment reconciliation.

BACKGROUND

[0003] The present systems and methods for handling medical billing/invoicing and payment reconciliations are cumbersome and inefficient. For example, currently (i) a patient receives medical services; (ii) a healthcare provider manually completes a form and uploads the same to an insurance company; (iii) the insurance company then manually makes a payment to the healthcare provider; (iv) the healthcare provider then manually reconciles the bill against the insurance company payment and determines an amount the patient still owes for the medical services; and (v) the healthcare provider then manually communicates with the patient to obtain payment of the patient portion of the medical bill. The current systems and methods are inefficient and labor-intensive.

[0004] Thus, it would be advantageous to develop a system and method for automating medical billing/invoicing and payment reconciliations between healthcare providers, insurance companies and patients. It would be further advantageous to permit ubiquitous mobile devices to facilitate portions of the methods undertaken by the system.

SUMMARY

[0005] One embodiment of the present invention is directed to a computer- implemented system comprising: memory and a hardware processor configured to: receive a data file representing medical services provided to a patient, said data file including one or more CPT codes; populate one or more insurance company claim forms using data, including said one or more CPT codes, from said data file; transmit said one or more populated insurance company claim forms to said insurance company; calculate an insurance payment amount due to a healthcare provider for said medical services, said insurance payment amount being a function of said one or more CPT codes and insurance coverage of said patient; cause monies equal to said calculated insurance payment amount to be transferred from an insurance company financial account to a healthcare provider financial account; calculate patient payment amount due to said healthcare provider, said patient payment amount being a function of said one or more CPT codes and said insurance coverage of said patient; transmit a payment request to said patient via electronic device; and cause an electronic payment received from a patient via said electronic device to be deposited into said healthcare provider financial account.

[0006] Another embodiment of the present invention is directed to a computer- implemented method comprising: receiving, via a hardware processor, a data file representing medical services provided to a patient, said data file including one or more CPT codes; populating, via said hardware processor, one or more insurance company claim forms using data, including said one or more CPT codes, from said data file; transmitting, via said hardware processor, said one or more populated insurance company claim forms to said insurance company; calculating, via said hardware processor, an insurance payment amount due to a healthcare provider for said medical services, said insurance payment amount being a function of said one or more CPT codes and insurance coverage of said patient; causing, via said hardware processor, monies equal to said calculated insurance payment amount to be transferred from an insurance company financial account to a healthcare provider financial account; calculating, via said hardware processor, a patient payment amount due to said healthcare provider, said patient payment amount being a function of said one or more CPT codes and said insurance coverage of said patient; transmitting, via said hardware processor, a payment request to said patient via electronic device; and causing, via said hardware processor, an electronic payment received from a patient via said electronic device to be deposited into said healthcare provider financial account.

[0007] In one embodiment, the provider is paid by the insurance company once the data file is uploaded to the system and evaluated by the same. Accordingly, the healthcare provider has complete control over receiving prompt insurance company payments. Similarly, if the healthcare provider uploads the data file promptly, a patient receives a payment link on a mobile device for paying the patient's portion of the medical service soon after receiving the medical service such that the healthcare provider's collection rate tends to be higher than with the "snail" mail procedures used currently.

[0008] In another embodiment, the system and method involves automatically reconciling and paying healthcare insurance claims by providers. The system and method involves a third-party advance payment of a claim by a healthcare provider to an insurance carrier. Once the insurance carrier pays the provider on the claim, the third- party recoups the advance payment and associated fee. The system is automated and involves communicatively connecting the third-party system to a provider's electronic medical records (EMR) and/or practice management software and provider's bank account.

[0009] Other variations, embodiments and features of the present invention will become evident from the following detailed description, drawings and claims.

