Web-based claims processing method and system

摘要

A novel electronic claims coding, billing and processing method and system specially adapted for processing insurance-related claims obviates the need for prior art faxing, telephoning and mailing of insurance claim information from service providers, and for electronic systems, eliminates the need for specialized or proprietary software for service providers. Broadly, the present invention provides a method of coding, billing and processing insurance claims that at least includes: a) via a first entity (such as a service provider), electronically gathering information comprising an insurance claim; b) connecting a front end first computer under the dominion of the first entity to a back end second computer under the dominion of a claims processing entity via the World Wide Web; c) transmitting an insurance claim from the first computer to the second computer via the World Wide Web; d) via the second computer, automatically processing the insurance claims; and e) via the claims processing entity, presenting processed insurance claims information to an insurer entity subsuming the responsibilities of deciding whether to pay a claim and payment of a claim.