CA3181273A1

CA3181273A1 - Provisioning medical resources triggered by a lifecycle event

Info

Publication number: CA3181273A1
Application number: CA3181273A
Authority: CA
Inventors: Paul J. Ketchel Iii; Ryan Aipperspach; Karen Martirosyan; Ani Osborne; Mark Kaufman; Michael Bischoff; Daniel Schmidt
Original assignee: MDSave Shared Services Inc
Current assignee: MDSave Shared Services Inc
Priority date: 2020-06-26
Filing date: 2021-03-31
Publication date: 2021-12-30
Also published as: WO2021262276A1; AU2021295668A1

Abstract

Apparatus and associated methods related to determining medical services appropriate to a patient in response to a patient lifecycle event: presenting the medical services to the patient for selection; optionally scheduling the selected medical services; and automatically presenting the selected services for prepayment. The patient lifecycle event may be, for example, a doctor's order, diagnosis, condition change, payment, admission, or discharge. The services presented to the patient may be determined in response to, and as a function of, the lifecycle event. For example, the services presented may include procedures determined after the lifecycle event, in view of patient medical history. In an illustrative example, the services presented may be based on medical indication, contraindication, provider or facility availability, or patient scheduling preference, advantageously permitting more medically relevant, beneficial, convenient, or cost-effective services. Various examples may advantageously provide a discount for a service bundle provided at a particular time or facility or by an affiliated physician or medical group.

Description

PROVISIONING MEDICAL RESOURCES TRIGGERED BY
A LIFECYCLE EVENT
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] This is a PCT Application based on U.S. App!. 16/913,662 filed Jun. 26, 2020, which is a continuation-in-part of U.S. App!. 16/685,888 filed Nov. 15, 2019, which is a continuation-in-part of pending U.S. App!. 16/520,906 filed Jul. 24, 2019, which is a continuation-in-part of U.S. App!.
15/055,076 filed Feb. 26, 2016, which is a continuation-in-part of U.S. App!.
14/874,004 filed Oct. 2, 2015, which is a continuation of U.S. App!. 14/827,026 filed Aug. 14, 2015, which is a continuation-in-part of U.S. App!. 14/461,209 filed Aug. 15, 2014, now issued U.S. Patent 9,123,072 issued September 1, 2015, which claims the benefit of Provisional App!. 61/866,922 filed Aug. 16, 2013, the contents of which are all incorporated herein in their entirety by reference thereto.
BACKGROUND OF THE INVENTION

[0002] Medical services are services provided to a medical patient. Some medical services may help improve or maintain a patient's health, based on disease prevention, diagnosis, or treatment. The practice of medicine encompasses medical procedures performed for a patient, which may include both preventive care and treatment. Medical service providers include doctors, hospitals, and health insurers.
A provider may offer medical services to patients by provisioning medical resources such as, for example, laboratory, imaging, treatment, or surgical facilities, to provide the services. Some medical services may require specially trained or licensed medical professionals. For example, a medical practice providing diagnosis and treatment for joint pain may provide medical services through the work of an orthopedic specialist. In some scenarios, patient access to a specialized professional or facility may be limited by cost, or availability. Some specialized medical professionals and related facilities may be scarce.

[0003] A medical practice may also limit the medical procedures offered to patients based on the availability of specialized professionals and facilities at a given time or location as increasingly seen with the onset of the COVID-19 pandemic. For example, the services offered to a patient may be determined based on allocating surgeons to various surgical facility locations at specific times. Services supplied, to. patients may be limited to the allocated Medical professionals and facilities, even when medical servitedemand exceeds supply at a given location or time. A medical practice providing many types of medical services may expend significant resources adapting the offered services to demand as cctst and demand change. Some medical practices may fail to capture: potential revenue lost .when resources to provide medical services are underutilized relative to medical.
service demand.
00041 The price of healthcare. services varies depending on specialty, procedure; and physician practice. In the United States, many patients do not have access to. a simple way to shop and compare the price of common medical procedures. Due -to the current managed.
carebased. payor system in the US, the cc* oftteatment is often determined by managed care organizations.
10051 These managed care organizations have specific formularies .for drugs and. procedures designed specifically to patients' individual health plans, which restrict the drugs and procedures available to patients in their particular plans, Patients have historically had no access to these price lists or fOrniularies and have had very few tools to atisig thein in finding and comparing health care services or predetermining the cost of a procedure. Currently prospective patients who Chose to compare medical costs are forced to conduct extensive, often inefficient, and time-consuming research to compare medical procedures prior to treatment.
100061 The rising cost. of healthcare is having a dramatic effect on. the U.S.
healthcare system.
Healthcare costs continue to outpace pace inflationary growth, provider reimbursement rates continue -to fall, and the -cost of patient insurance premiums are. increasing: To lower monthly premium costs, many patients are Choosing to purchase (and employers are choosing to offer) high deductible health plans as an alternative totraditional higher preinitint PPO health plans.
[00071 These high deductible plans require patients to pay cash payments for medical services until the high deductible is satisfied, and once this deductible has been met, the insurance carrier begins to cover medical costs. As a result, many patients are seeing exponential increases in out-ofpocket expenses for medical procedures and services. hi addition to more patients selecting high deductible plans, many patients cannot afford increased payments and are becoming uninsured or underinsured.
As the number of patients who are uninsured, underinsured, or on high deductible plans. grows; the needfor a mechanism that allows patients to find discounted medical services increases and an efficient payment system.

SUMMARY OF THE INVENTION
100081 Herein presented is an apparatus and associated methods related to determining medical services appropriate to a patient in response to a patient lifecycle event:
presenting the medical services to the patient for selection; optionally scheduling the selected medical services; and automatically presenting the selected services for prepayment. The patient lifecycle event may be, for example, a doctor's order, diagnosis, condition change, payment. admission, or discharge.
The services presented to the patient may be determined in response to, and as a function of; the lifecycle event. For example, the services presented may include procedures deterniined after the lifecycle event, in view Of.patierit medical history. than illustrative example, the servicespre.sented may be based on medical indication, contraindication, provider or facility availability, or patient scheduling preference, advantageously permitting more medically relevant, beneficial, convenient, or cost-effective services. Various examples may advantageously provide a. discount for a .service bundle provided at a particular time or facility or by an affiliated physician or medical group:
100091 In one wiped, S process iS provided, comprising: in response to detecting a patient lifecycle event, offering medical services to the patient, tompriSing: determining.
Medical services appropriate to the -patient; presenting the .medical services to the patient for selection; scheduling the selected medical services; and, automatically presenting the selected services for prepayment.
100101 Detecting the patient lifecycle event 'may further cOMprise receiYing.an -electronic message comprising an IiHR ailectronic Health. Record):
100111 Determining medical services appropriate to the patient may further comprise determining optional medical services that are not contraindicated for the patient based.
On the lifecycle event and the patient medical history determined as a function of the EHR..
100121 Detecting the patient lifecycle event may further comprise comparing a historical patient lifecycle state with the current patient lifecycle state.
1001.31 Detecting the patient lifecycle event may further com:prisedetermining if the patient lifecycle state changed,. based on comparing the previous patient lifecycle state with the currentpatient lifeeyele = state.
100141 Detecting the patient lifecycle event may further comprise determining the. current. patient lifecycle state based on medical. evaluation of the. patient. condition.
100151 The historical patient lifecycle state may be: one. of. new patient;
well patient, acute care patient, chronic. care patient, or recovering patient.
100161 The. current patient .lifecycle state may be one of: new patient, well patient, acute care patient, chronic care patient; or recovering patient.

10011 The patient lifecycle event may be one of: doctor's order- issued, patient service scheduled, patient admitted, patient -discharged, patient diagnosed, patient diagnosis changed, patient medical condition changed, patient age threshold readied, patient life expectancy changed, patient account balance due changed,.or patient insurance changed.
1100.18] Presenting the selected services for prepayment may further comprise presenting the selected.
services to a health insurance provider.
100191 Presenting-the selected services for prepayment may further compri.Se.
presenting the selected services; to the patient.
100201 The process may .further comprise bundling the selected services for and accepting -payment.
10021.1 Scheduling the selected medical services may further comprise sending the selected medical services to a hospital to be scheduled by the hospital.
100221 The selected services may be sent to the hospital after the selected services are scheduled, .in .Pir4pmsete: a scheduling event 100231 In an aspect, an apparatus is provided, comprising: a processor; a user interface, operably coupled with the processor; and, a memory, operably coupled with the processor, wherein the memory encodes processor executable program instructions and data to program and configure the processor to cause the apparatus to peiform operations comprising: receive tut electronic message- complisina an MIR; determine the current patient lifecycle state based on the MIR; determine if a patient lifecycle event occurred, based -On comparing a historical patient lifecycle state with the current patient. lifecycle state; in response to determining a patient lifecycle. event occurred;
determine medical services to be offered to the patient, wherein the medical -services are not contraindicated for the patient based. on the lifecycle event and the patient medical history determined as a function of the ERR; present the medical services to be offered to the patientin the user interface fir selection as a function of available service location and available service time; and, automatically present the selected serVices to the patient in Itt.11.10.rketitface for prepayment.
100241 The operations performed by the apparatus may further comprise schedule the selected .medical services based on associating an available service location and an available service time with a patient selected service location and a patient-selected service time.
100251 Schedule the selected medical services may further comprise send the.
selected medical services to a hospital to be scheduled by the hospital based on associating an available service location and an available service time with a patient selected service location and a patient selected Service time.
100261 The patientlifecycle event may further comprise patient service scheduled, [0027] The patient lifecycle event may further comprise doctor's order issued.

4 100281 The medical services appropriate to the patient may further- comprise a medical service.
determined-as a function of -the-patient lifecycle event.
100291 The medical services to be offered to the patient may further comprise a medical -service bundle based on medical facility- utilization determined as a function of time.
100301 The. operations performed. by the apparatus-may further comprise sending the medical service bundle to the patient in a shopping cart format rendered in an email or textmessage.
100311 The process may further comprise offering the patient a discount for prefinyment.
100321 In an aspect, an apparatus is provided,. comprising: a processor; and,, a memory, operably coupled with. the processor, w.herein the memory encodes processor executable programa instructions and data to program and configure the processor to cause the apparatus to perform operations comprising: receive an electronic message comprising an EHR; determine the current patient lifecycle state based on the ERR; determine if a patient lifecycle event occurred, based on comparing a historical patient lifecycle state with the current, patient lifecycle state; in response to determining a patient lifecycle event occurred: determine medical services, to be offered to the patient, wherein the medical services are not contraindicated for the patient based on the lifecycle event and the patient medical history determined as a function of the EHR, Wherein the medical services to be offered to the patient are determined as a fuuction of the patient lifecycle event, and wherein the medical services te.) be offered to the patient further comprise, a medical service bundle based on medical facility utilization determined as a function of fime; present the medkal serviceSta.be Offered to thepatient In a shopping cart format rendered. in an email or text message to the patient for selection as a function of available service location and available service time; schedule the medical services selected by the patient based orrassociating an available service location and an available service time with a patient selected service location and a patient selected service time; and, automatically: present the scheduled services to the patient With a discount offered for prepayment before a predetermined date.
100331 The patient lifecycle event may be patient service scheduled, and the medical service .bundle may further comprise a follow-up medical service medically indicated by-the patient service- scheduled.
100341 The histories] patient lifecycle state maybe new patient, and the current patientlifreycle state may be well patient.
100351 The historical patient lifecycle state may be new patient, and the current patient lifecycle state may be chronic care patient.
100361 The historical patient lifecycle state may be acute care patient, and the current patient li&eyele state may be recovering patient.

[00371 Thc patient lifecycle event may be one of: doctor's order- issued, patient service scheduled, patient admitted, patient -discharged, patient diagnosed, patient diagnosis changed, patient medical condition changed, patient age threshold readied, patient life expectancy changed, patient account balance due changed, or patient insurance changed.
[00381 Schedule the medical services may further comprise send the selected medical services to. a hospital to be scheduled by-the hospital.
100391 Various embodiments may achieve one or more advantages. For example, le some embodiments, medical practice profit may be improved. Such improved medical practice profit may be a. result. of reduced cost based on improved utilization of -medical practice resources that may be otherwise spent sending bills, collecting payment, handling payment in-person, and the like. Various implementations may reduce the effort required by a medical practice to offer medically relevant or beneficial services to a patient. This facilitation may be -a result of a patient lifecycle event triggering an offer for services Mated to the patient lifecycle event. For example, a patient lifecycle event or status change such as a doctor'.s order, patient registration, for a primary service, diagnosis, or Change in medical condition may automatically trigger other service offers medically indicated or beneficial with the primary service or change in lifecycle status. Some. embodiments may improve the cost effectiveness of medical service offerings. Such intim oved medical service cost effectiveness may be a result of improved resource utilization based on offering additional. medical services optionally available within the Same service window as a primary Service. For example, a, printery service ordered by a doctoror scheduled by a patient May trigger an offer of optional services that are within the same or simile .fileility or time slot service window as the primary service. In an illustrative, example, such an offer of optional services may enable a medical service provider to reduce cost and offer a discount to patients, as a result of improved resource utilization. Some examples may increase the quantity of medical -services performed by A medical. praCtice. This facilitation inay be a. result of increasing the chance of a patient scheduling an additional Or optional procedure selected from offered procedures determined in rosponse to a patient li&cycle event that has already occurred.
For example; a medical practice may be able to offer more medically -relevant -orbenericial services, or offermore costeffective service schedules, from. the temporal perspective after a patient lifecycle event has occurred, in view Of the patient's. medical history. In addition, after a patient lifecycle event, there may be -enhanced patient motivation to Schedule additional procedures- or respond to a discount offer, intprOving the chances for the. medical practice to provide additional services to the patient.
100401 Some embodiments may improve a patient's ease of access to medical services. This facilitation may be a result of reducing the patient's effort selecting, scheduling, and paying for medical .services.. Some examples may improve a patient's medical care experience.
Such improved patient medical care experience maybe a resUltof a medical practice offering a patient -a bundle of multiple services that could be performed in fewer visits, thereby reducing the numberof times a patient has to revisit a medical service facility: Some embodiments may improve, a patient's benefit from medical services. This facilitation may be a result of a medical. service provider offering the patient more medically beneficial services- tailored to the patient's condition or status in the patient lifecycle. in some embodiments, a patient's cost for medical services may be reduced. Such reduced Medical service ocist:
to a patient may be a result of a medical practice passing on to the patient.
medical practice cost savings based on improved medical practice resource= utilization .frorn optional services available within the same service window as a primary service. In some designs, a patient's cost for medical services may he reduced as a result of a medical practice providing a prepayment discount to the patient.
100311 Various implementations may construct a proposed medical service bundle for a patient in response to detecting a. patient lifecycle event has occurred. A. patient lifecycle event may be, for example, patient registration for a service, or; arty patient lifecycle event, including; but not limited to, a doctor's order, scheduling, administrative updates to patient records, patient admission, patient discharge, overdue payment, change in payment account balance due, and the like. The medical service bundle proposed. to the patient may include, fot example, the services dial weje actually provided or scheduled, or any additional or related services the patient Might be interested in.
100421 An exemplary implementation may, for example, receive electronic notification from an EHR
or other source,, determine the appropriate procedure(S) to offer to the patient, based on the data or codes in that electronic notification, create a shopping cart including a proposed medical semicebundle for the patient, and optionally email or text-the shopping cart to-the patient. The shopping cart may also be. saved in a portal. (for example, an exemplary .rvIDsave Direct portal implementation). In: an illustrative example, a 'provider using the portal where. the shopping cart was saved may --directly look up the shopping cart or service bundle to aid completing. the purehase, either in person, online (t7or example by live chat), or on the phone with the. patient.
100431 Some exampledesigns may include offered optional services that are chosen based on future procedures indicated for the patient, medical contraindication, provider or facility availability, or patient scheduling preference. Some embodiments may offer a discount for scheduling a particular bundle ("cart") of services at a particular date, time, or facility, or with a particular provider or doctor.
In an illustrative example, some implementations may permit a patient to select from the offered services and prepay for the selected services. In an example illustrative of various implementations' usage, in addition to minimizing the number of times = a patient has to revisit the facility, a medical practice may reduce resources spent on sending bills, collecting payment, dealing with payment in-person , -and the like.
100441 In an example illustrative of technical effect that may result from various implementations' usage, the trigger condition to construct a service offer using the time value of the temporal perspective after a patient lifecycle event. may improve, medical care. and reduce cost.
for example, a medical service- bundle determined after a patient lifecycle event may be more closely customized to the patient's medical Condition and medical history in view of the lifecycle event. Such a perspective yid*
triggered in response to a patient lifeeyele event may permit offering, more medically relevant additional procedures, may increase the. chance a patient may select an additional procedure, and may improve medical practice resource utilization, in contrast with offering the patient optional services before a patient lifecycle event (Such as before the patient is registered for. a procedure, or commits to a procedure schedule). In an illustrative example, a patient that has already scheduled a primary procedure on a given day may have already arranged their personal or professional .schedule to accommodate the primary procedure. Such a patient may be more likely to:
schedule an additional procedure at the same facility on the same day in response to a discount offer iftheadditional procedure Is not. medically contraindicated by the primary procedure.
100.451 hi some examples, a service may be scheduled by a hospital. For example, an embodinieut process or apparatus may determine a service, bundle, present the service bundle to a patient for selection of services the patient may be interested in, and then leave scheduling to a hospital. The services selected by the patient may be sent to a hospital. for scheduling by the hospital. Some designs may send out a shopping cart of services after scheduling, takes place, in response to the scheduling event; that is, using the scheduling event as a trigger to send out the shopping tart of services.
100461 Various implementations may create a shopping cart inresponse to a trigger condition to offer services. The trigger -condition to offer services may be a patient lifteyde event (for example, patient registration for a procedure, change in patient condition, diagnosis, doctor's order, admission, discharge, and the like). For example, patient registration for a primary service. may trigger other service offers that are-within the same service window- (for example, time slot and/or facility) of the primary service, permitting a medical practice to enhance utilization of facility services and resources, -.reducing the number-of times A patient may have to revisit the facility, and providing it Coat saving WI
the patient through prepayment.
100471 Exemplary embodiments of the present invention relate to the marketing and facilitating the sale of services and products. More specifically, exemplary embodiments relate to methods and apparatuses for providing a web-based mechanism allowing prospective patients to search for and compare healthcare services and products offered by local providers, including bundled sets of services, and facilitating prepaid purchases of such healthcare services and products by prospective patients at discounted rates.
100481 Exemplary embodiments of the present invention are related to an apparatus for facilitating purchases of services offered by service providers.. The apparatus includes an, application server providing a network service that is accessible to aplurality of users-through a plurality of client systems communicatively coupled to the .application server via a network and a. data storage system storing a.
service, offer database that is maintained by the application server.
100491 The service offer database comprises a plurality of service offer information records respectively associated with a plurality of service offers. The plurality of service offers includes at least one service .offer for a bundled set. of services. Each service offer information record comprises an indication of a primary service of the associated service offer, a purchase price tbr the associated service offer, a payment amount for the primary service, and compensation information for the primary service.
'Upon. receiving purchase information. for the user for purchasing the selected service offer iliD/11 the client system, the network service is operable to issue. a request to the funding source for funds corresponding to the purchase price included in the service offer information record associated with the selected service offer to pi mess- a purchase of the selected SUI vice offer by the user.
100501 In exemplary embodiments, each service offer for a bundled set of services comprises a bundled set of healthcare services provided by corresponding healthcare service providers.
10051] In exemplary embodiments, at least one service offer information record associated with a set-vice offer for a 'bundled set of services further comprises an indication of a facility for performing the primary. service, a facility fee for the facility, and compensation information for the facility fee.:
100521 In exemplary embodiments, at least one service offer information record associated with a service offer for a bundled set of set-vices further comprises an indication that at least one of the secondary services associated with the primary service is an optional seeondaty service.
100531 In exemplary embodiments, the data storage system stores a profile database that is maintained by the application server. The profile database comprises a respective account information record. for each of a. plurality of user accounts registered with the application server: The plurality of user accounts includes n plurality of customer accounts and a plurality of provider accounts. The.
account information record -for each user account comprising information for authorizing a user accessing the network service from one of the client systems to access the network service, in assOeiation with the user account.
100541 In exemplary embodiments, the plurality of provider accounts includes a plurality of physician accounts and a plurality of practice group accounts, the 'account information record for each practice group account comprises an indication of one or more of the physician accounts being affiliated with the practice group account 100551 In exemplary embodiments, the data storage system stores a transaction information database that is maintained by the application server. The transaction information database comprises a respective purchase information record for each processed purchase, by a user accessing the network -service from one of the client systems in association with a customer account, of a service offer that has been created by a user accessing the network service from one of the client systems in association with a provider account, the respective purchase- information record for each processed purchase comprising an indication &the service offer information recordassociated with the purchased service offer and, for each of the primary service and any secondary service .of the service offer, and an indication of whether the purchase has been redeemed with respect to the service.
100561 In exemplary embodiments, the network service, upon being accessed by a user of one Of the client systems to process a purchase of a service offer, generates a voucher for the user that specifies a unique confirmation number for the purchase and the corresponding service provider for each of the primary service: and any secondary service of the purchased service offer, and, for each of the primary service and any secondary service of the purchased service offer, sets the purchase information record for the processed purchase to indicate that the purchase has not been redeemed with respect to the service.
100571 Exemplary embodiments of the present invention that are related to computer-implemented processes and computer systems corresponding to the above-summarized exemplary embodiments directed to an apparatus are also described and claimed herein.
00581 The above-described and other features and advantages realized through the techniques of the present disclosure will be better .appreciated and understood with reference to the following detailed description, drawings, and appended claims. Additional features and advantages are realized through the techniques of the present invention. Other embodiments and aspects of the invention are descii bed in detail herein and are considered. a part of the claimed invention.