BRIEF DESCRIPTION OF THE DRAWINGS

[0010] Fig. 1 illustrates a block diagram of a wireless network of the type that may facilitate the embodiments of the present invention;

[0011] Fig. 2 illustrates a flow chart representing a prior art system of managing medical billing/invoicing and payment reconciliation;

[0012] Fig. 3 illustrates a first flow diagram detailing an arrangement of operations according to the embodiments of the present invention;

[0013] Fig. 4 illustrates a block diagram of a system according to the embodiments of the present invention;

[0014] Fig. 5 illustrates a flow chart detailing an exemplary methodology according to the embodiments of the present invention;

[0015] Fig. 6A illustrates an exemplary screen shot of a mobile device payment message sent by the system server according to the embodiments of the present invention;

[0016] Fig. 6B illustrates an exemplary screen shot depicting a communication string between the system server and patient involving the patient needing a payment plan according to the embodiments of the present invention;

[0017] Fig. 7A illustrates a diagram detailing the conventional and inefficient procedure for insurance claims to be reconciled and paid;

[0018] Fig. 7B illustrates a diagram detailing an exemplary methodology for reconciling and paying insurance claims according to the embodiments of the present invention; [0019] Fig. 8 illustrates a diagram of the system in communication with records/systems of a healthcare provider according to the embodiments of the present invention; and

[0020] Fig. 9 illustrates a flow chart detailing an exemplary methodology for reconciling and paying insurance claims according to the embodiments of the present invention.

DETAILED DESCRIPTION

[0021] For the purposes of promoting an understanding of the principles in accordance with the embodiments of the present invention, reference will now be made to the embodiments illustrated in the drawings and specific language will be used to describe the same. It will nevertheless be understood that no limitation of the scope of the invention is thereby intended. Any alterations and further modifications of the inventive feature illustrated herein, and any additional applications of the principles of the invention as illustrated herein, which would normally occur to one skilled in the relevant art and having possession of this disclosure, are to be considered within the scope of the invention claimed.

[0022] Those skilled in the art will recognize that the embodiments of the present invention involve both hardware and software elements which portions are described below in such detail required to construct and operate a system and method for automating medical billing/invoicing and payment reconciliation according to the embodiments of the present invention.

[0023] As will be appreciated by one skilled in the art, aspects of the present invention may be embodied as a system, method or computer program product. Accordingly, aspects of the present invention may take the form of an entirely hardware embodiment, an entirely software embodiment (including firmware, resident software, micro-code, etc.), or an embodiment combining software and hardware. Furthermore, aspects of the present invention may take the form of a computer program product embodied in one or more computer readable medium(s) having computer readable program code embodied thereon.

[0024] Any combination of one or more computer readable medium(s) may be utilized. The computer readable medium may be a computer readable signal medium or a computer readable storage medium. A computer readable storage medium may be, for example, but not limited to, an electronic, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any suitable combination of the foregoing. More specific examples (a non-exhaustive list) of the computer readable storage medium would include the following: an electrical connection having one or more wires, a portable computer diskette, a hard disk, a random access memory (RAM), a read-only memory (ROM), an erasable programmable read-only memory (EPROM or Flash memory), an optical fiber, a portable compact disc read-only memory (CD-ROM), and optical storage device, a magnetic storage device, or any suitable combination of the foregoing. In the context of this document, a computer readable storage medium may be any tangible medium that can contain or store a program for use by or in connection with an instruction execution system, apparatus, or device. Cloud storage may be used as well.

[0025] A computer readable signal medium may include a propagated data signal with computer readable program code embodied thereon, for example, in baseband or as part of a carrier wave. Such a propagated signal may take any variety of forms, including, but not limited to, electromagnetic, optical, or any suitable combination thereof. A computer readable signal medium may be any computer readable medium that is not a computer readable storage medium and that can communicate, propagate, or transport a program for use by or in conjunction with an instruction execution system, apparatus, or device.

[0026] Program code embodied on a computer readable medium may be transmitted using any appropriate medium, including but not limited to wireless, wireline, optical fiber cable, RF and the like, or any suitable combination of the foregoing.

[0027] Computer program code for carrying out operations for aspects of the present invention may be written in any combination of one or more programming languages, including an object-oriented programming language such as Java, Smalltalk, C++ or the like or conventional procedural programming languages, such as the "C" programming language, AJAX, PHP, HTML, XHTML, Ruby, CSS, Python, GO or similar programming languages. The programming code may be configured in an application, an operating system, as part of a system firmware, or any suitable combination thereof. The programming code may execute entirely on the user's computer, partly on the user's computer, as a standalone software package, partly on the user's computer and partly on a remote computer or entirely on a remote computer or server as in a client/server relationship sometimes known as cloud computing. In the latter scenario, the remote computer may be connected to the user's computer through any type of network, including a local area network (LAN) or a wide area network (WAN), or the connection may be made to an external computer (for example, through the Internet using an Internet Service Provider).

