SYSTEM AND METHOD FOR ENABLING HEALTH CARE PROVIDERS TO EFFECT COMPENSATORY INVOICING OF PATIENTS WHO USE A COVERAGE ENTITY IN ADDITION TO THEIR HEALTH INSURER

摘要

A system and method is provided for compensatory invoicing of a patient for health care services rendered by a Health Care Provider. The system and method enables a Health Care Provider to obtain payment of Full Rates for services rendered to a patient in circumstances where a Health Insurance Entity provides less than full-rate compensation (e.g., compensation at Contracted Rates) to the Health Care Provider AND the patient has been reimbursed additionally by another payment party for claims already paid for by the Health Insurance Entity. In one implementation, the patient contracts with the Health Care Provider to ensure that the Health Care Provider is fully compensated for the services rendered after the patient receives payments from a tortfeasor and/or First and/or Third Party Payment Entity (e.g., an auto insurance carrier, worker's compensation insurance carrier, Medpay, PIP etc.) for the services. The invention tracks claim(s) filed by the patient against the tortfeasor and/or First and/or Third Party Payment Entity and tracks payments) made by the tortfeasor and/or First and/or Third Party Payment Entity to the patient. The patient and/or the First and/or Third Party Payment Entity is then billed for the difference in payments made to the Health Care Provider by the Health Insurance Entity, effecting compensatory invoicing for a Full Rate fee chargeable by the Health Care Provider in cases when a tortfeasor and/or First and/or Third Payment party has reimbursed the patient for similar services as already reimbursed by the Health Insurance Entity.