BRIEF DESCRIPTION OF THE DRAWINGS
100591 The subject matter that is regarded as the invention is particularly pointed out and distinctly claimed in the claims at the conclusion of the Specification. The foregoing and other objects, features, and advantages of the invention are apparent from the following detailed description. of exemplary embodiments of the present invention taken in conjunction with the accompanying drawings in which:
100601 FIG. 1 is a Schematic diagram illustrating an example network architecture for a healthcare marketplace system that can be configured to implement exemplary embodiments of the present invention.
100611 FIG. 2 is a block diagram illustrating a server systeni in accordance with an exemplary embodiment of the present invention.
100621 FIGS. 5A-3D are. a number of screen shots illustrating examples of a graphical user interfaces that may be implemented by services provided within *customer portal in accordance with exemplary embodiments of' the present invention, [00631 FIG. 4A is an illustration of an example voucher that may be generated within a user interface by functions provided within a customer portal for a purchased service in accordance with. exemplary.
embodiments of the present invention.
100641 FIG. 4B is an illustration of an example Voucher that may be generated within, a user interface by functions provided Within a customer portal for a purchased service that is offered as g bundled set of services in accordance with exemplary embodiments of the present invention.
100651 FIG. 5 is a block diagram of an exemplary computer system -that can hc UscdfOr implementing exemplary .embodiment S of the present invention.
100661 FIG. 6 is a schematic diagram illustrating a second example network arehitecture for a healthcare- marketplace. system that can be configured. to implement exemplary embodiments of the present invention; and [00671 FIGS. -7A-7C are a number of screen shots illustrating examples of a graphical user interfaces that maybe implemented by services. provided, within a. provider portal in accordance with exemplary embodimentsof the preSent invention11 100681 FIG, 8: illustrates a flow chart of an insurance policy stored in the insurance database executed by the application server in accordance with exemplary embodiments of the present invention.
100691 FIG. 9 illustrates -a block diagram of a virtual payment system manager communicating with client system in. a healthcare marketplace system.
100701 FIG. 10 illustrates a block diagram of the application server showing deductible checker, shopping cart, and drug discounted card :in accordance with another embodiment of the present nvernion .
1007.11 FIG. 1.1 is a process flow illustrative of an example aspect of patient lifecycle event triggered shopping cart provisioning design.
100721 PIG. 1.2 is a. process flow illustrative aim example aspect cif patient lifecytte event triggered shopping cart provisioning design.
100731 FIG. 1..3 is a process flow illustrative of an example aspect of patient lifecycle event triggered shopping cart provisioning design.
100741 FIG. 14 is a process flow illustrative of an example aspect of patient lifeeyele event triggered shopping cart provisioning design:
100751 The detailed description explains exemplary embodiments of the present invention, together with advantages and Features, by way -of example with reference -to the drawings, in which similar numbers refer to shriller parts throughout the drawings. The flow diagrams depicted herein are just examples. There may be many variations- to these diagrams or the steps. (or operations) described therein-without departing from the spirit of the invention.. For instance, the steps may be performed in a differing order, or steps may be added, deleted, or modified. All of these variations are considered to be within the scope of the claimed invention 100761 Like reference symbols in the various drawings indicate like elements.
DETAILED DESCRIPTION
100771 While the specification concludes with claims defining the features of the invention that are regarded as novel, it is believed that the invention will be better understood from a consideration :ofthe description of exemplary embodiments in conjunction with drawings. It is of -course to be understood that the embodiments described herein are merely exemplary :of the invention, which can be embodied in various forms. Therefore, specific structural and functional details disclosed in relation to the.
exemplary embodiments described herein are not to be interpreted as limiting, but -merely as a representative basis for teaching one skilled in the art to variously employ the present invention in virtually any appropriate form, and it will be apparent to those skilled in the art that the present invention may be practiced without. these specific details. Further, the terms and -phrases, used herein are not intended to be limiting but rather to provide an -understandable description of the invention.
100781 Exemplary embodiments oft transactional marketplace system in accordance with the present invention will now be described with reference to the drawings. Exemplary embodiments of the present.
invetitien may be implemented to provide healthcare service providers and pharmacies with a.
mechanism to remotely offer healthcare services and prodUcts to prospective patients at discounted rates in exchange. for prepayment. of the costs for the services and products via a- network-based.
application (for example, a web-based application).
100791 In this regard, exemplary embodiments may 'further be implemented to provide prospective patients with a mechanism to remotely search, compare, and make pre-paid purchases of such healthcare services and products offered by local medical service providers and pharmacies via a network-connected device configured to access the network-based application,.
Exemplary embodiments may be. further implemented to provide healthcare service providers with the ability to remotely offetabundled set of healthcare services that are petforrned separately by -multi pie providers to prospective patients through such a network-based Mechanism in which the patient is provided the opportunity to make a prepaid purchase of such a bundled set of services.in a Single transaction via the network-connected device., whereby the network-based application facilitates a disbursed distribution of the payment among the multiple healthcare service providers that perform servicesineluded in the.
bundled set of services.
MUM] Rxemplaty embodiments may also be further implemented to provide a virtual payment system for facilitating and accounting for the exchange of payment for services and products purchased.
by (or otherwise on behalf of) patients and -offered by healthcare providers via the transactional marketplace system in which a respective virtual money account is established and utilized far each participant in transactions conducted within the marketplace system to manage and track the process Of exchanging 'actual currency and/or credits used to pay for the transactions through the use of corresponding virtual .funds created within the virtual payment system.

100811 In such exemplary embodiments, the virtual funds may be allocated and distributed to, exchanged among, and redeemed for -corresponding amounts of actual currency by various participants to etteli transaction for which payment is facilitated through the virtual payment system, and the participants to transactions within the virtual payment system for which respective virtual money accounts are established. and utilized may include, in. addition to patients, healthcare providers, or other -entities specified for receiving payments for .services or products offered through the marketplace system, third patty payers, and an entity that provides the transactional marketplace system.
100821 Exemplary embodiments may be further implemented. to provide various types of healthcare service providers, which may include individual physicians, practice groups, and hospital systems, with the ability to establish affiliations with one another -through such a network-based mechanism and provide various . options allowmg the -service providers to remotely offer healthcare services in association with these affiliations.
100831 Ti should further be noted that vatious aspects of exemplaiy embodiments Of the piesent invention described herein are not. limited to healthcare services (also referred to herein as procedures) and products but; rather,.rnay be implemented with respect to any suitable classes and types of services and products. that may be offered by any suitable classes and types of service providers and retailers.
[0084] Referring now to FIG. 1, a schematic diagram illustrating an example network architecture for a healthcare marketplace system MO that can be configured to implement exemplary embodiments of the present invention is provided. It should of course be understood that FIG: 1. is intended-as an example, not as an architectural limitation, for different embodiments of the present invention, and therefore, the particular-elements depicted in FIG.. 1 should riot' be considered limiting with regard to the environments withinwhich exemplary embodiments of the present invention may be implemented.
100851 In the examrth, illotrated in FIG. 1, healthcare marketplace system 100 is implemented as a client/server system that includes a central server system 110 that is commonly accessed by each user of the system through operation of any of a plurality of client systems 140 that are operatively coupled to the central server system via a communication network .150. Central server system 110 further includes a database server 112 that is coupled to .a data store 114 and an application server 116, and.
each client system 140 is a user terrninal or other client device implementing software for and running a respective Client application 142 for accessing services provided via a network-based application (also referred to herein as. a network service) implemented-by application server 116.

100861 As further illustrated, exemplary marketplace system 100 may also include at least one third-party server system 1.60 to enable Other functionality that may be accessed and utilized by server system na to provide and/or enhance the network service discussed herein. In exemplary embodiments, marketplace system 100 can include additional servers, clients, and other devices not shown in FIG... 1., The parti cular architecture depicted in FIQ.. I is provided, as an example.
for illustrative purposes and, in exemplary embodiments, any number of client systems 140 may be connected to server system 110 at any given time via network 150, and server system 110 can comprise multiple server components and databases located. within a single server system or within multiple server systems, -where the mut tiple server systems are integrated with or accessible by users of client systems 140 as a distributed.
s.erver.system via network 130..
1.00871 in exemplary embodiments, network 1.50 can be configured to facilitate. communications between server system 110 and client systems 140, as well as communications with and between other devices and computers connected together Within marketplace 'system .100, by any suitable wired (including optical fiber), wireless technology, or any suitable combination thereof, including, but not limited to, personal area networks (PANS), local area networks (LANs), wireless networks, wide-area networks (WAN), the Internet (a network of heterogeneous networks using the Internet Protocol, IP), and virtual private networks, and the network. may -also utilize' any suitable hardware, software, and firmware technology to connect devices such -as, for example, optical fiber, Ethernet, ISDN (Integrated Services Digital Network), T-1 or T-3 link, FLO' (Fiber Distributed Data Network),. -cable or wireless LlvIDS.network Wireless LAN, 'Wireless PAN' (for example,.1tbA, Bluetooth, Wireless LISB, Z-Wave and ZigBee), HontePNA, Power line communication, or telephone line network.
Such a network.
connection can include intrariets, extranets, and the Internet, may contain any Dumber of network infrastructure elements including routers, switches, gateways, etc., can comprise a Circuit switched network, such. as the Public Service Telephone Network (PSTN), a packet switched network, Such as.
the -global Internet, a private WAN or LAN, a telecommunications -network, a broadcast-network, or a point-to-point network., and may utilize a variety of -networking. protocols now available or later developed including, but not limited to the Transmission Control Protocol/Internet Protocol (TCP/IP) suite of protocols for communication.
100881 In exemplary embodiments, application server 116, database server 112., and any other servers employed within server system 110 and third-party servers utilized Within marketplace system I00 can be implemented within any suitable Computing system. or systems such as a workstation computer, a mainframe eoniptiter, a. server system (for example, SUN ULTRA workstations running the SUN

operating system, IBM RS/6000 workstations and servers running the AIX
operating system, or an IBM e.Seriee eServer running -710S, NM,. or LINUX OS), a server cluster, a distributed computing.
system, a cloud based computing system, or the like, as well as any of the various types ofecimpating systems and devices described below with reference to the client systems 140..
Server system 110 may be implemented using any of a variety of architectures.. For example, application server 116 and.
database server 112 may also be implemented independently or as a single, integrated device. While the exemplary embodiment illustrated in FIG. 1 depicts application server 116 and database server' .112 as individual components, the applications provided by these servers, or various combinations of these applications, may actually .b.e server applications running on separatephysicaLdevices. In this. regard, server- system 110 may comprise, a number of computers connected together via a network and, therefore, may exist as-multiple separate logical and/or physical units, and/or as multiple servers acting in concert or independently, wherein each server may be comprised of multiple separate logical and/or physical units. In exemplary embodiments, server system 110 can be connected.tonetwork150 through a collection of suitable security appliances; which. may be implemented in hardware, software; or a combination of hardware and software.
100891 As illustrated in FIG. 1, application server 116:is communicatively coupled to database server 112. Database server 112 is connected to data store 114, which comprises a plurality of databases that are maintained by database server 112, accessed by application. server 116 via database services.
provided at a front end by database server 112, and store information on a variety of matters that is utilized in providing the services offered via the network service provided bythe application server, as described below in greater detail.
100901 The machine learning algorithm 15 instructs the service offer database.
114h to store each healthcare service provider service corresponding to the user selection and displays the bundled set of service, offers via thegraphical user interface/provider portal 130 that matches the users selection, 100911 Any machine-learning algorithm 1.5 can be employed, such as neural networks, expert systems, Bayesian. belief networks, fuzzy- logic, data fusion engines and the like. The system may also employ combinations of various artificial intelligence techniques to the service offer database 114h.
1009.21 The. machine learning algorithm IS takes into account of each and every parameter of user inputs such. as type of disease, location, expertise, procedures, hospitals, pricing etc. Thus, the machine learning algorithm 15 displays the best restilts/hits based on the inputs and preferences of the user.