[0028] Aspects of the present invention are described below with reference to flowchart illustrations and/or block diagrams of methods, apparatus (systems) and computer program products according to embodiments of the invention. It will be understood that each block of the flowchart illustrations and/or block diagrams, and combinations of blocks in the flowchart illustrations and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions/acts specified in the flowchart and/or block diagram.

[0029] These computer program instructions may also be stored in a computer readable medium that can direct a computer, other programmable data processing apparatus, or other devices to function in a particular manner, such that the instructions stored in the computer readable medium produce an article of manufacture including instructions which implement the function/act specified in the flowchart and/or block diagram.

[0030] The computer program instructions may also be loaded onto a computer, other programmable data processing apparatus, or other devices to cause a series of operational steps to be performed on the computer, other programmable apparatus or other devices to produce a computer-implemented process such that the instructions which execute on the computer or other programmable apparatus provide processes for implementing the functions/acts specified in the flowchart and/or block diagrams. As used herein, a "terminal" should be understood to be any one of a general purpose computer, as for example a personal computer or a laptop computer, a client computer configured for interaction with a server, a special purpose computer such as a server, or a smart phone, soft phone, tablet computer, personal digital assistant or any other machine adapted for executing programmable instructions in accordance with the description thereof set forth above.

[0031] Fig. 1 shows a system 100 according to the embodiments of the present invention. A central server 105 runs proprietary software 110 for facilitating the embodiments of the present invention. The central server 105 communicates with patients and providers via electronic devices 115-1 through 115-N including mobile smart phones, laptop computers and desktop computers. Depending on the embodiment, the central server 105 may communicate directly to an insurance company's FTP server 120 or link directly to an Electronic Health Record (EHR) system 125.

[0032] Fig. 2 shows a block diagram 200 representing the current system/method of billing/invoicing and reconciling payments for medical services (e.g., colonoscopy). A patient first travels to a service location (e.g., medical office) 205 and receives medical service (e.g., visit family doctor because of flu-like symptoms). Each medical service has an associated code known as a Current Procedural Terminology (CPT) code (e.g., 4123 for a colonoscopy). During the patient visit, the healthcare provider gathers the patient's personal information, CPT code and insurance information (e.g., insurance member ID). On a systematic basis (e.g., weekly), the healthcare provider's administrative staff (e.g., billing department) creates a claim 210 (via a CMS 1500 Health Insurance Claim Form or the like) using the patient's personal information, CPT code and insurance information. The claim 210 is then submitted using the form to the patient's insurance company. The claim 210 is memorialized in a designated healthcare claim form (e.g., Form 837). The completed form is then transmitted to the insurance company 215. The insurance company then adjudicates the claim, meaning the insurance company authorizes and approves the claim, and releases the money 220 from its financial institution 225 to the healthcare provider 205. Once the insurance company has transmitted the claim payment to the healthcare provider for the medical services 230, the healthcare provider's administrative staff reconciles bills/invoices and seeks patient co-payments 235, if any. Upon receiving a mailed bill, the patient 240 may submit payment 245 to the healthcare provider. The current system is fraught with inefficiencies for all parties involved.

[0033] The inefficiencies include delays with insurance company payments to healthcare providers, delays with healthcare providers billing patients, delays with mailed patient bills and delays with patient payments to healthcare providers. The system and method detailed herein eliminates or reduces such inefficiencies.

[0034] Fig. 3 shows a first flow diagram 300 detailing an arrangement of operations according to the embodiments of the present invention. A patient first travels to a service location (e.g., medical office) 305 and receives medical service (e.g., cortisone injections). During the patient visit, the healthcare provider gathers the patient's personal information, CPT code and insurance information. The healthcare provider's administrative staff then creates a claim data file 310, including services performed, to upload to the system server 320. The claim data file may be a standard claim form (e.g., CMS 1500 Health Insurance Claim Form) or similar document or file. The system server 320, via the software running thereon and using the uploaded data file, automatically generates a standard healthcare claim form (e.g., Form 837) and transmits the same to the insurance company 315. Simultaneously, the system server 320 automatically calculates the amount of coverage to be paid by the insurance company to the healthcare provider. The amount of insurance coverage is premised on the services performed and the patient's subject coverage. The system server 320 then causes the calculated amount to be transferred from the insurance company's financial account to the healthcare provider's financial account. The system server 320 also determines the patient payment or co-payment amount 325 and transmits a payment message 330 to the patient's mobile device via text or email. The payment message includes a payment link allowing the patient to pay the invoice via the mobile device. The system server 320 may receive the patient's information from the healthcare provider, insurance company server 120 and/or EHR server 125.

[0035] A system/method structure 400 according to the embodiments of the present invention is shown in Fig. 4. Once a patient receives medical services, healthcare provider personnel completes a CMS 1500 Health Insurance Claim Form and uploads the same 405 to the insurance company 415 via a system server 410 running proprietary software. A FTP link may be used to upload the CMS 1500 Health Insurance Claim Form to the insurance company 415. The system server 410 detailed herein may be integrated into the insurance company's current infrastructure or may be remote therefrom and communicate therewith via wired or wireless technology. Once the system server 410 receives the CMS 1500 Health Insurance Claim Form or necessary data in another format, the system server 410 calculates the amount owed to the healthcare provider from the insurance company. The system server 410 causes or facilitates the transfer 420 of the insurance payment from the insurance company's financial institution to the healthcare provider's financial institution 425. The system server 410 further calculates the amount owed by the patient to the healthcare provider and transmits a payment message, including payment link, to the patient via text message or email 430. The patient pays 435 using the mobile device link and the payment is received by the healthcare provider 440.

[0036] Fig. 5 shows a flowchart 500 in timeline form according to embodiments of the present invention. At 505, patient Jane Smith has a colonoscopy (CPT code 4123) at a healthcare facility. Jane Smith is a Gold Plan member of her insurance company. At 510, a healthcare provider administrator completes a CMS 1500 Health Insurance Claim Form and uploads the same to the insurance company via a system server configured to facilitate the embodiments of the present invention or else the insurance company receives the completed CMS 1500 Health Insurance Claim Form and transmits a copy to the system server. At 515, the system server then determines/calculates the amount owed by the insurance company to the healthcare provider for services rendered. The system server also automatically populates Form 837 or similar claim form. In this example, the insurance company owes the healthcare provider $750 and the patient owes the healthcare provider $250. At 520, the system server causes the $750 to be transferred from the insurance company's bank to the healthcare provider's bank. Simultaneously, at 525, the system server also transmits an invoice to Jane Smith's mobile device (or other electronic device) via text or email. The invoice is transmitted with a payment link whereby the patient may pay the invoice using the mobile device. At 530, Jane Smith makes the payment via her mobile device. At 535, the payment is deposited into the healthcare provider's bank account.

[0037] As shown in Fig. 5, the time from uploading the claim form to the healthcare provider receiving full payment can be minutes depending on the length of time the patient requires to make their payment.

[0038] Fig. 6A shows an exemplary screen shot 600 of a mobile device 605 payment message sent by the system server. The system server is also configured to automate responses to patient text messages or emails. Fig. 6B shows an exemplary screen shot 610 depicting a communication string 615 between the system server and patient involving the patient needing a payment plan.

[0039] Fig. 7A shows a diagram 700 detailing the conventional and inefficient procedure for insurance claims to paid. The conventional procedure results in claim payments within an inefficient 30 to 120+ days. Responsive to a patient being treated 705, a superbill is created 710 for the biller and an insurance claim is then submitted 715 to the insurance carrier by the biller. The biller may be part of the healthcare provider or a third party. It may then take up to 120 days for the claim to be adjudicated whereby the insurance carrier pays the biller 720. The biller then pays the healthcare provider 725 and invoices the patient for those amounts unpaid by the insurance carrier 730. Finally, the patient pays the invoice 735 which pays the provider 740. [0040] Fig. 7B shows a diagram 750 detailing an exemplary methodology for paying insurance claims according to the embodiments of the present invention. With the present system and method, claims may be paid in 24 hours. In this embodiment, the system 100 may be communicatively connected to a healthcare provider's electronic medical records (EMR) and/or practice management software 800 and healthcare provider's bank account 805 for automated procedures as shown in Fig. 8. Alternatively, healthcare providers may drag and drop or otherwise manually input claims or superbills into the system 100 via an interface or dashboard. Responsive to a patient being treated 755, a claim or superbill is automatically transmitted to the system 100 or the healthcare provider transmits the claim or superbill manually 760 to the system 100. The system 100 then completes and submits an insurance claim form (e.g., form 837) to the insurance carrier on behalf of the healthcare provider 765. The form is completed based on information entered into the system 100 by the healthcare provider. Upon acknowledgment of the claim by the insurance carrier, the system 100 pays the healthcare provider for the claim immediately 770. The system 100 accesses funds controlled by the operator of the system 100. That is, the system 100 is advancing payment to the healthcare provider. The system 100 also causes the patient to be invoiced promptly 775 which naturally hastens the payment by the patient to the healthcare provider 780. The system 100 is configured to check the status of the claim and, via the system dashboard, claim status may be presented to healthcare providers. Once the insurance carrier submits their electronic remittance (e.g., ERA form 835), the system 100 confirms the payment amount and the future date of payment from the insurance carrier to the healthcare provider 785. Once the electronic payment from the insurance carrier is deposited into the bank account of the healthcare provider, and based on reconciliation by the system 100, the system 100 causes the transmission of money from the bank account of the healthcare provider to the operator of the system 100 as repayment for the advanced claim payment made by the system 100 to the healthcare provider 790. The system 100 also collects a service fee related to the advance claim payment.