100931 As used herein, the term "data store," "data storage unit," storage device", and the like can to any suitable memory device-that may be used for storing: data including manual tiles, machine-readable files, and databases. In exemplary embodiments, application server 116, database server 112, and data store 114 may have implemented together a single computing device, implemented within a plurality of computing devices locally coupled. to each other via a suitable communication medium, such. -as a serial port cable, telephone line or wireless frequency transceiver;
implemented within a plurality of computing -devices remotely coupled to each otlier via hetvVoi-k- 150, or any suitable combination thereof.
100941 C116P1 Systems 140 are doinputer devices to which one or more users, which May be healthcare providers offering services or products or patients seeking to purchase heal thcare'servicesor products, or their human agents (for example personal representatives or assistants)õ
have, access, It should be noted that: the term "user" is used herein to refer to one who uses a computer system, such as one of client systems 140. As described in greater detail belOw., client systems 140 are each operable by such users to access server system 110 via network 150 and act as clients to access services offered by the network service provided by the server system within exemplary marketplace system 100. For this purpose, each client system includes a respective client application 142 that executes on the client system and allows a user to interact with server system 110 via application server 116.
100951 In exemplary embodiments, the computer systems of client systems 140 can be any of a wide range of Suitable coinputing devieeS such as one Or more workstations, desktop computers, laptops, or other personal computers (PCs) (for example, 'IBM or compatible PC
workstations running the MICROSOFT 'WINDOWS operating, system or LIMA OS, MACINTOSH computers running the MAC OSX operating system, or equivalent). non-traditional-computer digital devices such as Personal Digital Assistants (PDAs) and other handheld 'or portable electronic devices, smart phones and: other mobile: handsets, tablet computers, neibook computers, game consoles, home theater PCs, desktop replacement computers, and the like, or any other suitable information processing devices. An exemplary computer system for client systems 140 is described in greater detail below with reference to Fla. 5..
100961 hi general, during operation of exemplary marketplace system 100, a client system 140 -first establigheg connection to server system 1.10 via network 150. Once the connection has been established, the connected client system may directly or indirectly transmit data to and access content from the application server 116. A user accessing application server 116 through the connected client system can thereby to use a client application 142 to access services provided by the application server, which are described in greater detail below, via a User interface implemented by th.e client application within which the Client application renders the information served by the application server.
100971 In exemplary embodiments, application server 116 can implement network service as a non-web client application (kith as a mobile application); a Web client 'application, or 'both to provide the services accessed by client systems 140 within server system 110, and client applications 142 can correspondingly be implemented as non--web client applications, web client applications, or both for operation by users of the client systems to interact with application server 116 and access the services provided thereby. For example; application server 116 can comprise a web server configured to provide.
a web application for the respective client applications implemented on client Systeins 140 thatare configured to provide web-based user Interfaces for utilizing the services provided by the web server.
For instance; the user interfaces of client applications implemented on client 'systems 140 can be configured. to provide 'various- options corresponding to the functionality offered. in exemplary atelididitheirts described herein through suitable user interface controls (for example, by way Of menu selection, point-and-click, dialog box, or keyboard command). In one gtheral example, the user interfaces may provide "send" or "submit" buttons that allow users of client applications to transmit requested information to application server 116. The user interfaces can be implemented, for example, as a graphical user interface (GM) that renders a common display structure to represent the network service, provided by application server 116 for a user of a client platfonn_ 100981 More specifically, in such an.example, application server 116 can, for example, be configured to provide services.via a web-based software application hosting a corresponding website that includes a number of web pages (e.g., screens), and client applications 142 can comprise a web browser executing on client systems 140, such that the services provided- by application server 116. are accessible to Client systems 114 using the lriternet or an intranet. Users of client systems 140 may thereby access the website provided by application server 116 by, for example, inputting or following .a link to the uniform resource locator (LAW for the website in the web browser, which then enable users to display and interact with information, media, and other content embedded within the web pages of the website provided by application server 116. The web-based software application can transmit information that can be processed by the web browsers to render a user interface using, for .example, a browser-supported programming languages such as JavaSeript, ltrlML, tr.rmi,5, and CSS, or the like, and can communicate with theweb browsers using, for example, liTTPS, POST
and/or GET requests.
Client applications 142 and application server 1.16 may be configured so that information transmitted between client systems .140 and server system 110 can be encrypted and sent over a secure network connection to protect, for example, patient privacy.
100991 Referring now to FIG. 2, a block diagram illustrating an exemplary embodiment of server system. 110 is provided. AS illustrated in. FIG. 2, application sexver 116 is implemented to provide a plurality of services via a customer portal 120 and a plurality of .services via a provider portal 130, As described herein, application server 116 can be implemented to provide a.
respective set services for each of various types of users (for example, unregistered guests; customers, individual. phySicians, nurses, office staff, practice grout.) administrators,: hospital systern administrators, pharmacy administrators, and the like), and write of the services offered by application server 116 can be commonly applicable to and accessible by all types of users, While other services can be applioable to and accessible only by specific. types Of users.
[0100] For purposes of descriptiony, the terms. "providers and "previder users" are used herein to reef to the general Class of users that register with the system offer healtheale services or products for -purchase by customer users registered with the system, which can include individual physician users, practice group administrators, hospital system administrators, pharmacy administrators, and the like.
In addition, a user account for a particular provider can have any number of authorized users, As an example, an account established for a physician can have the physician as one of its users. It can. also have nurses or office staff working for the physician as other authorized.
users. The other authorized users can log into the account and perform various. actions with the permission and under the supervision of the physician.
101011 .A single hospital system account May be established and -shared by multiple staff inember's higlittiTMEtn. For purpose of illustration., there can be a designated user (for example', an account administrator) who is responsible for managing the account, The administrator can be provided with greater access rights within server system 110 with respect to the account. tn exemplary embodiments, the particular client applications 142 or the particular client systems 140 that are utilized for accessing application server 116 can be respective to and customized. for each type of user account. For example, the particular-client application thatis utilized for each type of account can be implemented to a provide virtual computing platform that is specific to the services offered for that type of account.
101021 As further illustrated in. exemplary embodiment of FIG. 2, and as will also be described hi greater detail below, data store 114 comprises a plurality of databases that ate maintained and accessible by application server 11.6 via database server 112, including a customer profile database 114a, a physician profile database 11413, a practice group profile database 114c, a hospital system profile database 114d, a pharmacy profile database 114e, a .condition information database 114f, an available services database 114g, a service offer database 114h, an available products dittabasz 1141,e product offer database 114j, a transaction information database 114k, and one or more additional databases 1141 that may be. used for 'storing any other suitable information that may be utilized by server system 110 (for example, -system usage data, audit trail data, data used internally within, the system by appl cati on sewer 116 and the 101031 The customer -profile database 11.4a is configured to register users thereby providing user's personal information for purchasing healthcare services. The physician profile. database 114b is configured to register and maintain records of individual physician offering healthcare Services. The condition information database 1141 is configured to register and maintain information records for Various health conditions and diseases for which corresponding healthcare services arc offered.
101041 Physician profile database 114b is used to maintain account i TlibiThati on records Ibr individual physician users that register with server system 110 to offer healthcare services for purchase by ti,T(iTs registered with the system, as well As account information records for individual physicians that arc registered with the system in association with a practice group or hospital :system (as described in greater detail below). For each physician for which an account is registered With server system 110, various items of informatien relevant to the physician, Such as name, practice 'specialty, office location(s) and hours, a profile picture, contact information, biographical inforinaticin (Such as awards, honors, publications, patient testimonials, and other information that can be helpful for marketing the physician to customers accessing The system),111RLs or references to websites and social media profiles:, group- practice and hospital affiliation(s), outside facilities that are used for particular procedures performed by the physician (for example, particular hospitals or clinics), compensation information (indicating a financial account for receiving payment for.purehases-Of services offered by the physician via the system), and any other suitable identifying information, as well as a unique user name and password associated. with the account that can be used to log into the account, may be included in the respective account information record for the physician that is maintained within physician profile database 114b. The account information record for each physician can also be:
associated with an. account status and a unique physician account identifier within physician profile database 114b that is used by application server 116 for performing various operations.
101.051 practice group profile database 114e is used to maintain account information, records for practice group administrator users that register with server system 110 to offer healthcare services provided by physicians affiliated, with a practice group for purchase by customer users registered with the system. For each practice-group for which-an account is registered with server system 110, various items of information relevant to the practice, such as practice group name, location and hours, -contact information, I.J.Rts or references to websites and social media profiles for the practice group, physician and. hospital affiliation(s); outside facilities that: are used for particular procedures performed! by physicians affiliated with thepractice group, compensation information (indicating a financial account for receiving payment for purchases of seiviees offered by affiliated physicians via -the systeM), and any other suitableidentifying.information, as well as a unique user name and password associated with the account that can be used by the practice group administrator to. log into the account, maybe inetuded in the respective account information record for the practice group that is maintained within practice group profile database 114c. The account information record for each practice group can also be associated with an account status and a unique practice. group account identifier within practice group profile database 114c that may be used by physician users. registered with the system for affiliating with the practice group and used by application server 116 for performing various operations.
101061 The hospital system .profile database 114d is configured to register and maintain account information records for hospital system administrators -providing pre-paid healthcare services. Hospital system profile database 114d is used to maintain account information records for hospital system administrator users that .register with server system 11.0 to make on-site, in-person sales of pre-paid healthcare services provided by physicians affiliated -with a hospital system for purchase by patients operating:client systems within marketplace system 100: For each hospital systemfor which an -account is registered with serversystern 1.10, various items of information relevant tO the hospital system, Such as practice group and physician affiliation(s), facilities that are used for particular procedures performed by physicians affiliated with the hospital -system, compensation information (indicating a -c. ............. .
briaricuti aecount for receiving payment for purchases. of services offered by affiliated physicians via the system), and any other suitable identifying infoffnation,as well as a unique user name and password associated with the account. that can be used by the hospital system administrator to log into-the account, may be included in the respective account-information record for the hospital system that is maintained within hospital system profile database 114d. The respective account information record for the hospital system may further include a plurality of unique user names and passwords associated with the account that can be respectively used by hospital' system staff members to log into the account The account information record for each hospital system can also be associated with an account status and a unique hospital system account identifier within hospital system profile database 114d that may be used by physician users registered with the system for affiliating with the hospital system and used by application server 116 for performingvarious operations.
101.071 :Phamiacy profile database 114e is used to maintain account information records for pharmacy administrators that register with server system 110 to oiler healthcare products, such as prescription drugs and medical supplies, for purchase by customer users registered with the system. For each pharmacy for which an account is registered-with server system 110, various items of information relevant, to the pharmacy., such as name, location(s) and hours, contact information, URLs or references to web.sites and social media profiles, compensation information (indicating a financial account for receiving payment for purchases of ph:ducts offered by th.e .phatady via the system), and any other suitable identifying information, as well as a unique user name and password associated with the account that can be used to log into the account, may be included in the respective account information record for the pharmacy that is maintained within pharmacy profile database I
14e. The 'account inforination -record for each pharmacy can also be associated -with an account status and a unique pharmacy account identifier within pharmacy profile database 114e that is used by application server 116 tbr perforthing 'various operations.
fp 108] Condition information database 114f is used to maintain information records for -various health conditions and diseases for which corresponding healthcare services (for example, test and treatments)That can be offered by providers registered with server system 110 for purehate by customer users registered with the system. In exemplar* embodiments, the various cOnditions, and diseases for which respective information records are maintained in condition information database 114f and the information that populates the respective information record for each condition or disease can be created and maintained by. a baekt-end administrator of server system 110. For each condition or disease for -which an information-record-is created, various items of information relevant to the condition or disease, such as name, description, causes, risk factors, symptoms, common treatments, corresponding healthcare services that can be offered by providers registered with server system 110 (for example, each associated healthcare service may be identified within the information record using a unique procedure identifier that is used to identify an information record for the service within available services database I Mg as discussed below), and any other suitable information may be included in. the:
respective information record for the condition or disease that is maintained within condition.
information database 114f.
101091 'fhe available service database 114g is configured to register and maintain records of various healthcare services offered by at least one of a physician; and a hospital..
Available services- database 114g is used to maintain information records for various healthcare. services (for example, test and treatments) that can he offered by providers registered with server system 110 for purchase by customer users registered with the server system. In exemplary embodiments, the respective information records for healthcare servi ces that are maintained in available services database I
1.4g and the information, that populates the respective. information. record for each service can. be created and. maintained by a back-administrator of server system 110. For each service for which an information record. is .created, various items Of information relevant 'to the service, such as riaine, procedure detail, one Or More medical specialties- with which the procedure is commonly associated., cost information (ter example, average prices for the service for patients that are uninsured arultur have a high deductible insurance plan and an average price for purchasing the service that is offered by providers registered with server system 110), a medical code number id:WWI:111,g the service according to the nomenclature used by a formal medical classification system (for example, a code that is used to identify the service according.
to the Current Procedural Terminology (CPT) code set), a procedure identifier that is used by application server 116 to uniquely identify the. particular service, and any other suitable information may be included in the respective information record for the service that is maintained within available services database I litg, t 10f Additionally, in exemplar), .embodiments, the information record for each service that is maintained within available services database 114g may further include an indication of the whether the service can be offered by providers within marketplace system 100 *man individual primary .service or as a primary service of a bundled set of a plurality of services (for Which. a single payment for the bundled set of Services will be disbursed to different provider an- each a the services in the bundled :set). In such embodiments, for each service for which. the information record includes an indication that the service is offered as a primary service of' a bundled set of services, various items Of additional information. relevant to the. bundled set of services associated with the service, that is indicated to be a primary service may be included in the respective information record for the primary service that is:
maintained within available services database 114g. Suchitems of information relevant to the bundled set of services included in the respective information record for a primary service may include, for example, items of information describing one or more secondary services associated with the primary service (Such as name, a.medical code. number such as a CPT code identifying the service according to the nomenclature used by a. formal medical classification system, and a secondary procedure identifier that is used by application server 116 to uniquely identify the particular secondary service in association with the unique procedure identifier for the primary service), one or more procedure identifiers for other services for which an information record is maintained within available services database 1.14g that are considered to be secondary services associated with the primary service, an indication of whether performance of each of the one or more secondary setviceS (for which a single customer payment for the bundled set of services will be -di gbursed among different respective providers for the services in the bundled. set) is optional or required in, association. with performance. of the primary service, and an indication of Whether the primary service is required to be performed at an outside .facility. In addition, in such embodiments, for each service for which the information record includes an indication that the service is offered As a pineal), service of a bundled set of services, the Cost information that is included in the respective information record for the primary service that is maintained within available services database. 114g can include respective cost information for each of the primary service, the one or secondary -services, and, if required, the use of an outside facility for the primary- service individually (for example, average prices for each service and facility of the bundled set of services for patients that are uninsured and/or have a high deductible insurance plan) in addition to an average price for purchasing the bundled, set of services that is offered by providers registered with server system 110.
101111 Semis:* offeredatatetee 1 Otis used to maintain information records for healthcare services that are being.offered by providers registered with the system for. purchase by customer users registered with the system. In this regard., it should be noted that the same service may be separately offered by multiple different providers registered with the system and, thus, service offer database 11.4h can include multiple information records for the same service that are each associated with a different provider. For each offered service for which a respective information record is maintained within service offer database 114h, various items ofitiforittatiorereleVant to the service being offered, such as the unique procedure identiner for the information record within available services database I 1 4g for the service, the unique Account identifier for the account information record (within physician profile database 1.141',, practice grow. profile database. 114c, or hospital system profile database 114d) of the.
provider that is offering the service through the system, the unique:
physician account identifier forthe account information record. within physician profile database 11.4b of the physician. user that will perform the service, a location at which the service will be performed, a discounted price for purchasing the service within marketplace system- 100, a regular price for the-service-when the service is purchased outside of the system, the unique account identifier for the account information record (within physician profile database 114b, practice group profile database 114c, or hospital system profile database 114d) of the provider for which payment for the service when purchased through the system is to be directed, a payment amount to be transferred to the-provider for Which payment for performing the service is to be directed, additional descriptive information that may be provided by the provider offering the service, a procedure offer identifier that is used by application. server 116 to uniquely identify -the offering of the particular service: by the provider within the system,. and any other-suitable information may be included in the respective information record for- the offered service that is maintained within service offer database .114h., [01121 Additionally, in exemplary embodiments, the information records for offered services that are maintained within service offer database 11411 can include information records that include additional information for services that are offered by providers registered with the system as a bundled set of services. In this regard, the infonnation record foreadh offered service that is maintained within service.
offer database 114h may further include an indication of the whether the offered service is being offered as an individual primary service or as a primary service of a bundled set of a plurality of services (for which a single customer payment for the bundled set of services will be disbursed among different respective providers for the sulfites in the bundled set):. In such embodiments, fortach offeredserviee for which the information record includes an indiction that the service is being Offered by a provider as a primary service of a bundled set of services, various items of additional information relevant to the bundled set of services associated with the offered service that is indicated to be a primary service.
may be included in the respective information 'record for the offered service that is maintained within service offer database 114h. Such items of information relevant-to the bundled set of services included in the respective information record for an offered service within service, offer database 114h that is.
indicated to be a primary service of a bundled set: of services may include for example, items of information for each secondary service such as the -unique procedure identifier for the information record within available services database 114t for the secondary service (or the. Secondary procedure identifier that is included in the available services database 114g to uniquely identify the particular secondary service in association with the unique procedure identifier for the offered primary service where the inforination, record for the primary service being offered in the available services database.
114g includes an indication that the-service-is offered as a primary service of a bundled set of services), the unique physician account identifier for the account information record within physician, profile.
database 114b of the physician user that will perform the secondary service, a location at which the .7117.7144.11rec3r6e performed, a discounted price for purchasing the secondary service within marketplace system 100, a regular price for the secondary service when the service is purchased outside of the -system, the unique account identifier for the account information record (within. physician profile database 114b, practice group profile database 114c, or hospital system profile database 114d) of the provider for which payment for the secondary service when purchased through the system is to be directed, a payment amount to be transferred to the provider for Which payment for performing the secondary service is to be. directed, and an indication of whether performance of the secondary service.
is Optional or required in. association with performance of the primary service. The items of i nformati on relevant to the bundled set of services included in the respective information record for an offered service, within service offer database 114h that is indleated. to be a primary service of a bundled set of services may further include, for example, an indication of Whether the primary service is to be performed at an outside facility and, if the primary service is to be performed at an outside facility, items of information pertaining to each of one or Morefacilities thatna ay be used to perform the priMary service such as, for example, name,: address, contact. information, facility fee, and compensation information indieatinga financial account thatis used by thefaeility forreceiving a facility fee:.
101131 Available products database 114i is used to maintain information =
records for various healthcare products (for exaMple, prescription drugs and medical supplies) that can be offered by pharmacies registered with server system 110 (that is, pharmacies for whiehr an:account' infbrmation record is maintained Within pharmacy profile database 114e) fOrpurchase by customer users registered with the system. In exemplary embodiments, the respective information records for the healthcare products that are maintained in available products database 114i and the information th:at populates the respective information record for each product can be created and maintained by a back-end administrator of server- system 110. For each product for which an information record is created, various items of information relevant to the product, such as name(s), a list of dosage level options .(for prescription drugs), size options (for certain medical' supplies), and the like, a description of the product, an indication Of whether a prescription is required to purchase the product, information for rendering a respective predefined finable form for submitting prescription information for the product within a user interface; cost information (for example, average prices for the product for patients that are uninsured and/or have a high deductible insurance plan and a lowest price for purchasing the product that is offered for the.service by pharmacies registered with server system 110), a product identifier that is used by -application server 116 to uniquely identify the particular product, and any other suitable information may be included in therespective intormationsecord for the product that is maintained within available products database 1141.
101141 Product offer database 114j is used to maintain information records.
for healthcare products that are being offered by pharmacies registered with the system for purchase by customer users registered with the system. In this regard, it should be noted that the same product may be separately offered by, multiple different pharmacies registered With the system and, thus, product offer database 114j can include multiple infoi-mation records for the same product that. are each associated with a different provider. For each product. offered. by a pharmacy for which a respective information record is maintained within product offer database -114jõ variousiteins onnDoinati on .'%!.1eYant.teilhe product being offered, such as the unique product identifier for the information record within available products database 1141 for the product, the unique pharmacy account identifier for the account information record. withi n. pharmacy profile database 114e of the pharmacy that is offering the product, 4 discounted.
price for purchasing the product from the identified pharmacy within marketplace system 100, a regular price for the product when the service is purchased -outside of the system from the identified pharmacy, a payment amount to be transferred to the pharmacy that is offering the product, additional descriptive information that may be provided by the pharmacy offering the product, a product offer identifier that is used by application server 116 to uniquely identify the information record for the offering of the particular product by the pharmacy within the system, and any other suitable information may be included in the respective information record for the offered product that is .maintained within product offer database 114j,.
101.151 The transaction information database 114k is configured to maintain records of purchases made by registered users. Transaction information database 114k is used to maintain information records for purchases that have been made via the system by registered customer users of healthcare services and products being offered by registered providers. For each purchase of a service or product that has been made using the system, various items of information relevant to the purchase may be included in the respective information record for the purchase that is maintained 'within transaction information database 114k. In general, the items of information relevant to each purchase that is included in the respective information record for the purchase: that is maintained within transaction information database 114k can include, for example, the unique customer account identifier. of the account information record for the purchasing customer within customer profile database 114a, the unique procedure offer identifier:of the information, record for 4 purchased.
service within service offer database .1.14h or the unique product offer identifier of the information record for a purchased product within product offer database 114j, a purchase date, and a unique :transaction identifier that is. used by application server 116 to uniquely identify the information record for the purchase of the service or product within the system.. For each purchase ofa service that has been made using the system, the items of information relevant, to the purchase included in the respective information record for the purchase that is maintained within transaction information database 114k may further. inelude = the unique physician account identifier for the .account information record within physician profile database 114b of the physician user that is designated as performing the purchased service. in the information record for the purchased service within service offer database 114h, an indication of whether the purchase-has been redeemed and,. if the purchase has been redeemed, a redemption-date:
101.161 Additionally, in. exemplary embodiments, the information records for purchased services that are maintained within transaction information database 114k- can include information records that include additional information for purchases and services that are offered by providers registered with the system as -a bundled Set. of services, In this regard, the information record for each purchased bundled. set of services that is maintained within transaction information database 114k may include an indication of a particular otitside sfacility that has been selected for performing the primary service of the 'bundled set of services and, for each service of the bundled set of services thatis included within the purchase (for example, each required secondary service or each Optional secondary service selected by the customer user to. he included within the purchase, as. well as. the primary service), the unique physician account identifier for the account information record within physician profile database I 14b of the physician -user that is designated as performing the service in the information record for The purchased service within service offer database 114h, an indication of whether the purchase has been redeemed with respect to that particular service, and, if the purchase has been redeemed with respect to that particular service, a redemption date for that particular service:
101171 FIG. 3A is a screen shot illustrating an example of a graphical user interface, provided by such a home page 300 tbr customer portal 121M4he ilht. exilthple, the search interface provided at home page 300 can include a drop-down mono- 302, a search entry field 304, a.
location entry field 306, and a search button 308õ Drop-down menu 302 provides a set of' selectable options that allow the user to search for particular procedures offered by provider users registered with the system, particular products offered by pharmacy users registered with the system,: information on providers- registered with the system, and information on health conditions that is maintained within system. In exemplary embodiments, navigation and search service 124 can be configured- to use location information that may be gathered by any.suftable'lmAttion determining functionality implemented on. the client system to provide a default location entry (for instance, city name and/or zip code)within location entry field 306. In such embodiments, navigation and search service -124 may be further configured to request permission from the user via the user interface to be able to access and utilize- such location: information for this purpose:
[01181 In one example, when the user selects the option Within, drop-down menu 302 to search for a particular service offered by provider users registered with the: system, the user can then proceed to enter the name of the service within search entry -field 304 in conjunction with selecting the particular service, the user can also enter a city name and/or zip. code or opt to utilize a default location entry Within location entry field 306 to localize a search radius for providers offering the. selected service for purchase via marketplace system 100.
101191 Once the appropriate search information is entered, the user can then select-the search button to direct navigation and search service.124 to conduct a search of local providers registered with server system 110 and offering the inputted healthcare service for purchase via marketplace system 100.
Navigation and search. service 1.24 can conduct such a location-based search by accessing, tbr example, service oiler database 114h in conjunction with physician profile database 11.4b, practice group prOfile.
database 114c, hospital system -profile database 114d, and/or any other suitable infOrmation and databases to which the application server has access to filter the information records included within available services database 114g for healthcare: services: that match the specified search criteria, and.
then present the -results of the search to user within a search result listing page.
101201 in exemplary- embodiments, whenever navigation and search service 124 is. directed to conduct a location-based search by a user (for example, for local providers offering the inputted healthcare service or, as discussed below, for local providers generally or for local pharmacy providers offering healthcare products), the navigation and: search service can be configured. to maintain the location specified within location entry field 306 for search within a data object for a session with application server 116 that. is maintained for the user.
101211 FIG. 3:B is a screen shot illustrating an example of a GUI provided by a search result listing.
page 310 for customer portal 120 that presents a list of providers offering the service specified within search ontry field 304 within a default search radius (firr exarriple, 50 miles) of the location specified within location entry field 306 returned in the search conducted by navigation and search service 124.
In the illustrated example, search result listing page 31.0 includes a result listing section 311, a result filtering section 16, and a result ..sorting section .1 g. Result filtering section 116 provides various user .,.......
interface. controls for refining the results of the search presented within result listing section .3-11 by modifying the search criteria or inputting additional search criteria. In the illustrated example, result filtering section.
101221 In exemplary embodiments,. such a. search result listing page 310 can be implemented to present any other appropriate information relevant to the search criteria specified by the user, such as, for example, a graphic depicting the average cost information included in the information record for the particular product spthfied iii the search criteria that is maintained in available products database 114j (for prescription drug products, the average cost information can be provided fora default quantity of the prescription drug..or, alternatively, based on a calculation r performed by navigation and search service 124 for the quantity specified by the user using the average cost information for a default quantity as a reference).. Each. entry for an offered product. listed in the.
product search result listing page can include portions presenting information from. the account information record of the pharmacy that is offering the product through the system (for example, pharmacy name address, = and contact information.), cost information for purchasing the offered. product-through marketplace system 1.00 (for example, the discounted price for the product. that is specified in the information record for the offered product within product offer database. 1).4j or, for -prescription drugs, a price that is calculated based.
on the specified discounted price in relation to the quantity specified by the user) and a cost savings difference between the discounted price and the regular price for the product when the product is purchased outside of-the system as specified in the information record for-the offered product), and an option to select to purchase the offerral product listed in the entry (for example, via an "Add to. Cart"
button). Whena user selects the option to purchase an offered product listed in the product search result .listing page, navigation and search service 124 can be configured to update the session data object for the session with application server n6 that is presently being maintained for the user to include an indication that. the user has selected the offered product for purchasing (for example, by including the product offer identifier that is -maintained within product offer database 11.45. to uniquely identify the offering of the particular product by the pharmacy) in association with any other requited information (for example, in the case of a prescription drug, the quantity that is specified by the user and the price that is calculated based on the discounted price for the product that is specified, in the information record for the offered product within product offer database 114j in relation to the quantity specified by the user). Upon selecting one or More services and/or products for purchase in association with a session With application server 116, the user may thew have an option to navigate to, a Customer purchase. page (for example, a "Check-Out" page) to proceed with purchasing the selected item(s) With respect- to an account information record .maintained within customer profile database 1.14a for a leitgiamstomer user, 1231 For each offered service for which a respective entry is included in the purchaseinfortnation section, the entry- may include, for example, information retrieved from physician profile database 114b, available services database 114g, service offer database 114h, and the session data object such as the name of the physician that will -perform the service, a service name, and an indication of whether the service is being -offered as a. primary service of a bundled set of services. Each entry for an Offered.
service that is included in the purchase information section may further include user interface controls accessible by the user to remove the offered service from the purchase information sectien (and correspondingly direct purchasing service-126 to remove the indication the offered setviceas having.
been selected in the session data object) and/or to adjust a service quantity to be purchased by the user, a.n.d a:price for purchasing the offered service that is calculated based on the service quantity specified by the user and the discounted price for the service that is specified in the information record .for the offert.td. service within service offer database 114b- in relation to the quantity specified by the user.
10124.1 In addition, for each entry for an offered service induded.in the purchase information section that is being offered as a primary service of a bundled set of services, the entry may further include user interface controls accessible by the user to present Additional information about the bundled set of services and .make additional selections regarding the offered service. The additional information .may include, for example, - information retrieved, from physician profile database 114b, available services database 114g, and service ofkr database 114b, such as the name of physician that will perform each secondary Service, a serViet natrit for each secondary service, an indication of whether each secondary service is required or optional, and an indication of 'whether the primary service is required to be performed at an outside facility. In association with each secondary service for Which an indication that the secondary service is optional is presented, the additional information may further include the discounted price for the secondary service that is specified in the information record for the offered service within service offer database 114b, and an associated user interface control may be provided that allows the user to select whether to purchase the optional secondary service in association with the offered service. In -association with an indication that the primary service is required to be performed at An outside facility, the additional information May further include name and location information for each facility for. which information is Specified in the information record for the offered service within service offer database 114h, and, i finformation is specified for more than one facility in the infonnation record for the offered service, the facility fee for each specified facility may be presented in association with a user interface control that is provided to allow the user to select one of the facilities at -which to have the primary service performed. Purchasing service 126 can be configured to, based on any optional secondary service and facility selections that are made by the user with respect-to an entry for an offered service included in the purchase information section that is being offered as a primary service of a bundled set of services, recalculate and update the price for purchasing the offered service that is presented in the: entry for the offered service. In exemplary embodiments, the-default initial settings for any optional secondary service and multiple facility selections for a service being offered as a primary service of a bundled set of services and, thereby, the default initial price for purchasing the offered.

.service that is presented in the entry for the Offered service, may be based on a selection. to purchase.
each optional secondary service and a selection of the facility having the lowest facility fee:
101251 :En the example screen shot depicted in FIG. 3B, each entry for an offered service listed in.
result listins section 311 -includes a first portion 312 presenting information from. the account information record within physician profile database 114b of the physician that will perform the service as specified in the information record for the offered service Within service offer database 114h (for example, the physician's name, specialty, and profile picture), a second.
portion 313 presenting information from the aceount inforrnati on record of the provider that is -offering the service through the system (for example, provider name) and the location at which the offered Service will be performed (for example, address and telephone number), and a third portion 314 presenting cost. information for purchasing the offered service through application server 116 (for example, the discounted .price-for The service that is specified in the information record. for the offbred service within service offbr database 114h and a cost savings difference between:the discounted price and the regular price for-the service when the service is purchased outside of the system from the; provider as specified in the information record for the offered service within service offer database 114h), and an option to select to purchase the offered service listed in the entry (for example, via an "Add to Cart" button included within-third portion 314). When a user selects the option to purchase an offered service listed in result listing section 311, navigation and search service 124 can be co,gfigigkAtompOtegtte session data object for the session with application server 116 that is presently being maintained for the user to include an indication that. the Lisa has selected the offered service for purchasing (for -example, by including the procedure Offer identifier that is maintained Within Service offer database 1.1=4h to uniquely identify the offering of the particular service by the provider).
101261 Referring now to FIG. 3C, a screen shot -illustrating an example of a GUI provided by a healthcare service information page 320 implemented by navigation and search service 124 for a particular healthcare service i s provided. In the illuatrated example, healthcare service information page 320 includes a procedure overview section 322, a cost comparison graphic 324, and a. provider listing section 326.
101271 The information presented in provider listing section 326 can be generated in a manner similar to the. information included in result listing section 311 of example search result. listing- page 310 depicted in -FIG. 3B to present a list of providers offering the particular service within a default search radius (for example, 50 miles) of a location determined by navigation and search service 124. The particular location that is utilized for this puipose may be determined using, for example, a location that is stored within the session data object for the session with application server 116 that is presently being- maintained for the user or location information that is gathered by any Suitable location determining functionality implemented on the client system to provide a default location entry. hi the present example, provider listing section 326 presents an entry for each offered service for which a respective information record is maintained .within service offer database 114h that matches the particular service for which healthcare service information page 320 is generated and along with the determined locution. Each entry for an Offered service. listed in provider listing section 326 presents-information from the account. information record within physician profile database 114b of the physician that will perform the service as specified in the information record for the offered service within service offer database 114h (for example, the physician*s name and profile picture) and cost information for purchasing the offered service through application server 11.6 (for example, the discounted price for the service that is specified in the information record for the offered service within service offer database 11.411). In-the present example, provider listing section further indedes. a location entry field 327 that, in conjunction With a "submit" button 328, allows a user to specify a particular location (for example, a city name and/or zip code) and submit a request for navigation and search service 124 to conduct a search and update the information presented in provider listing section 326 to present a list of providers offering the particular service within the default searCh adius of the newly specified location. Navigation and search service. 124 can also be configured to, in response to such a request update the location that is maintained within the session data Object for the session with application server 116 that is presently being maintained for theuser.
101281 In exemplary embodimentS, .as further illustrated in FIG. 3D, physician information section .332 can farther include .additional user interface elements such as a 'Leave a review" button '333., a "Request. an appointment" button 334, and a map element 335 depictinga mapped location of an office location included within respective account information record that. is maintained for the particidar physician user in physitiart profile database 114b (which navigation and search service 124 may be configured to. generate by remotely accessing a third-party mapping service).
In response to a user selecting 'Leave a review" button 333, navigation and search service 124 can be configured to implement suitable user interfate controls for allowing the user to post or submit a review of the particular physician to server system 118. in response to receiving such a review; navigation andsearch service 124 can be configured to, for example, 'include information pertaining to the review within the respective account information record that is maintained for the particular physician user in physician profile :database 114b or send an electronic message. to the:physician user pertaining to the. review, for example, by way of email utilizing: the contact information specified in the.
respective account nform anon record for the physician.
101291 In response to a user selecting "Request an appointment button 334, navigation and search.
service 1.24 Can be configured to, implement suitable user interface controls for allowing the user to submit a request for scheduling an appointment to the particular physician user (for example, by sending a notification to the physician user by utilizing the contact information specified in the respective account. int7ortnation record for the physician. that includes contact information for the user).
Navigation and search service 124 may alSo be configured.toimpleMent suitable user interface controls for allowing the user to Schedule an appointment with the particular physician user. Navigation and search service 124 may provide this fianetionality by, for example, accessing a service with which the particular physician user is associated, which may be a service offered by application server 116 or ofThicd. by a third-party service provider.
101301 In the present example, as illustrated in F10. 3D, the information presented in offered procedures section 336 of physician profile page 330 can includes listing of healthcare. services offered by the particular physician for purchase through marketplace system 100.
101311 In the illustrated example, physician profile page 330 includes a physician information section 332 and an offered procedures section 336. The information presented in physician information section 112 can be generated based on the information that is included in the respective account information record that is maintained for the particular physician .user in physician profile database 114b and may include various items &information 'relevant to the physidan, such as name, practice specialty, office location(s) and hours, a profile picture, contact information, biographical infonfnation (such as awards, honors publications, patient testimonials, and Other information that may be of interest to prospective customers accessing the system), URLs or references to websites and social media profiles, and group practice and hoSpital -affiliation(s).
101321 In exemplary embodiments, the user interface implemented by account management service 122 may he further configured to provide user interface- controls for requesting authorization for payment of a predetermined fee to gain access to the ability to make prepaid purchases of healthcare services and products offered within marketplace system 100. The payment.
information input by the user may be an instruction to use the billing information- included within the respective account information record established for the user within customer profile database 114a or -submission of -alternative payment information such as, for example, bank account information, Credit or debit card information, or other electronic payment information (such as information for utilizing an account the User has with Pay Pal or any another- entity facilitating payments and money transfers to be made through the-Intemet), which may be for an account maintained for the user or an account maintained for another person or entity that the user is authorized to utilize for this purpose [01331 Account management service 122 can be configured to, upon the authorization and appropriate payment information being provided. by the user, access a corresponding third-party payment servicing system and utilize the payment information to direct the payment servicing system to transfer the amount for the payment authorized by the user from the account servieer of theuSer to finariCial account maintained = by the providers of marketplace System 100, In this regard, the respective account information record established for the user within customer profile database 1.14a can further include an account status that is managed by account management service. 122 for the user indicating whether the user is presently provided with the ability to make prepaid purchases of healthcare services and products offered within marketplace syStem 100.
101341 Upon a user registering a customer account with server system 110 to establish an account information record within customer profile database 114a and logging into his or her customer account (for example, by accessing a login user interface element or a login screen within the user interface.
implemented by customer portal 120 to provide the user name and password associated with the sarlobnU **Amer then proceeds with purchasing any Offered service or product for which the session data object fOr the session with application server 116 that is being maintained fcir the user includes an indication that the user ha.s selected for purchasing. For example upon the user selecting an option within the user interface implemented by navigation and search services 124 to navigate to a customer purchase page and initiate a purchasing session with purchasing service: 126 to purchase one or more of the offered items -indicated as having been selected by the user in the session data object in association -with the registered customer account for the user.
101351 The purchase information section included, within the user interface implemented for the payment page may further include a.total price for the purchase that is equal to. a Sum of the respective price for purchasing the corresponding offered item included for each entry included in the purchasing inforination section. lii exemplary embodiments, purchasing service 126 may be configured to adjust the total price based on any applicable state taxes or any discount codes submitted by the user. In this.
regard, purchasing service 126 may be further implemented to provide A user interface element allowing a. user to submit any application discount codes to application server 116, 101361 For this purpose, the user interface controls: implemented within a payment .section may include a button that is accessible by the user to provide authorization for the request to be issued to the specified funding source (for example, a "Submit" or "Purchase" button) along suitable user interface elements accessible by the user to input the, purchase information specifying. the funding source to use for the. purchase. The purchase. information input by the user may be an instruction to use the billing information included within the respective account- information record for the customer-aticount of thei user within customer profile database 11.4a Or submission of .alternative purchase information such as, forexample,_ bank account. information, credit or debit card information, or other electronic payment. information. (suchus information for utilizing an account the user has with. PayPal or any another entity facilitating payments and money transfers to be made through the Internet). The purchase information may, for example, specify an account maintained' for the user,. an account maintained .for another person or entity that the user is authorized to utilize for this purpose, or an entity.
that has arranged to be invoiced and provide reimbursement for purchases, of healthcare services and.
products made by the user within marketplace system 100.
=11)131.1 airchasing server 1:26 can also be configured to, upon processing the payment for the purchase of the offered service, generate a voucher for the customer user within the user interface for the purchased service that can be utilized by the customer user-to redeem the purchase and receive the service, from the physician specified. for the offered service (the providers of marketplace system 100 can have pre-arranged agreements with providers registered with the system that the providers will -agreeto honor -such vouchers generated by purchasing server 126 for purchased services). An example of such a voucher is illustrated in HO, 4/IL As depicted in the example, example windier-400 can be generated to include identifying information for the customer user- 402, identifying and contact information for the physician specified for the offered service 404, a description of the purchased service. 406, a confirmation number 408 for the:purchase, which may be generatedby purchasing server 1.26 based on the unique transaction identifier that is included in the respective information record for the purchase that is maintained within, transaction. information.. database 11.4k, and instruetions for redeeming the voucher 410. The confirmation number may also be provided- in the electronic confirmation message to the customer user and electronic notifications to the physician user that will be performing the service and the.provider user for the offered service sent by purchasing system 126 to the customer user. The voucher can be presented to the user within the user interface, for example, as printable and/or machine readable form.

101381 Purchasing server .126 can be configured to, upon processing the payment for the purchase of the offered service that is being offered as a primary service in conjunction with a bundled set of services, navigate the user interface to a purchase. confirmation page and send an electronic confirmation. message to the customer user and electronic notifications to each physician that will perform a service of the bundled set of services and the provider user for the offered. service. (as specified according to the information record for .the offered service within service offer- database 114h), for example, by way of email utilizing the contact- information specified in the respective account information records for the customer, the physicians, and the provider for the offered service.
Purchasing server 126 can be. also be configured to generate a. respective if record .for the completed purchase with corresponding information within transaction information database 114k, which initially indicates that the purchase has not yet been redeemed with respect to the primary service, each secondary service, and any facility specified .for the purchased offered service.
101391 Purchasing server 126 can also be configured to, upon prOcessing the payment for the purchase of the offered service that is being offered as a primary service in conjunction with a bundled set of services, generate .a voucher for the customer user within the user interface for the purchased service that can. be utilized by the customer user to redeem the purchase and receive the -service from the corresponding physician specified for each of the services of the bundled set of services (the providers of marketplace system 100 can have pre-arranged agreements with providers registered with the system that the providers will agree to honor such vouchers generated by purchasing server 126 for purchased services). An example of such a voucher for a bundled set of services is. illustrated in FICI:
4B, As depicted. in the example, example Voucher -400 can be generated to inelude identifying information for the customer user 402,. identifying and contact information for each physician specified for a service and any facility included in the offered service 404, a description of each service of the purchased service 406, a confirmation number 408 for the purchase, which may be generated by purchasing server 126 based on the unique transaction identifier that is included in the respective information record. for the purchase That is maintained within transaction information database 114k, and. instructions- for redeeming the voucher 410. The confirmation number (or any other suitable redemption information such as a one or two dimensional bar code, a QR. code, or any other form of machine readable information) may also be provided in the electronic confirmation message to the customer user and electronic notifications to -the physician user that will be performing the Service and the provider user for the offered service sent by purchasing system 126 to the customer user. The voucher can be presented to the user within the user interface for example, as printable and/or machine readable form.