[0041] Fig. 9 shows a flow chart 800 detailing an exemplary methodology for reconciling and paying insurance claims according to the embodiments of the present invention. At 805, a claim or superbill is transmitted to the system 100. At 810, an insurance claim form is completed and submitted by the system 100 to the subject insurance carrier on behalf of the healthcare provider. At 815, it is determined if the submitted claim has been acknowledged or otherwise substantiated. If the insurance claim is acknowledged, at 820, the system 100 causes the healthcare provider to be paid for the insurance claim. At 825, it is determined if the electronic payment from the insurance carrier has been deposited into the bank account of the healthcare provider. At 830, upon reconciliation by the system 100, the system 100 causes the transmission of money from the bank account of the healthcare provider to the operator of the system 100 as repayment for the advanced claim payment made by the system 100 to the healthcare provider. The system 100 may also collect a service fee related to the advance claim payment.

[0042] Although the invention has been described in detail with reference to several embodiments, additional variations and modifications exist within the scope and spirit of the invention as described and defined in the following claims.

Claims

We claim:

1. A computer-implemented system comprising:

memory and one or more hardware processors;

a communication link with a healthcare provider' s practice management software and bank account designated for receipt of at least insurance claims;

said one or more hardware processors running executable instructions to:

receive one or more of healthcare insurance claims and superbills from said healthcare provider's management software;

submit insurance claim forms to an insurance carrier on behalf of said healthcare provider;

upon acknowledgement of said insurance claim by said insurance carrier, cause advance payment of said insurance claim to said healthcare provider by deposit of monies into said healthcare provider's bank account; and

upon payment of said insurance claim by said insurance carrier to said healthcare provider, withdraw monies from said healthcare provider's bank account commensurate with said advance payment of said insurance claim.

2. The computer-implemented system of claim 1 wherein said one or more hardware processors are further running executable instructions to: upon payment of said insurance claim by said insurance carrier to said healthcare provider, withdraw a fee in addition to said monies from said healthcare provider's bank account commensurate with said advance payment of said insurance claim.

3. The computer-implemented system of claim 1 wherein said one or more hardware processors are further running executable instructions to: check status of payment of said insurance claim by said insurance carrier to said healthcare provider.

4. A computer-implemented method comprising:

communicatively linking a healthcare provider's practice management software and bank account designated for receipt of at least insurance claims to an insurance claim payment system, said insurance claim payment system having at least memory and one or more processors running executable instructions for:

receiving one or more of healthcare insurance claims and superbills from said healthcare provider's management software;

submitting insurance claim forms to an insurance carrier on behalf of said healthcare provider;

upon acknowledgement of said insurance claim by said insurance carrier, causing advance payment of said insurance claim to said healthcare provider by deposit of monies into said healthcare provider's bank account; and

upon payment of said insurance claim by said insurance carrier to said healthcare provider, withdrawing monies from said healthcare provider's bank account commensurate with said advance payment of said insurance claim.

5. The computer-implemented method of claim 4 further comprising said one or more processors running executable instructions for: upon payment of said insurance claim by said insurance carrier to said healthcare provider, withdrawing a fee in addition to said monies from said healthcare provider's bank account commensurate with said advance payment of said insurance claim.

6. The computer-implemented method of claim 4 further comprising said one or more processors running executable instructions for: checking status of payment of said insurance claim by said insurance carrier to said healthcare provider.