101401 Upon the user indicating an intention to register as a physician user;
the user will be able to initiate a negi strati On session with account management service-131 to register a physician account with server system 110. Account management service 131 may be configured, for example, to implement a user interface that includes a series of pages with user interface controls accessible by the user to guide the user through the account registration process and prompt the user to input various types of information or media to be maintained by database server 112 -within a respective aceountinformation record that is established for the LetOtr within physician profile = database 114h such as, for ektirnple,.
name, practice specialty, office location(s) and hours, a profile picture, contact information (Such as an email address and/or a telephone itupthet), biographical information (such as awards, honors, publications, patient testimonials, and other information that can be helpful for marketing the physician to customers accessing the system), 1.1Rts or references to websites and social media profiles, compensation information (indicating a financial account for receiving payment for purchases or services offered by the physician -via the systeral information pertaining to outside facilities that. are used for particular services performed by the physician (for example, information pertaining to particularhospitals or clinics such as name, address, contact information, facility fee, and compensation information indicating a financial account. that is used by the-facility for receiving a facility fee), and any other suitable identifying (a descriptive information.. The uses.
interface may also be implemented by account management service 131 to prompt the user for any group affiliation codes or hospital affiliation codes..
101411 Procedure management service 133 may be configured, for example, .to implement a user interface that includes a series of pages with user interface controls accessible by the usetto guide the user through the service offering process and prompt the user to input various types of information to be maintained by database server 112 within a respective information record that is. established in association with the uniquephysician account. identifier for the physician within service offer database.
114h. Upon the user indicating an intention to offer a healthcare service for purchase (for example, by selecting a "Offer Service" tab withinthe practicegroup account page implemented by provider portal 130), the user will be able to initiate a service offering with procedure management service 133 to offer a healthcare service performed by affiliated physicians for purchase via server system 110. For example, the user may be provided with a drop-down menu providing a list of selectable medical specialties and, upon selecting a particular medical specialty, the user can be presented with a list of selectable healthcare services for which an information record for the service is maintained within available seniCes database 114g in association with the specialty.

pm]
:Upon the user selecting a particular service from this list, procedure management service 133 can assist the user with offering the service for purchaseand establish the respective information record for the offered service within service offer database 114h. in particular, procedure management-service 133 can present the user with a selectable list of the physician users affiliated with the practice group from which the: user can submit. an indication one or more of the. affiliated physicians with which. to offer-the service in conjunction with the practice group account. For each selected affiliated physician user, procedure management service 133 can establish a respective information.
record f& the offered service within service offer database 114h by populating the information record with the unique procedure identifier for the information recordwithin available services database 114g for the selected.
service, the unique account identifier for the account information record for the practice group within physician profile database 114b as the provider that IS offering the service through the system,: the unique account identifier for the account information record for the physician user within physician profile database 114b as. the physician user will perform. the service, a location at which the -service will be performed, the unique account identifier for the account information record (within physician profile database I.14h, practice group profile database :1:1.4c, or hospital system profile. database 1.14d) of the provider for which payment for the service when purchased through the system is to be directed (or, alternatively, other financial account information) as indicated by user input received from the practice group administrator, a payment amount to be transferred to the provider or other financial detwill6tuahich payment for the service is to as specified by user input received frorrithe practice group administrator, a discounted price for purchasing the service within marketplace system 100 (Which may be calculated, for example, by adding a negotiated commission fee to the payment amount specified by the-practice group administrator), a regular price for the service when the service is purchased outside of the sy.stern,; additional descriptive information that may be provided via input received from the practice group administrator, a procedure offer identifier, and any other suitable information (such as an indication that the service is required.to be.
performed at an outside facility and relevant facility information as specified by user input received from the practice group administrator).
101431 in exemplary embodiments, procedure management service 133 can also assist the practice group administrator with offering services for purchase as a bundled set of services within marketplace system 100 and establishing the respective information record for the service-offered as a bundled set of services .within service offer database 114h. in particular, procedure management service 133 can present-the user with an option to indicate that a particular service selected by the user should be offered as a ptimary service of a bundled set of services.or, alternatively, the information record for a particular service .selected by the user that is maintained within available services database.' I4g can include an indication that the service can be offered by providers within marketplace system 100 as a primary service of a bundled set of a plurality of Services, 101.441 For a selected service for which such. an indication is provided, procedure management service 133 may be configured, for example, to implement user interface controls accessible by the user to guide the user through the process for offering the selected service as a primary service of a bundled set of services and prompt the. user to input various types of information to populate a respective information record that is established in association with the unique practice group- account identifier for the practice group within service offer database. 1.14h.
Procedure management service 133 cari first present the user with a selectable list of the physician users affiliated with the practice group from which the user can submit an indication of affiliated physicians with which to offer the primaiy service in conjunction with the practice group accOuntaind then populatethe information pertaining to the primary service in the information record with the unique procedure identifier-for the information record within available services database 114g for the selected service, the unique account identifier for the account information record forthe practice group within physician profile database 114b as the provider that is offering. the primary service through the system, the unique account identifier for the account information record for the physician user within physician profile database 114b as the physician user will perform the primary service, a location at which The primary service will be performed, the unique account identifier for the amount information record (within physician profile database 114b,. practice group profile database 114c, or hospital system profile database 1144) of the provider for which payment for the primary service when purchased through the system is to be directed or, alternatively, other financial account information) as indicated by user input received from the practice group administrator, a payment amount -to be transferred to the provider or other financial itOtotoe.Uor which payment Ibr the. primary service is to be directed ..as specified by user input received from the practice group administrator, a discounted price for purchasing the primary service Within marketplace system 100 (which may be calculated, for example, by adding a negotiated. commission fee to the payment amount for the primary service- specified by the practice group administrator), a regular price for the primary service when the primary service is purchased outside of the system, additional descriptive information that may be provided via input received from the practice group administrator, a procedure offer identifier, and any other suitable information.
101451 Procedure management service 133 can then receive an indication, either from the information record for a particular service selected by the user that is.
maintained -within available services database 1-14g or through selections made by the User of Services offered by affiliated physicians for which an information record for the service is maintained within available services database. 114g,. of one or more secondary services to be included in the bundled set of services.
Procedure management service can then populate the information pertaining to each secondary -service in the information record with the unique procedure identifier for the information record within available services database I I 4g: for the secondary service (or the secondary procedure identifier that.
is included in the available services database 114g to uniquely identify the-particular secondary -service in association with the. unique procedure identifier for- the offered primary service where the information record for the primary service being offered in the available services database 114g.
includes an indication that the service is offered. as a primary service of a bundled set of services),.-the unique physician account identifier .for the account information record within physician profile database 114b of the physician user that will perform the secondary service, a location at which the service will be pertbrmed, the unique account identifier for the account information record (within physician profile database 114b, practice group profile. database 1.14e, or hospital system profile database 114d) Of the provider for which payment for the primary service when purchased through the system is to be directed for, alternatively, other financial account information) as indicated by user Input received from the practice group administrator, a payment amount to be transferred to the provider or other financial account. for which payment for the secondary service is to be directed as specified by user input received from the practice group administrator, a discounted price for purchasing the seeoridttry service within marketplace system 100 (which may be calculated, for example, by adding a negotiated commission fee to the. payment amount for the secondary service specified by the practice group administrator), a regular price for the secondary service when the secondary service is purchased outside of the system, and an indication of whether performance of the secondary- service is optional. or required in association with .performance of the primary service.
Procedure managentent service ten fiirther populate the information in the information rebord With an indication of whether the primary service is to be pertbnned at an outside facility and., if the primary service is to be. performed at an outside facility, items ofimformation pertaining to each Of one or more.
facilities that may be used to perform the -primary service such as, for example, name, address; contact information, facility fee, and compensation information indicating a financial -account that is used by the facility for receiving a facility fee (as specified by user input received from the practice group administrator).
f01461 Upon the user indicating an intention to request payment for a purchased service that have been performed (for example, by selecting a "Voucher Processing" tab: within the physician account page implemented by -Novi derportal 130), the user will be able to initiate a-voucher processing-session with transaction processing service 136. In particular, transaction processing service 136 may be.
configured, for example, to implement a voucher history page- within the user interface that presents information relevant to the physician user for a list of purchases for which the respective, information record for the purchase that: is maintained within transaction information database 1141. includes the unique physician account identifier for the physician. user within physician profile database I Mb as the physician user that is designated as performing.aserviee included-the purchase (for example; a primary or w,tzoodary liervice for -a bundled set of ervides): The relevant inforthation for each listed purchase may include, for example, the voucher confirmation number or redemption code, name and contact information for the customer user, a description of the service the physician user is designated as performing for the purchase, a purchase date, and a voucher redemption status.
Such a voucher history page may also be accessed in association with the user account. for the' physician user to verifY vouchers presented customers requesting to have a service performed in association with a voucher.
101471 The Voucher history page can also provide a user interface demerit in.
association With each of the listed purchases for which the voucher redemption status for the:
service the physician user is designated as performing indicates the service has not been performed that is accessible by the physician user to submit a verification to application server 116 that the physician user has performed the service for the customer user in accordance with the purchase.
INA Referring again to FIG. 2,. in exemplary embodiments, when a user operating a Client system to access application Server 116 via a corresponding client application executing on the client system initiates a registration with server system 1 le and specifies an intention to register as a practice group administrator Oar example, via a user interface element on any page implemented by navigation and search service 124), the user will be able to initiate .a registration session: with account management service 131 to register a practice group account With server system 110.
Account Management service 131 may be configured, for example, to implement a user interface that includes a series of pages with user interface, cOntrols accessible by the user to guide the user through the account registration process and prompt the user to input various types of information or media to be maintained by database server 112 within a respective account information record that is established for the user within practice-group profile database 114c such as, for example, practice group name, *location and hours, contact information (such as an email address andior a telephone number). URI,s or references to websites and social media profiles for the practice group-, information pertaining to outside facilities that are used for particular procedures by physicians affiliated with the practice group, (for example, information pertaining to particular hospitals or clinics such as name, address, contact information, facility fee, and compensation information indicating a financial account that is used by the facility for receiving a facility fee), compensation information (indicating a financial account for receiving payment for purchases of services that are performed by affiliated physicians via the-system), and any other suitable identifying or descriptive information...
[01491 The voucher history page can also provide a user interface element in association with each of the listed purchases for which the voucher redemption status for the service indicates the servi cehas-not been. performed that is accessible by the practice group user to submit. a verification to application server 116 that the affiliated physician user specified as performing the service has performed the service for the customeruser in accordance with the purchase.
101501 In exemplary:embodiments, when a user operating a client system to access application server 116 via a corresponding client application executing on the client system initiates a registration with server system 110 and specifies an intention to register as a hospital system administrator (for weal-14e, via a user interface element on any page implemented by navigation and search service 124), the User will be able to initiate a registration session with account management service 131 to register a hospital system account with server system. HO. Account management service. 131 may be configured, for example, to implement a user interface that includes a series of pages- with user interface controls accessible by the. user to guide the user through the account registration process and. prompt the user to.
input various types of information or media to be maintained by database 'server 112 within a respective account information record that is established for the user within hospital-system profile database 114d such as, for example, contact intbrmation (such as an email address and/or a telephone number), information pertaining to outside facilities that can be used for particular procedures by physicians affiliated with the hospital system (for example,, information pertaining to particular hospitals or clinics such as name, address, contact information, facility- fee, and compensation information indicating a financial account for that is used by the facility for receiving a facility fee), compensation. information (indicating a financial accountfor receiving payment for purchases of services performed by affiliated physicians via the system)õ and any other suitable identifying. or descriptive information.
101511 In exemplary embodiments, the functionality that is provided within provider portal 130 for users of hospital system accounts can vary in certain respects from the functionality that may be provided within provider portal 130 for users of practice group accounts. For example, with respect to physicians that are affiliated with the hospital system account, users of hospital systein accounts may only be provided with access. rights (for example, to view, modify, and specify in a service being offered by the hospital system fin- purchase) :to services offered for purchase by affiliated physician users that have been specified by the physician users as being hospital procedures with respect to the.
physician accounts. Hospital system users may also beprovided with functionality to, as an alternative to selecting a service by .accessing a list of selectable medical specialties when initiating a service offering with procedure management service 133 to offer a service.performed by affiliated physicians for purchase. via server system. 110, submit a search query for a service by inputting descriptive terms or a medical code number that is used to identify the service (for example, according to the CPT code set) or access a list of affiliated physicians and, upon selecting a particular affiliated physician from the list, be presented with a list of selectable healthcare services for which an information record for the = service is. .maintained within service offer database 114h that indicates .the selected physician as the physician that will perform the service.
101521 In addition, because ahOspital system may be more likely tootUr a higher quantity of services for purchase as a bundled set of services -within marketplace system 100 than other types of provider users, the functionality implemented by provider portal 130 within the user interface for allowing a user of a. hospital system account to manage information pertaining to services offered by the hospital system for purchase and to view .a history of transactions performed for services offered for purchase.
by the hospital system within server system 110 may include an .additional user interface element that is accessible by a user for the hospital system account manage and view information pertaining to only services that are offered by thehospital system as a bundled set of services.
101531 FIG, 5 is a block -diagram of an exemplary computer System 600- that can be used for implementing exemplary embodiments of the present. invention, computer system 600 includes one or more processors, such as processor 604. Processor 604 is connected to a communication infrastructure 602 (for example; a communications bus, cross-over bar, or network). Various software. embodiments are described in-terms: of this exemplary computer system. After reading tin s-description, it will become apparent to a person of ordinary skill in the relevant: art(s) how to implement the invention using other cornpurer systems and/or computer architectures.
101541 Exemplary computer system 600 can include a display interface 608 that forwards graphics, text, and other data from the communication infrastructure 602 (or from a frame buffer not shown) for display on a display milt 610. Computer system 600 also includes a main memory 606, which can be random access memory (RAM),. and may also include a secondary memory 6.12.
Secondary memory 61.2 may ineludeõ for example; a hard disk drive 614 and/or a removable storage drive 616, representing a floppy disk drive, a magnetic tape drive, an optical disk drive, etc.
Removable storage drive 6.10 reads from and/or writes to a removable storage unit 618 in a manner well known to those having. ordinary skill in the art. Removable storage unit 618, represents, for example, a floppy disk, magnetic tape, Optical disk, etc. which read by and written to by removable-Storage drive 6.16. As will be appreCiated, removable storage unit 618 includes a computer usable storage medium having stored therein computer software andfor data.
[01551 In exemplary embodiments, secondary memory 612 may include other similar means for allowing computer programs or other instructions to be loaded into the computer system. Such tneans may include, for example, a removable storage unit 622 and. an. interface 620.
Examples of such may include a program cartridge and cartridge interface (Such as that found in video game devices); a removable memory Chip (such as an EPROM, or PROM) and associated socket, and other removable storage units 622 and interfaces 620 which allow Software and data to be transferred from the removable storage unit 62.2. to computer system 600.
1:01561 Computer system 600 may also include a coin muniCations interface 624.
Communications interface 624 allows software- and data to be transferred between the computer system and external devices. Examples of communications interface 624 may include a modem, a network inteiface (such as an Ethernet card), a communications 0311, a PCMCIA slot and card etc.
software and data transferred via communicadons interface 624 are in the form of signals which may be, for example electronic, electromagnetic, optical, or other signals capable of being received by communications interface 624.
These signals are provided to communications interface 624 via a communications path (that is, channel) 626. Channel 626 carries signals and may be implemented using wire or cable, fiber Optics, a phone line, a. cellular phone link, an RF link, and/or other communications channels.
[0157] In this document, the torimi "computer program medium," "Computer usable Medium," and "computer readable medium" are used to generally refer to media such as main memory 606 and secondary memory 612, removable storage drive 616, a hard disk installed in hard disk drive 614, and signals:. These computer program products are Means for providing software to the computer system.
The computer readable medium allows the computer system to read data, instructions, messages or message packets, and. other computer readable information from the computer readable medium. The computer readable medium, for example, may include non-volatile memory, such as Floppy, ROM, Flash memory, Disk drive memory, CD-ROM, and other permanent storage. It can be used, for example, to transport Information, such as data and computer instructions, between computer systems.
Furthermore; the computer readable medium may comprise computer readable information in a transitory state medium such as..a network link and/or, a network. interface including a wired network or a wireless network that allow a computer to read such computer readable information.

101581 Computer programs (also called computer control logic) are stored in main memory 606 and/or Secondary memory 612, Computer programs may also be received via communications interface 624. Such computer programs, when executed, can enable the computer system to perform the features of exemplary embodiments of the present invention, as discussed herein. In particular, the computer programs, when executed,. enable processor 604 to. perform the features of computer system 600.
Accordingly, such computer programs represent controllers of the computer system.
10159] Referring now.to FIG. 6, a Schematic diagram illustrating an example network architecture for healthcare marketplace system 100 within which an exemplary embodiment of a provider pricing tool in accordance with the present invention is implemented. It should of Course be understood that "FIG. 6 is intended as an example, not as an architectural limitation for different embodiments of the present invention, and therefore, the particular -elements depicted in Bkli: 6-should rot be. conSidered limiting with. regard to the environments within. whi ch. exemplary embodiments of the present invention may be i in plertiented.
101601 in the example illustrated in FIG. 6, the particular components that are utilized for providing the provider pricing tool are integrated within system 100 in conjunction with the components of the system Its described above with reference to the exemplary embodiments illustrated FIGS, 1 and 2.
More specifically, the. pricing tool 137 is shown in FIG. 6 as being implemented within procedure management setvice 133 included within provider portal 130, and data store 1.14 further comprises a service pricing informatiOn database 114m and a cost adjustment information database 1.14n that are maintained by database server 112, are accessed by application server 116 via database services provided at a front end by database server 112, and retain information collected from a variety of data sources that is utilized in providing the services offered via the provider pricing tool within the network service provided by the application server, as described below it greater detail.
tot 6 tj in the present 'exemplary embodiments, for Use in conjunction with the physician service pricing information within service pricing information database 114m, a corresponding set of cost adjustment data can be compiled and maintained Within cost adjustment information database 114n that can be applied to account forgeographical variances in physician costs.
The cost adjustment data can, for instance, be compiled from and/Or determined based upon the Geographic Practice Cost Indices (GPOO, which is used along with IWITs-in Medicare Physician Fee Schedule (PPS) provided by CMS
to determine allowable payment amounts for medical procedures in a manner that reflects geographical variations in practice cost. GPCis are used to help standardize the differences in resource costs incurred in operating a private medical practice across geographic areas when those costs are compared with the national average costs for the physician work, practice expense, and malpractice insurance components of the fee schedule.
101.621 More specifically, the CMS- has established a GPC1 for every Medicare payment locality-for each Of The three relative value unit components for a procedure (that is, the RN/Us for work, practice expense, and malpractice), and the GPCis are applied. in the calculation of a fee schedule payment.
amount by multiplying the RVI./- for each component times the GPCI for that component.: A listing of the current OPCI locality structure, including state, locality area (and when applicable, counties assigned .to each locality area), and the corresponding GPCis for each locality, can be obtained from the CMS website, and this information can be compiled and maintained within cost adjustment information database 114n by a back-end administrator of server system 110. In exemplaiy embodiments, a-specific cost adjustment factor can be determined based on the GPC1 information for each designated locality area and maintained Within cost adjustment information database 114n. For example, a standard rate adiustment factor for each designated lOcality area can be determined by calculating an average (or any other suitable aggregate or composite-based) factor by which the corresponding. GPCis for the locality impact the standard national rate derived for each service. As another example., such a standardrate adjustment factor for each. designated locality area can be derived directly from the Geographic Adjustment 'Factor (GAF) that is determined- for .the locality by CMS.
The GAF for each designated locality area is calculated. as the weighted average of the three GPCis, where the weights are the percentage of RA/Us:nationally made up by the PW,.
PE, and MP RVUs.
101631 In another example, for each service for which the information record within service priding information database 114m includes an indication that the service is offered as a primary service of a bundled set of services along with an indication that the primary service is required to be performed at an outside facility, the respective pricing information that is included in the information record for the use of the outside facility can be determined by whether the use of the outside facility is classified as a facility outpatient service or a facility inpatient service. For instance, for each facility outpatient service,. the respective pricing information that is included, in the information record for the use of the outside facility can be obtained from the APC price data that is maintained in association with CPT or HCPCS procedure codes by CMS. CMS assigns: individual services classified according to HCPCS
codes to APCs based on similar clinical characteristics and Sinii ar costs.
Thus, APCs are essentially line-level fee schedules 'in which each HCPCS code for a service is assigned to one of hundreds of individual APCs, and for almost every APC, the fee is determined by multiplying a prospectively established scaled relative weight for the. services clinical APC by a conversion factor (CF) to arrive.
at a national unadjusted payment ratefor the APC.
101.641 Accordingly, in exemplary embodiments, for each service for-which a respective information.
record is maintained within service pricing information database 114m and a corresponding APC is provided by CMS, the corresponding national unadjusted payment rate for the facility outpatient.
service: can be included in the set of pricing information of the respective information record for the service within service pricing information database 114m.
101651 In the present exemplary embodiment, for use in conjunction with the facility outpatient service pricing information within service pricing information database 114m discussed above, a corresponding set of cost adjustment data can be compiled and maintained within cost adjustment information database 1.14n that: can be applied to account for geographic differences. The cost adjustment data for the .facility outpatient service pricing information can, for instance, be compiled from and/or determined based upon the facility wage index that is maintained by the CMS.
101661 In the present exemplary embodiment; for use in conjunction with the ladil ity inpatient service pricing information within service pricing information database 114m discussed above, a corresponding Set of cost adjustment data can be compiled and maintained within cost adjustment information database I 14n that can be applied to account for geographic differences.
101671 Similar to the example discussed above with regard to the cost adjustment data for the facility outpatient service pricing information, the costadjustment data for the facility inpatient service priding information can, for instance, be compiled from and/or determined based upon the facility wage index that is maintained by the CMS. As noted above, in exemplary embodiments, the facility wage index intbrmation can be obtained from CMS and maintained within cost adjustment information database 11,1 n, [0168] In this regard, it should be noted that certain services. for which the respective information record. within service pricing information database 1.14m includes an indication that the service is offered as a primary service of a bundled :set of services along with an indication that the primary service is. required tei be. performed at an outside facility may facilitate a mapping of the use. of the outsidefaeility to both facility 'outpatient service pike data and facility inpatientservite price data. in exemplary embodiments, for such services, a back-end administrator of server 'system 110 can make a determination of which set of facility price data is more suitable to include in the set of pricing information of the information record. For example, such a determination may be based upon whether the particular service is more typically perfornied as a facility outpatient service or a facility inpatient service in alternative exemplary embodiments, for each Service for which the respective:information record within service pricing information database 114m includes an indication that the service is offered as a primary service of a bundled set of services along with an indication that the primary service is required to be performed at an outside facility for which the use of the outside facility can be mapped to both facility outpatient service price data and facility inpatient service price data, respective information records can be maifitaitiedlbr the service as an outpatient facility service and for the service as an inpatient, facility service within service pricing information database 114m.
101691 In this regard, anesthesia time is a -continuous time period from the start of anesthesia. to the end of an anesthesia service, and one-time unitCorresponds to a 15-minute interval, or fraction thereof, starting from the time the physician begins to prepare the patient for induction and ending when the patient .may safely-be placedunder post-operative supervision and the physician is no longer in personal attendance The conversion factors are listed by the CMS according- to locality. Thus, the conversion factor in the formula listed above will correspond to the locality of the performing provider.
101701 In exemplary embodiments, to access the functionality provided by pricing tool 137õ a provider user, upon registering a provider account With server system 110 (for example, a physician, practice group, or hospital system account) to establish an account information record. within the corresponding profile database Maintained -within data. Store 11.4 and logging into his or her 'physician account, the tiger may be directed to a provider account page implemented by provider portal 130 that provides a set of user interface controls that. can be accessed by the user to access functionality provided by procedure management service 133 to offer healthcare services fOr purchase by customer users registered with the system. As noted above, in the present exemplary embodiment the accessible functionality- provided by procedure management service 151 in this regard includes the functionality provided by .pricing tool 137, 101711 In particular, upon the provider user indicating an intention to utilize pricing tool in conjunction with offering healthcare services for purchase via server system 110 (for example, by selecting a "Service Pricing Tool" tab within the provi der account.page-impl emented by provider portal 130), the user will be directed man interactive service pricing page with.
information that is generated haagd..en emlnrotmation maintained in the respective information record for the provider within the corresponding profile database maintained within data store 114 and therespecti ve information records for healthcare services that are maintained in service pricing information database 114m. Price setting tool 137 may be configured, for example, to implement the interactive service pricing page to provide the provider user with detailed pricing information and recommended rates for services that may be.
offered by the provider for purchase via Server system 110, as well as various user interface controls accessible by the user to petform adjustments to the recommended rates as desired.
101721 FIG. 7A is a screen shot illustrating a first -example of a graphical user interface provided by such a service pricing page 700 for a user accessing provider portal 130 in association with a registered iftpital system account. In the example illustrated in FIG. 7A, the user interface provided at Service pricing .page 700 includes a medical. specialty drop-down menu 702, a locality adjustmentsection 704, a recommended rate adjustment Section 706, a detailed pricing information section 708, and. a set of selectable buttons 71.0a ("Email Prices"), 71-0b ("Save CharigeS")õ and 710c ("Take Live"), the use of which will be described in greater detail below. Drop-down menu 702 provides a list of selectable medical specialties (for example, orthopedics, general surgery; cardiac imaging, etc.), and pricing tool is implemented to, in response to the user selecting a particular medical specialty using drop-down Menu 702, configure the user interface options and populate the inforniation displayed within locality adjustment section 704; recommended rate adjustment section 706, and detailed pricing. information section 708 in accordance with the selected medical specialty and further based on information maintained in the respective information record for the provider that is maintained within hospital system profile database 114d, information that is maintained in the respective i nformati on records tbr each service indicated as being commonly associated with the selected medical specialty within service pricing information database I 1-4m, and. infortnation maintained within cost adjustment information database 114n., which, as discussed above, can be. accessed by pricing loci!
137 via database services provided. at .a front end by database server 112.
101731 For -instance,, in the example screen shot illustrated in. FIG. 7A, the user has selected "Radiology" from medical specialty drop-down menu 702, and pricing tool 137 has, it response to this.
selection, configured the user interface options and populated the information displayed within locality adjustment section 704, recommended rate adjustment section 706, and detailed pricing information section 708 in accordance with the selection of "Radiology" from drop-down menu 702. More specifically, as shown in FIG: 7A, locality adjustment section 704 has been configured to include a physician locality section and. a facility section in response to the selection of "Radiology" from drop-down menu 702. The physician locality section is provided for making pricing adjustments based on the locality of a physician that is affiliated with the hospital system and would be performing the radiology services being priced. The facility section is included within locality adjustment section -704 in response to pricing tool 137 recognizing that the respective information records for services indicated as being commonly associated with the selected medical specialty of radiology within service pricing information database 114m include- information records having an indication that the service is a primary service of a bundled set of services that is required to be performed at an outside facility and is provided for making pricing adjustments based on the facility that is affiliated with the hospital system. at which. the radiology services being priced would be performed.
101741 In the present. example, the physician locality section includes a, physician location field 704a and a physician location rate field 704b, and the facility section includes a.
facility field 7046 and a facility rate -field 704d. The physician location field. 704a is for receiving and displaying an entry specifying the location of a physician that would be performing the. Services indicated Its -bdittg commonly associated with the selected medical -specialty of radiology within service pricing information database 114m, and. the physician location rate field 704h isconfigured to provide a rate adjustment factor for thc pricing information included in detailed pricing information section 708 for the services indicated as being 'commonly associated with radiology. In exemplary embodiments, pricing tool 137 can be configured to derive an initial physician location catty based on the location assmiated with physician affiliation(s) included in hospital system profile database 114d and include This derived physician location entry as a default value within physician location field 704a. Physician location rate field 704b is .provided -for receiving and displaying a geographic adjustment rate -for physician services that, by default, is derived based on information maintained in cost adjustment information database 114n and provided by pricing tool 137 in correspondence with the physician location entry that is currently specified -within physician location field 704.a. More particularly, in exemplary embodiments, pricing tool 117 can be configured to access the physician rate coat adjustment data in cost adjustment information database 1140 that corresponds to the physician location entry that is currently Specified within physician location field 704a (for example, a Standard rate adjustment factor determined for a designated locality area that.
encompasses the specified physician location entry) and derive a corresponding geographic adjustment rate that is displayed as a default-value within physician location. rate field 704b 101751 In the present example, pricing tool 137 is further configured to allow the provider user accessing service pricing page 700 to proceed to enter text corresponding to a desired location of the physician that would perform the -services associated with the selected medical specialty within physician location field 704a. In this regard, pricing tool 137 may be configured to require that the text entered by the user in physician location field .704a correspond to a particular locality area for which corresponding physician rate adjustments are maintained in cost adjustment information database 114n.

101761 The fiat of suggested physician locations provided by pricing tool 137 can further include an Option for the user to select a standard, national physician rate rather than a particular geographic location. in response to a specification of a new physician location within physician location field 704a, pricing tool 137 can be configured to dynamically access the physician rate costadjustmentdata in cost adjustment information database I 1.4n that corresponds to the newly-specifiedphysician location entry that iscurrently specified within physician location field 704a and derive a corresponding geographic adjustment rate that is displayed as the current value within physician location rate field 704b.
101771 In exemplary embodiments, pricing tool 137 can be Configured to derive an initial outside facility- entry based on the facility affiliation(s) included the respective 'information record for the hospital system accountin hospital system profile database 114d being used to access the: pricing tool 137 functionality via provider portal 130. and include this derived facility entry as a default value within facility field 704c. Facility rate field 704d is provided for receiving and displaying an adjustment rate for facility services-That, by default, is derived and provided by pricing tool 137 in correspondence with the characteristics of 'the facility that is currently specified as the entry within, facility field 704c.
101781 In the present example, pricing tool 137 is further Configured' to allow the provider user accessing serviCepricing page 700.tOproceed to enter text corresponding to a name of a desired atitside.
facility at which the services associated widi the selected medical specialty would be. performed within facility-field 704e. In this regard, pricing tool 137 may be configured to require that the text entered by the user in facility field 704c correspond to the name of a particular facility specified in the facility affiliations included the respective information record for the hospital system account in hospital system profile database I I4d being. used to access the pricing tool 137 functionality via provider portal 130, 101791 With continued, reference to the example screen shot illustrated in FIG. 7A, pricing tool 137 has, in response to the user selection *Radiology" from -medical specialty drop-down menu 702, configured the user interface options and populated. the. information displayed within rate adjustment section 706. More specifically,, as shown in FIG. 7A, rate adjustment section-706 has been configured.
to include a physician rate adjustment field 706a and a facility rate adjustment field 706b in response to the selection of' "Radiology" from drop-down menu 702. Physician rate adjustment 'field 706a IS
provided for making a general pricing adjUStiliallt to.the pricing information included in detailed pricing information section 708 for 'physician fees for the services indicated as being commonly associated with radiology as desired by the provider user that may be based on any budgetary considerations -spfie the provider and/or physician..

101801 With continued reference to the example screen shot illustrated in FIG.
7A, as noted above, pricing tool 137 has, in response to the tiger selection "Radiology" from medical specialty drop-down menu 702, configured the user interface options and populated the information displayed within detailed pricing information section 708. In general, as. shown in FIG. 7A, detailed pricing information section. 708 is generated by pricing tool 137 as a table with various interactive user interface, controls that includes a procedure column 711, a facility price column 71.2, a physician price column 713, an additiotial fee colurnn 714, eind a: total: amount column 71$.
10181I The information in procedure column 71.1 is generated by pricing FA 137 to include a row entry for oath procedure category listed in the respective information records for services 'that are maintained in Service pricing information database 114m and include an indication that the service is commonly associated. with the: medical specialty selected via drop-down menu 702, which is "Radiology" for the example screen shot depicted in FIG. 7A. For instance, the procedure categories listed in procedure column 711 in the present example include "Bone Density DXA Extremity"
radiology procedures, "Bone Density DXA Scan"- radiology procedures, and "Videofluoroseopic Swallowing Study" radiology procedures. As further illustrated in FIG. 7A for the example of the "Bone. Density DXA Extremity" radiology procedures listing in in procedure column 711, detailed pricing information section 708 is implemented -to include user interface elements that are accessible by the user.
101821 In the present example, the expanded information for the "Bone 'Density DXA Extremity"
radiology procedures liSting includes row entries for a "Dx.a bone density/peripheral" service and a "Fracture assessment via dxa" service. As fiuther illustrated in FIG. 7A, the expanded information for a particular procedure category further includes, for each servict categorized as a sub-procedure of the.
procedure category, a medical code number used to identify' the service (for example, a CPT code), a base facility rate, a base -physician rate, an adjusted facility rate, and an adjusted physician rate: The base physician rate for each service listed in the expanded display is obtained by pricing kid 137 from standard national physician rate derived for the service and the adjusted physician rate for each service listed in the expanded -display- is calculated by pricing tool 137 for display within detailed pricing information section 708 by multiplying the corresponding base physician, rate by both the: current value:
that: is specified in physician location rate field 704b of locality adjustment section 704 and the current percentage value that is specified in physician rate adjustment field 706a of retornmended rate adjustment section 706.

101831 in the present example, as further illustrated in FIG. 7A, the expanded information for a parfiedilerrOcedure category further includes a physician price field 71 I a that specifies a price-that will be set by the provider user for each of the services that have-been categorized under the expanded procedure category and a facility price field 711b that specifies a price that will he applied by the provider user for the use of an outside facility foreach of the services that have been categorized under the expanded procedure category.
101841 in exemplary embodiments, pricing tool 137 can be configured to derive and include initial, default price values within physician price field. 711a and. physician price field. 711.a As further indicated in the example screen shot illustrated in FIG. 7A, the row entry for aparticular procedure category will include a pricing value under physician price column 713 that corresponds to the pricing value- that is speeified within physician price field 71.1a in the expanded display for the procedure category, and, likewise, the row entry for a particular procedure category will include a pricing value under facility -price cola-inn 712 that corresponds to the pricing value that is specified within. facility price field 711b. in the expanded display for the procedure category.. In this regard, pricing tool 137 can be configured to dynamically update the. pricing values provided under physician price column 71.3 and facility price column 712 in response to changes to the price values within physician price field. 711a and facility price field71.1b respectively. As further illustrated in FIG. 7A, the row entry fora particular procedure category can include a pricing value under total amount column 715 that is provided as a sum of the price values listed under facility price. column 712õ physician price column 713, and, if included, additional fee column 714 in the rowentryfora particular procedure.category This represents the actual pride at which each service listed in the expanded display for a procedure category would be offered for -poi-Chase via marketplace system 100 as a bundled set or services from the provider user accessing servieepricing page 700 via providtirportal 101851 As noted above and further illustrated in FIG. 7A, the user interface provided at service pricing page 700 in the present example :also. includes a set of accessible user interface controls 710a ("Email Prices"), 710b ("Save Changes"), and 710c ("Take Live"). For purposes of the present example, these user interface controls are provided within service pricing page 700 as selectable buttons. In the present exemplary embodiment, pricing tool 137 can be configured to, in response to a provider user selecting "Save Changes". button 710b, generate an information record that includes indications of all of the i nformation 101861 In the.present exemplary embodiment, pricing tool 13.7 can. be configured to, in response to a provider .user selecting "Email Prices" button 710a, provide user interface controls for allowing. the user to specify an email address and send an electronic document that includes indications of the pricing nform ati on .
[01871 Finally, with reference: to the present example, pricing tool 137 can be configured to., in.
response to a preVider tiger selecting "Take Live" button 710e, automatically initiate, on behalf of the provider user, a service offering with procedure management service 133 to offer each of the services currently included within detailed pricing information section 708 of service pricing page 100 for the particular medical specialty presented..selectedby the user from drop-down menu. 702 for purchase via server system 110. In this manner, -priting tool. 137 can provide a Mechanism.
for a provider-to Offer a large number of services for purchase via Marketplace.systein 100 by customer users registered with the system without having to perform full set. of operations described above for accessing flinctionality provided by procedure management service 1.3.3 to offer each of the services individually..
1.01881 FIG. 713 is a screen shot illustrating a second example of a .graphical user interface provided by service pricing page 700 for a user accessing provider portal 130. in association with a registered hospital system account. In the example illustrated in Ma 713, the user has selected "General Surgery"
from medical specialty drop-down menu 702,. and pricing tool 137 has, in response to this selection, configured the user interface options and populated the information displayed within locality adjustment section 704, rate adjustment section 706, and detailed pricing information section 708 in accordance with the selection of -"General Surgery" from drop-down menu 702..
.More specifically, as Shown in FIG. 7B, locality adjustment Section 704 has been configured, to include, in addition to the physician locality section and the facility section described above with reference to the example illustrated. in FIG. 7C, an anesthesia locality section in response to the selection of "General Surgery"
from drop-down menu 702. The anesthesia locality section is included within locality adjustment section 704 in response to pricing tool 137 recognizing that the respective information records for services.
101891 in the present example, the anesthesia locality section includes an anesthesia location field.
704e and an anesthesia location rate- field 704f The anesthesia location field 704c IS for receiving and.
displaying an entry specifying the location at which the services indicated as being commonly associated with. the selected medical specialty of general surgery within service pricing information database 114M would be-Performed, and thean.esthesia location rate field 704f is configured to provide a rate adjustment factor for the pricing information. included in. detailed pricing information. section. 708 for the services indicated as being commonly associated with radiology.