7. A computer-implemented system comprising:

memory and a hardware processor configured to:

receive a data file representing medical services provided to a patient, said data file including one or more CPT codes;

populate one or more insurance company claim forms using data, including said one or more CPT codes, from said data file;

transmit said one or more populated insurance company claim forms to said insurance company;

calculate an insurance payment amount due to a healthcare provider for said medical services, said insurance payment amount being a function of said one or more CPT codes and insurance coverage of said patient;

cause monies equal to said calculated insurance payment amount to be transferred from an insurance company financial account to a healthcare provider financial account; calculate a patient payment amount due to said healthcare provider, said patient payment amount being a function of said one or more CPT codes and said insurance coverage of said patient;

transmit a payment request to said patient via electronic device; and

cause an electronic payment received from a patient via said electronic device to be deposited into said healthcare provider financial account.

8. The computer- implemented system of claim 7 wherein said patient payment request is transmitted via text or email message to said electronic device.

9. The computer- implemented system of claim 7 wherein said payment request includes a payment link configured to allow payment to be made via said electronic device.

10. The computer-implemented system of claim 7 wherein a FTP link is used to transmit said one or more populated insurance company claim forms to said insurance company.

11. A computer-implemented method comprising:

receiving, via a hardware processor, a data file representing medical services provided to a patient, said data file including one or more CPT codes;

populating, via said hardware processor, one or more insurance company claim forms using data, including said one or more CPT codes, from said data file;

transmitting, via said hardware processor, said one or more populated insurance company claim forms to said insurance company;

calculating, via said hardware processor, an insurance payment amount due to a healthcare provider for said medical services, said insurance payment amount being a function of said one or more CPT codes and insurance coverage of said patient;

causing, via said hardware processor, monies equal to said calculated insurance payment amount to be transferred from an insurance company financial account to a healthcare provider financial account;

calculating, via said hardware processor, a patient payment amount due to said healthcare provider, said patient payment amount being a function of said one or more CPT codes and said insurance coverage of said patient;

transmitting, via said hardware processor, a payment request to said patient via electronic device; and

causing, via said hardware processor, an electronic payment received from a patient via said electronic device to be deposited into said healthcare provider financial account.

12. The computer-implemented method of claim 11 further comprising requesting, via said hardware processor, a patient payment via text or email message to said electronic device.

13. The computer-implemented method of claim 11 further comprising including, via said hardware processor, a payment link along with said patient payment request made via said electronic device.

14. The computer-implemented method of claim 11 further comprising simultaneously calculating, via said hardware processor, said insurance payment amount and transmitting said payment request to said patient via said electronic device.

15. The computer-implemented method of claim 11 further comprising simultaneously transmitting, via said hardware processor, said insurance payment amount from said insurance company financial account to said healthcare provider financial account and transmitting, via said hardware processor, said payment request to said patient via said electronic device.

16. A tangible non-transitory machine readable medium storing instructions that, when executed,

cause the computing device to perform a method, the method comprising:

receiving a data file representing medical services provided to a patient, said data file including one or more CPT codes;

populating one or more insurance company claim forms using data, including said one or more CPT codes, from said data file;

transmitting said one or more populated insurance company claim forms to said insurance company;

calculating an insurance payment amount due to a healthcare provider for said medical services, said insurance payment amount being a function of said one or more CPT codes and insurance coverage of said patient;

causing monies equal to said calculated insurance payment amount to be transferred from an insurance company financial account to a healthcare provider financial account;

calculating a patient payment amount due to said healthcare provider, said patient payment amount being a function of said one or more CPT codes and said insurance coverage of said patient;

transmitting a payment request to said patient via electronic device; and causing an electronic payment received from a patient via said electronic device to be deposited into said healthcare provider financial account.

17. The computer-implemented method of claim 16 further comprising requesting a patient payment via text or email message to said electronic device.

18. The computer-implemented method of claim 16 further comprising including a payment link along with said patient payment request made via said electronic device.

19. The computer-implemented method of claim 16 further comprising simultaneously calculating said insurance payment amount and transmitting said payment request to said patient via said electronic device.

20. The computer-implemented method of claim 16 further comprising simultaneously transmitting said insurance payment amount from said insurance company financial account to said healthcare provider financial account and transmitting said payment request to said patient via said electronic device.