101901 Anesthesia location rate field 704f is provided for receiving and displaying a geographic adjustment rate for physician services That, by. default, is derived and provided by pricing tool 137 in correspondence with the anesthesia location entry that is currently specified within anesthesia location field 704e.. More particularly, in exemplary embodiments, pricing tool 137 can be configured to access the information pertaining to anesthesia rate adjustments in service pricing information database I 14n corresponding to the anesthesia location entry that is currently specified within anesthesia location field 704e and derive a corresponding geOgraphie adjuAinent rate that is displayed as. a -default yalutt daft.
anesthesia location rate field 704e. The corresponding geographic adjustment rate can be derived, for .ex,ample, based on. a ratio of the -CMS anesthesia conversion :factor to a standard, national anesthesia conversion factor.
101911 Specification of anew location within anesthesia location field 704e,.
pricing toed 137 can be configured to dynamically access the information pertaining to physician rate adjustments in geographic -factors database I .14n corresponding to the newly-specified phySician-locationtatry within anesthesia. location field 704e and derive a corresponding geographic adjustment Tate that is displayed as the current value within anesthesia location rate field 704f. In the present example, pricing WO! 137 is also configured to allow the provider user to directly access anesthesia location rate field 704f and specify a desired value 'for the geographic adjustment rate that will override the particular geographic adjustment rate that i.s derived by pricing tool. 137 based on thelocafion entry within anesthesia location .field 704e and displayed as the current value within anesthesia location rate .field 7041 The effect of such an entry- being submitted within anesthesia rate field 704f will be described below with reference to detailed pricing information section 708.
101921 With continued reference to the example screen shot illustrated in FIG.
7B, as noted above, pricing tool 131 has, in response to the user selection "General Surgery" from medical specialty drop-down menu 702, configured the user interface options and populated theinformation displayed: within rate adjustment section 706:
1=01931 With. continued reference to. the example screen shot illustrated in.
FIG. 7B, as noted above, pricing tool 137 has,. in response to the user selection "General Surgery"
from medical specialty drop-down menu 702, configured the user interface options and populated the infOrmation displayed within detailed pricing. i nforrnaticin section 70:8, In general, as shown in FIG.
7B, detailed pricing: information section 708 is generated by pricing toOl .137 a -a table with various interactive user interface controls that includes, in addition to procedure 'column .711, facility price column 7IZ physician price column.
713, additional fee column 714, and total. amount column 715:,. -an anesthesia price column 716. As illustrated. in FIG, 7B, the expanded information for a particular procedure category further includes, for each service categorized as a sub-procedure of the procedure' category, in addition to a medical code number used to identify the service, a base facility rate, a base physician.
rate, an adjusted facility rate, and an adjusted physician rate.as described above with reference to FIG. 7A, a. base anesthesia rate and an adjusted anesthesia rate.
101941 In the present example, as further illustrated in. FIG, 714, the expanded information fel- a particular procedure category further includes, in addition to physician, price field 711a and facility price field 711 b, an anesthesia price field 711e that specifies a price that will be applied by The provider user for each anesthesia service -performed in assoCiation With the services that have been, categorized under the expanded procedure category.
[01051 For example, pricing tool 13/ can be configured to enable the user select between using the average of the corresponding adjusted anesthesia. rates: for all services listed in the expanded display for a procedure category for the price values within anesthesia prieelield 711 e -or the highest of the corresponding-adjusted anesthesia rates for all:services listed in. the expanded display for a procedure category for the price values within anesthesia price field 711e. In exemplary embodiments, pricing tool 137 can be further configured to allow the provider user accessing service pricing page 700 to access anesthesia price field. 711e to input a particular price value within this field.
101961 As further indicated in the example screen shot illustrated in FIG. 7B, the row entry for a particular procedure category will include a pricing value under anesthesia price column 716 that corresponds to the pricing value, that is specified within anesthesia price field 711c in the expanded display for the procedure category. In this regard, pricing tool 137 can be configured to -dynainieally update the pricing value provided under anesthesia price column 71.6 in response to changes to the price value within anesthesia price field 711c. As discussed above, in exemplary configurations of pricing tool 117, such changes -to the price -value within anesthesia price field 711e in the expanded display for a particular procedure category may occur in response. to. changes to any of the current. value that is specified in anesthesia location rate field 704f of locality adjustment section 704, the current percentage value that is specified in anesthesia rate adjustment field /06c of recommended rate adjustment section 706., changes in the particular method employed by pricing tool 137 to derive and set the price value within anesthesia price field 711c, and directentries Of a particular price value by a provider user within anesthesia price -field 71.1c.

101971 As further illustrated in FIG, 7B, the row entry for a particular-procedure category can include a pri cing value under total amount column 715 that is provided as a. sum. of the price values hated under facility price column 712, physician price column 713, anesthesia price column 716, and, if included, additional fee column 714 in. the row entry for a particular procedure category. This represents the actual price at which each service listed in the expanded display for a procedure category would. be offered for purchase via marketplace system 100 as a bundled set of services from the provider Um-liodeashig service pricing page 700 via provider portal 130. In exemplary embodiments, pricing tool 137 can be further configured to provide an option via user interface controls implemented -within = service pricing page 700 for a. provider user that is accessing the service pricing page 700 and has selected a medical specialty from drop-down menu 702 for which pricing tool 137 recognizes that: the respective information records for services:indicated -as-being commsaly-As,..so4ated ---17111111e selected medical specialty within service pricinginformation database 114m include information records having an indication that the service is. a: primary service of a bundled set. of services that a secondary -service associated with the primary service in the bundled set is an anesthesia procedure to not include Information and options pertaining to the associated anesthesia procedures and anesthesia pricing information within the service pricing page for the selected medical specialty.
101981 FIG. IC is a screen shot illustrating a third -example ofa graphical user interface provided by service pricing page 700 for a user accessing provider portal. 130 in association with a registered hospital system account. In the example illustrated in FIG. 7C, the user has selected "GI"
(gastroenterology) from medical specialty drop-down menu 704 and priCingtool 137 has, in response to this selection, configured the user interface OptionS anti populated the information displayed Within locality adjustment section .704, rate adjustment section 706, and detailed pricing information section 708 in accordance with the selection of "OP from drop-down menu 702..
101991 In general, as shown in FIG. 7C, detailed pricing information section 708 is generated by pricing tool 131 as a table with various interactive user interface controls that includes, in addition to procedure column 711, facility price column 112, physician price column 713,.
additional fee column 714, and total amount column 71.5, a pathology price column 717.
102001 As illustrated in FIG. 7C, the expanded information fora particular procedure category further includes, for each service categorized as a sub-procedure of thepraxiwiairenategaty; 'in addition to a medical code number used to identify the service, a base facility rate, a base physician rate; an adjusted facility rate, and an adjusted Physician rate as described above with.
reference to FIG. 7A, a base pathology rate. The base pathology rate for each service listed in the expanded display is obtained by pricing tool 137 from the patholegy rate. for the. service that is stored within the respective, information record maintained for the service Within service pricing information database 114m for display within detailed pricing information section .708.
102011 In the present .example, as further illustrated in FIG, 7C, the expanded information for a particular procedure category further includes, in addition to physician price field 711a and facility price field 71.1 b, a pathology price field 711 d that specifies a price that will be applied by the provider user for each pathology service performed in association with the services that have been. categorized under the expanded procedure category. In exemplary embodiments, pricing tool 137 can be configured to derive and include an initial, default pride value within pathology price field 711d. For example, pricing tool 137 can derive and set the default price value within pathology price field 7.11d as the average of the base pathology rates for all services listed in the expanded display for a. procedure category. In exemplary embodiments, pricing tool 137 can be further configured to allow the provider user accessing service pricing page 700 to access pathology price field 71.1d to input a particular price value within this field, 102021 As further indicated in the example screen shot illustrated in FIG. 7C, the row entry for a particular procedure category will include a pricing value under pathology price column 717 Thar corresponds to the pricing value that is specified within pathology price field 711d in. the expanded display for the procedure category. hi this regard, pricing -tool 1.37 can be configured to dynaittically update the Pricing value provided. under pathology price column 717in response tO changes to the price value Within pathology price field 711d. As further illustrated in FIG. 7R, the row entry for a particular procedure category can 'include a pricing value under total amount column 715 that is provided as a sum of the price values listed under facility price column 71.2, physician price column 713, pathology price column 717, and, if included, additional fee column 714 and anesthesia price column 716 in the row entry for a particular procedure category. This represents the actual price at which each service listed in the expanded display for a procedure category Would be offered for purchase as a bundled set of services via marketplace system 100 from the provider user accessing service pricing page 700 via provider portal 130.
102031 in exemplary embodiments, the functionality that is provided within provider portal 130 for users of -hospital system accounts can Anther include a set of user interface controls implemented by service selling service 135 that can be accessed by .a user of a hospital system account to sell prepaid purchases of services to a customer in-person by operating a client system located at, for example, a medical clinic being -visited by the customer to access application server -11.6. In this regard, service soiling service 135 may provide. functionality allowing a user of a hospital system account to sell, in addition to services that are offered for purchase by the hospital within server system 100, services that are constructed by -a user of a hospital system account, including bundled sets of services.
102041 In exemplary embodiments, the user interface implemented by account management service 131 may be further configured to provide user interface controls for requesting authorization for payment of a predetermined fee to gain access to the ability to offer healthcare products for putellase=
within marketplace system 100. Such a fee may beõ for example, a one-tit-Me charily or a. periodic:charge (such as a monthly, biannual, or annual fee).
102051 'Upon the user indicating an intention to offer a. healthcare product for purchase (for example, by selecting a "Offer Service" tab within the 'Pharmacy account page:implemented by provider portal 1.30), the user wilt be able to initiate a. product offering with, product management service. .134 to offer a healthcare product for purchase via server system 110.
1020611 Upon the user indicating an intention within. the pharmacy account page implemented by provider portal. 130 to access various account management functions, the pharmacy administrator can access various user interface elements provided by account management service 131 to, for example;
manage pharmacy and payment or compensation information, Manage information pertaining to products offered for purchase by the pharmacy, and view a history of transactions performed. for products offered for purchase by the pharmacy within server system 11Ø
I02071 In exemplary embodiments disclosed herein, because certain healthcare information may be consideredhighly confidential, marketplace system 100 canbe implemented to provide for a high-level of security for information transferred between Clientapplications executing on client systems 142 and application server 116. For illustration, whenever applicable, marketplace system 1.00 (for example, for operations and. functionalities) may be implemented to comply with requirements under the Health Insurance Portability and Accountability Act (1-11PAA). For example, if certain type of information -should not beaccessible to a specific party (for example, a prescription product manufacturer or service provider) according. to 1-11P:AA. requirements OT other confidentiality concerns, system 100 can implement information-control or information-protection measures that ensure the specific party cannot access that type .of information. As another example, to protect patient privacy, information 'transmitted over a computer or 'communication network, such- as information 'transmitted between application server 116 and any client system 140 and electronic messages transmitted by server system 110, can be encrypted. In exemplary embodiments, system 100 can be HIPAA-validated to ensure.
privacy and comply with all requirements, 102081 FIG. 8 illustrates a flow chart of an insurance policy stored in. the insurance database (114o, shown in FIG. 2) executed by the application server (.1.16, shOwn in FIG.. 2).
The insurance database is programmed to provide an optimized bundled price. 802 for healthcare services.
For exemplary purposes, the system maximizes .collections at. each phase in the user's care cycle. For various phases.
there is an option for paying the payment 804. The patient is referred or scheduled for a procedure, where the patient may receive a push notification to: pay prospectively.
Alternatively; the patient checks-in at a provider's location and the patient pays: at the point of service such as by cash, card, digital wallet, etc. Alternatively, the patient is made to pay after services are provided and/or at discharge wherein, the patient receives a push notification to pay retrospeetively.
102091 Further, each of the patients information is monitored such as but not limited to a doctor's order/schedule (for example, CRC Redox), propensity to pay data (C.TIC-Vendor), benefit Status (CRC-ribbon health) and CareCredit pre-approval. Based on the patient intbrmation, a doctor's order is matched. Further, the price is set based on the patient's capacity and/or willingness:to pay for the service and/or product_ Further, each payment is monitored.to check if a patient is paying out-of-pocket. The.
system compares the bundled Price. to the remaining. patient deductible to determine the patient's sIt'stpheif3rallry for the services and/or product.. Furthermore, patients are allowed to pay either in fiill or through CareCredit.
102101 The system is configured to pay the optimal price in fnii every time to the hospital/phy.sicianlpharmacy and any associated service provider. The-procedure is transparent and acceptable to both patients and the provider. The service providers collect the maximum data on the patients who are willing to pay, Further, the hospital may leave revenue on the table by charging less than what patients are willing to pay [02111 The application server (.116; Shown in FIG.. 2) processes the data stored in the insurance database 114o and allows the user to access the insurance information via, an insuranee management service (14, shown in FIG. 2). The hospital sends an electronic claim to the system after care is delivered to the patient. The -system then distributes payment and sends an electronic remittance file based on the information stored in the insurance database 114o. The system passes the electronic claim to the insurance company 806 to update the patient's accumulator (not for reimbursement). The insurance 806 then notifies the system of accumulator status. The system then .sends an update to the.
patients.
102121 FIG. 9 illustrates a block diagram of a virtual payment system-manager 170 communicating with a client system in a healthcare marketplace system in accordance With another exemplary embodiment of the present invention. As noted above, exemplary embodiments of the present invention may be implemented to provide, a. virtual payment system for facilitating and accounting for the exchange of payment for services and products purchased by (or otherwise.
purchased on behalf of) patients and offered by healthcare providers via the creation, transfer, and redemption of Virtual funds within A central server system 110.
102.131 In some exemplary anibodiments, the virtual payment. system manager 170 is configured to facilitate the tracking and rnanagement of promotional credits that may be offered by the providers of a healthcare marketplace system 100 to registered users of the server system 110 for taking certain -ea.le.An the system in association with their registered accounts.
102141 For example, the providers of a marketplace system 100 may offer a.
promotion to potential customer users in whicheach user, upon completing registration of a respective customer account with server system 110, will receive a credit of a specified amount of funds (far instance, a credit Of $25) that the customer user may use to purchase services and/or products offered within marketplace system 100 by provider users that are registered with server system 110.
102151 In one embodiment, the virtual payment System manager 170 is configured to, access the database server 112 to create the respective account information record. for the virnial money account for the customer within :the virtual money account database 114o, and access database. server 11.2 to create a new virtual fund corresponding to a specified amount for a promotional credit within the database of virtual fund objects included, in the respective account information record.
102161 In this regard, the virtual payment system manager 170 generates a unique identifier for the new virtual Rind object being created and defines the attributes of the object to include an indication of the value of the corresponding virtual funds, the unique identifier generated for the object., an indication that the original funding source IS a credit that was conveyed by theproviders of marketplace system 100, a creation timestamp for the object, an indication that the corresponding virtual fun& for the object are not presently allocated to use as payment for an offered service or product' purchased within the marketplace system, and, optionally, an indication of an expiration date for the promotional credit by which-the-customer user must use the credited funds to purchase the services and/or products offered within marketplace-system 1-00.
102171 In such an example, the virtual payment system manager 170 is configured to further access database server 112 to also create a corresponding.new virtual fund object for the pitmotional credit within the container of virtual fund objects included in the respective account information record for a ilaspeoliWifietual money account that is being maintained within virtual money account database 114o for an entity that. provides, the marketplace system (which may have already been established, for example, by a backend adininistrator of 'server system 110). More specifically, virtual payment system manager 170 generates a: unieue identifier for the new Virtual fund object being treated and define the attributes of the object. to include an indication of the value of the corresponding virtual funds as a negative value, the unique identifier generated for the 'object, an indication that the. original funding source is-a corresponding amount of real currency hcldWithin an external financial account maintained.
by the providers of marketplace system 100 (and thereby owed -to the virtual, payment system. by -the marketplace system providers), and. a creation tirnestamp for the Object.
102181 In one embodiment the virtual payment system manager 170 is also configured to, upon.
creating the -corresponding virtual fund objects for the promotional ereditwi thin the respective account information records for the. virtual money accounts for-the custOmer user and the entity that provides the marketplace systein within virtual Money account database-114o; updates the total Mande values and available balance values included, in the sets of general information within the respective account information records for the respective virtual money accounts appropriately to reflect-the newly-created.
virtual fund objects.
102191 In the example illustrated in FIG. 9, the particular components that are utilized for proaiding the virtual payment system are integrated within system' 100 in conjunction with the components of the system AS described -above and herein below with refereaee to the exemplary embodiments illustrated FIGS. 1 and 2. In particular, as depicted in Fla 9, application server 116 is further implemented. to include virtual -payment system manager 170. As also depicted. in FIG. 9, data store 114 further comprises virtual money account database 114p, which is maintained by database server 112, is accessed by application server 116.
102201 in the present exemplary embodiment, virtual payment system manager 170 is shown in FIG:, 9 as including a virtual account management module 171, a transaction tracking module 172, a communication module 173, a virtual fund creatiOn and disbursement module 174, a virtual payment processing module 175, and an adjustment processing module. 176. In general, the various modules implemented Within virtual payment system Manager 170 in the present exemplary embitidiments are configured to interact with one another, customer portal 120, provider portal 130, and data store 114 via database server 112 to perform the various operations described in the examples. provided above pertaining to exemplary embodiments in which a virtual payment system is implemented within server system 11Ø.
102211 The virtual account management module 171 is configured to access virtual money account database 11.4p to create respective account information records for respective virtual money accounts of .participants to transactions conducted within marketplace system 100. The virtual account management. .module 17.1 retrieves, maintains, performs .modifications to respective information account records as necessary M response to participants that are logged-tit to server system 110 accessing the account management functions provided by account management service 122 or account Management service 13.1 to manage and viewinformatiOn pertaining to the respective virtual money accounts for the participants within the virtual payment system.
102221 Transaction tracking module 172 cart, for example, be configured to dynamically perform updates to the .accounting details pertaining to transactions conducted within the virtual payment system.. The module 172 dynamically calculates and performs updates to the balance values that are included within the general information in the reSpectiveaccount intbrination records for the respective virtual Money accounts in response to transaCtions conducted within the virtual payment. system 102231 Further, module 172 dynamically -perfornit- processing for handling virtual fund objects- that have been created within the virtual .nioney zittotuit based on promotional croditsthat have expired in response to such expirations occurring, and dynamically perform processing for reversing payment processing operations performed within the virtual payment system for purchases of offered services and products that have not been redeemed within expiration periods specified for sueb purchases in response. to. the end of such expiration periods being reached 102241 Communication module 173 can, for example, be configured to :generate notifications and reports:with respect to virtual money accounts managed and transactions conducted within the virtual payment system:, transmit generated notifications and reportsto corresponding components of customer portal 120 and provider portal 130, receive notifications and information from corresponding components of customer portal 120 and provider portal 130, and process such received notifications and information.

102251 Virtual fund creation and disbursement module 174 can, for example, be configured to implement -functionality-for creating or instantiating. neskvirtual fund objects within -respective account information records for virtual money accounts as needed for transactions conducted within the virtual payment system, processing disbursal requests within the virtual payment.
system (including functionality for deleting virtual fund objects), and performing automatic-periodic disbursals for virtual money accounts within the virtual payment. system.
10226.1 Virtual payment processing module 175 can, for examplmi Itieffeentissrad. re implement functionality for performing operations for facilitating payment processing within the virtual payment.
systeM for purchases of Offered services and products by customers users registered with server systeM
110, as well as to perform corresponding updates to the attributes defining the virtual fund Objects within the respective .account information records in response. to perfenning such operations for facilitating payment processing within thc virtual payment: system. Adjustment-processing- module. 176 can, fbr example, be configured to implement functionality for- performing operations for processing cancellation requests, refund requests,. and other modifications to purchases of offered services and.
products for which payment processing is handled within the virtual payment system, as well as to perform corresponding updates to the attributes defining the virtual fund objects within the respective account intbrmation -records in response to performing such operations for processing cancellation requests, refund requests, and other modifications to purchases within the virtual payment system.
102271 In exemplary embodiments disclosed herein, because certain healthcare information may be considered highly confidential, marketplace system 100 can be implemented to-provide fora high-level of security for information transferred between client applications executing on client systems 142 and application server 116. For illustration, whenever applicable,. marketplace system 100 (for example, for operations and furictionaliti es) may be implemented tocomply with requirements underthenealth Insurance Portability and Accountability Act (IIIPAA). As another example, -to protect patient 'privacy, information transmitted over a computer or communication network, such as information transmitted between application server 116 and any client system 140 and electronic messages transmitted by server system 110, can be encrypted. In exemplary embodiments; system 100 can be HIPAA-validated to ensure privacy and comply with all requirements.
102281 R.G. 10 illustrates -a block diagram of the application server showing a deductible checker, shopping cart -and drug discount card in accordance with another embodiment of the present invention.
The.. application server 116 may further include a deductible checker 1002 to look up the patient's deductible, a shopping cart 1004 for providing details of pricing to the user, and a drug discount card 1006 forthe user for subscription of healthcare Services.
102291 The deductible checker 1002 allows patients/user's to look up their deductible and to let the user know whether the healthcare service offered is at better and/or competitive prices. The Shopping cart 1004 is automatically .communicated to the registered users with the pricing details of the healthcare services with which they intend to proceed. The shopping cart 1004 is automatically communicated such as but not limited to email, SIvIS, flashing on the graphical user interface, and any other similar communication networks etc. The shopping Cart 1004 automatically checks for any deductibles, insurance and accordingly generates the pricingfor the user.
102301 In another embodiment, the shopping can 1004 is verified by an mtalyst to confirm the pricing. Thus., the shopping cart is sent to the analyst system and 'then to the user. ThiS allows the user to pie-pay for the. healthcare services. Further, the shopping cart 1004 is generated with the right bundled prices (e.g. accounting for discounts when certain procedures arepurchased together etc.). The drug discount card 1006 is provided to the users who subscribe to the healthcare services 102311 FIG. 11 is a process flow illustrative of an example aspect of patient lifecyde event triggered shopping cart provisioning. design. The method depicted in FIG. 11 is given from the perspective of an exemplary patient lifecycle event tri ggered shopping cart provisioning engine (SCPE) implemented via processor-executable program. instructions executing on the SCPE processor 604, depicted in .F10, 5. in various embodiments, the processor 604 implementing the process 1100 may-be configured in an exemplary system. 100 as described herein with reference to any of Has.. I, 6, and 9.
For -example, the depicted process may execute as processor executable program instructions on processor 604 configured in the application server 116, depicted in FIGs. 1, 6, and 9. In various embodiments, the method depicted. in FIG. 11 may also be understood as from the perspective of proee.ssomexectitable program instructions executing on a -mobile device operably coupled with the network 150, depicted at least in. FIGs. 1, 6, and 9. In the illustrated.
embodiment, the SCPE. executes as program instructions on the processor 604, depicted in FIG. 5. In some embodiments, the SCPE May execute as a cloud service communicatively and operatively coupled with system services, hardware resources, or software elements local to and/or external:10 the SCPE processor 604, 102321 The depictedmethod 1100 begins at step 1105 with the Processor 604 receiving an electronic message comprising a patient medical data update. The electronic message may include an ERR
(Electronic Health Record). The. EHR may include updated patient medical data.
The patient medical data may be upd.ated. relative. to historical patient medical data. The processor 604 may access and store.
the patient medical data using the. customer profile database 114a, depicted in FIG. 2.
102331 Then, the method continues at step 1110 with the processor 604 determining, if a patient lifecycle event is detected based on. the updated patient medical data. The processor 604 executes the process 1200, depicted by FIG.. 12 and described herein, to determine if a patient lifecycle event is detected. The processor .604 may determine if a patient lifecycle event is detected based. on accessing and storing patient,. practice, or condition data using, for example, any of customer profile database 114a, practice group profile database 114c, or condition information database 114f, depicted in FIG.. 2.
102341 Then, the method continues at step 1115 with the -processor 604 performing a test to determine if a patient. lifecycle event is detected, based on the execution of process 1200 by the processor 604 at step 1110. Upon a determination by the processor 604 at step 1115 that a patient- lifecycle event has not been detected, -the method continues at step 1105 with the processor- 604 receiving an electronic message coMptisi rig a. patient medical data update.
102351 Upon a determination by the processor 604 at step 1115 that. a patient lifecycle event has been detected, the method continues at step 1120 with the processor 604 executing the process 1300, depicted by FIG. 13 and described herein, to determine a medical service bundle to be offered. The.
processor 604- may -determine the medical service bundle based on accessing and storing medical service, data using any of customer profile database 114a, physician profile database 114b, practice group profile database 114eõ condition information database 114f, or available service database 114g, depicted in FIG. 2.
1.02361 Then, the. Method -continues at step 11.25 with the processor 604 executing the process 1400, depicted by FIG. 14 and described- herein, to offer the medical service bundle for eelectien and prepayment. For example, the processor 604 may offer the medical service bundle for selection and payment through the customer portal 120 (depicted by FIG. 2), using techniques similar to. those described herein with reference to the account management service 1.22 and purchasing. service 126 (both depicted by FIG. 2).
102371 Then, the method continues at step 1130 with the processor 604 performing a testto determine if payment' for the medical service bundle has been received. Upon a determination by the processor 604. At step 1130 payment has not been received, the method eontinues at step 1105 with the processor 604 receiving an electronic message comprising a patient medical data update.
192381 Upon a determination by the processor 604 at step 1130 payment was received, the method continues at step 1135 with the processor Ofei...seliedelita the paid services. In various embodiments, the method may repeat. In some designs, the method may end.

102391 FIG, 12 is a process flow illustrative of an example aspect of patient lifecycle event triggered Shopping cart provisioning design. The method depicted in Ha 12 is given from the perspective of an exemplary patient lifecycle event triggered shopping cart provisioning engine (SCPE) implemented via processor-executable program instructions executing on the SCPE processor 604., depicted in FIG.. 5.
In. various embodiments, the processor 604 implementing the process 1200 may be configured in an -exemplary system 100 as described herein with reference to any of FIG's. 1, 6, and O. In various embodiments, the method depicted in. FIG. 12 may also be understood as from the perspective of processor-executable program instructions executing on a mobile device operably coupled with the network 150, depicted-at least in FIGs. 1,.6, and 9. :For example, the depicted process may execute as processor executable program instructions on processor 604- configured in the application server 116, depicted in .FIGs. 1, 6, and:. in theillustrated embodiment, the SCPE executes as program instructions on the processor 604, depicted in .FIG. 5. In some embodiments, the SCPE may execute as a cloud ,scrvice.; coruntinica.tively and operatively coupled. with system. services,, hardware resources, or software elements local to and/or external to the. SCPE processor 6.04. The depicted method 1200 begins at step 1205 with the processor 604 performing a test to determine if the patient is a new patient.
The processor 604 may implement. the test to determine if the patient is a new patient: based on patient medical data encoded by an MIR, 102401 Upon a determination by the processor 604 at step 1205 the patient is a new patient, the method continues at step 1245 with the processor 604 indicating th the invoking process that a patient lifecycle event occurred, 102411 Upon a determination by the processor 604 at step 1205 the patient is not a new patient, the method continues at step 121.0 with the processor .604 determining the patient's historical patient lifecycle state based on patient medical data. The historical patient lifecycle state may be the patient's lifecycle state. preVits4othe lcutrentalvocation of proeeas 1200. The historical patient lifecycle 'state may be administratively assigned. The historical patient lifecycle stale may be programmatically determined by the processor 604 as .a function of patient .medical data encoded by an EHR. The.
processor 604 may determine the historical patient- lifecycle state - based on, for example, patient medical data encoded by a previously processed EHR, administratively configured patient medical data, or an administratively configured lifecycle state. In -illustrative examples, the EHR may encode patient physiological data such. as, for example, a laboratory test report indicating the concentration of a substance in the patient'sbody, or a test result indicating a measured patient physiological parameter such as blood .pressure, 'heart. rate, weight, or height. The processor 604 may programmatically determine the historical patient lifecycle state based on, for example,, operations such as comparing,. or correlating, patient medical data encoded by an EHR with one. or more range of similar data to determine the patient lifecycle state. In an illustrative example, the processor 604 may determine, the patient lifecycle state to be new patient, well patient, acute care patient, chronic care patient, or recovering patient. Other patient aifeeyele states may be determined by the processor 604 based on.
programmatically -analyzing patient medical data such as laboratory results and measurements to determine correspondence with standardized or administratively determined medical data ranges. For at step 1210 the processor 604 may determine a patient with a blood pressure hi a.
predetermined range is an acute care patient based on patient. medical data encoded by an ElaR.
102421 Then, the method continues at step 1215 With the processor 604 determining the current patientlifecycle state based on updated patient-medical data. The processor 604 may programmatically.
determine the current patientlifecycle state based on updated patient medical data encoded by an .EHR.
The ERR encoding updated patient medical data may be provided as input to the system as a result of a patient's examination by a medical professional.. The. EHR. encoding updated patient. medical data may be provided as input to the system as a result of a measurement by a doctor during a patient visit.
The UM encoding updated patient medical data may be provided as input to the system as a result of.
a measurement remotely performed. by a patient in a care context such as telemedicirre, or self-care by the patient in the patient's home. The operations perfeemed by the processor 604 to detenuine the current patient lifecycle state at step 1215 are in. line with the operations performed by the processor 604 at step 1210 to determine thehittOrical patient lifecycle state. in any ease, the processor 604 at step 1215 determines the current patient lifecycle state based on evaluating patient medical data. that has been updated. In this example, the patient medical data has been updated.
relative to the patient medical data analyzed by the processor 604 at step .1210 to determine the historical patient lifecycle state.
102431 Then, the method, continues at step. 1220 with the processor 604 comparing the historical patient lifocycle State determined by the processor 604 at step '1210 with the current patient lifecycle state determined 'IV tbe pittiKSOttinis: at step 1215, to determine if a.
patient lifecycle event occurred based on the comparison. In an illustrative example, -the processor 604 may compare the historical and current lifecycle states based on comparing archived patient medical data-With updated patient medical data.
102441 Thee, the Method continues at Step 1225 with the processor 604 performing a test to determine if the patient condition changed. The processor 604 may determine if the patient condition changed based on comparing -archived patient medical data, such as, for example, a previous blood pressure measurement or laboratory test result, with patient medical data updated by a.
more recent measurement or result. For example, the prucessor -6-04 may determine patient condition changed if a more recent test result or measurement is in a different range than a previous test result or measurement. Upon, a determinatiOn at step 1225 by the processor-604 patient condition' changed, the method continues at step 1245 with the processor 604 indicating to the invoking process that a patient lifecycle event occurred.
102.451 Upon a determination by the processor 604 atstep 1.225 the patient condition did not change, the method continues at :step 1230 with the processor 604 performi nu. a test to determine-if the' patient-status changed. The processor 604 may determine if patient Status changed based on adminiSkatively configured or programmatically determined patient.statits. The processor 604 may determine if patient status changed based on comparing archived patient data With updated patient data. The patient data used by the processor 604 to determine patient status may be medical, billing, payment, insurance, or other data. In an illustrative example, patient status may be new patient, activepatient, inactive patient, former patient, referral patient, or referred patient. For example, the processor 604 may determine patient status changed from active to inactive if the patient has not kept. an appointment for at: least a predetermined time period. The processor 604 may determine the patient is a new patient if patient records were not previously accessible to the system. A referral patient may have been referred from another medical practice, and in view of this, patient care of such a patient may benefit from customized consideration, in line with what 'may be known by one of skill in the art.. A.
referred patient may have specific goals resulting in. the patient's referral to another medical.
practice, or to a specialist, for example. In an illustrative example, the referred patient May benefit from optional services offered through the specialist's practice. JP any case, upon a determination by the processor 604 at step 1230 the patient status changed, the method continues at step 1245 With the processor 604 indicating to the invoking process that a:patient lifecycle event occurrect 102461 Upon a determination by the processor 604 at step 1.230 the patient status did not change; the method Continues ...'step 1235 with the processor 604 performing a test to determine if another patient lifecycle event occurred. The operations petfortned by the processor 604 at step 1235 to determine if another patient lifecyele event has occurred may include. comparing archived patient data with updated patient- data encoded. by an .EIIR received with a notification or administratively configured. in the system. In any case-the processor 604 may determine a patient lifecycle -event other than: a Change in patient condition or Status has occurred, based on comparing the archived. and updated patient data, to determine if a Change has occurred based on the comparison. The change detected by the processor 604 may be any change in patient data that has. not been identified previously.

102471 Upon a determination by the processor 604 at step 1235 another patient lifecycle event has not occurred, the method Continues at step 1250 with the processor 604 indicating to the invoking process that. no patient lifecycle event occurred.
102481 Upon a determination by the processor 604 at. step 1235. another patient. lifecycle event has occurred-, the method continues at step 1240 With the processor604 determining the patient lifecycle event that did occur, based on the patient lifecycle state .compari son performed by the processor 604. at step 1220. The operations performed by the processor 604 to determine the patient lifecycle event at step 1240 are in line with the operations performed. by the processor 604 at step .1225 and step 1230 with deeper analysis of the patient data at: -step 1240. The patient data analysis performed by the processor 604- at step 1240 may include lifecycle event determination based on patient data input to a predictive analytic,, machine learning, or artificial intelligence model trained with patient data.
102491 Then, the method continues at step 1245 with the processor 664 indicating to the invoking process that. a patient lifecycle event- occurred. In various embodiments, the method may repeat. In some designs, the method may end.
102501 FIG. 13 is a process flow illustrative of an example aspect of patient lifecycle event triggered shopping cart. provisioning design. The method depicted in 'FIG. 13 is given from the perspective of an exemplary patient lifecycle event niggered.shopping cart provisioning engine (SCPE) imPlemented via processor-executable program instructions executing on the SCPE processor 604, depicted in. FIG. 5.
In VIITi011S embodiments, the processor 604 implementing the proetSs 1300 May be configured in an exemplary system 100 as described. herein with reference to any of .FIGs. 1, 6, and 9. For (maniple, the depicted. process may .execute as processor executable program instructions on processor 604 configured in the application server 116, depicted in FIGs. 1, .6, and -9. In various embodiments, the method depicted in FIG. 13 may also be understood as from the perspective of processor-executable program inStructiOns executing on a mobile device operably coupled with the netWork 150, depicted at least in FIGs. I., 6, and-9.. In the illustrated embodiment, the SCPE executes as. program instructions on the processor 604, depicted in FIG. 5. In some embodiments, the SCPE..may execute as a eloud-serviee communicatively and operatively coupled with system services, 'hardware resources; or software elements local to. and/or .external tothe SCPE processor 604. The depicted method 1300 begins at step 1305 With the processor 604 creating:a default service bundle. Th.e.default service bundle created by the processor 604 may include a service for which a patient is already registered. The service for which the patient is already registered may be a primary serviceõ The default service bundle may include a service: window parameter related to a bundled service, such as, for example, location., facility, time slot, or doctor. The processor 604 may create the default service bundle as an empty bundle with no service, Or no setvice-Window.
(02511 Then, the method :continues at step 1 MO with the processor 604 identifying. appropriate optional services to offer to the patient based on patient medical data..
Theprocessor 604 may determine an optional service is appropriate to a patient if the optional service considered is not contraindicated.
by medical care -standards, in view of the patient's medical- condition. The patients medical .condition may be determined by the pi-oceSsor 604 using. techniques similar to those described herein with reference to process 1200,:depi eted by FIG. 12.
102521 Then, the method continues at step 1315 with the processor 604 determining if any optional services determined at step 1310 by the processor 604 as appropriate are medically indicated for the patient based on the current patient lifecycle event and. patient medical data. The processor 604 may determine an optional service is .medically indicated for a patient if the service is related by medical care standards to the. patient condition, for example, f a medical care standard suggests a doctor treating a patient with a given condition should also. consider treatment with a particular class of drug or screening by a particular test for another condition, the processor 604 may determine that consideration of the drug treatment or screening test may be medically indicated for the patient based on the current. patient lifecycle. event and patient medical data.. The current patient lifecyCle event may be determined by the processor 604 using techniques similar to those.
described herein with reference to process 1200, depicted by FIG. 12.
102$31 Then, the method continues at step 1320 with the processor 604 performing a test to determine if medically indicated procedures should be added to the default service bundle, based on the determination by the processor 604 at step 1315, as to whether appropriate optional services may be medically indicated. Upon a determination at step 1320 by the processor 604 some appropriate optional service-is medically indicated, the method continues at step 1325 with the processor 604 addingat- least one medically, indicated appropriate optional service, to the default service bundle. The service, added to the service bundle.: by the processor 604 may include a. service window parameter related to -the added service, such as, for example, location, facility, time slot,- or doctor.
102541 Upon a determination at- step 1320 by the processor 604 no appropriate optional service is medically indicated, the method continues at step 1330 with the processor 604 performing a: tea to determine if a follow-up service may be added to the service bundle. A follow-up service may: be, for example, mandatory,auch as a post-surgical visit for suture removal. In sotnecases, a follow-up service may be optional. A candidate fellow-up service: considered by the processor 604 for addition to the service, bundle may be a follow-up service to a primary service, or a follow-up service to an optional service.. Upon a determination by the processor 604 at step_ 1330 some follow-up-Service may be added to the Service bundle, the method continues at step 133:5 with the processor 604 adding: at least one follow-up service to the.:service bundle.
1025.9 Upon a determination by the processor 604 at step 1330 no follow-up service may be added to the service bundle, the method continues at step 1340 with the processor 604 determining if additional optional services are available within the same service window (for example, location, facility, time slot, or doctor) as a piiirnary service.
[02561 Then, the method continues at step 1345 with the processor 604 performing .a test.to determine if an -optional service available in the. same service window as a primary service may he added to the service bundle. Upon a determination at step 1345 by the processor 604 an optional service available in the same service window as a primary service may be added to the service bundle, the method continues at step 1350 with the processor 604 adding to the service bundle an optional service available within -the same service window as a -printery service.
102571 Upon a determination at step 1345 by the processor 604 no optional service available in the same service window as a primary service may be added. to the service bundle, the method continues at step 1355 with the processor 604 determining if performing bundled services in another optional service window (that is, a service window different from, or alternative-to, the Ornery service window) would improve resource.utilization. The resource utilization data evaluated by the processor 604 at step 1355 May include facility, equipment,. or medical -professional cost per unit time, percent idle time, or percent active time, The processor 604 may determine..if resource utilization may be improved based on comparing calculated projected utilization of one or more resource based on the resource utilization data for more than one service window. The processor .604 may determine the relative cost to provide service in various service windoWs,; to. facilitate offering a discount determined by the processor 604 as a function of relative resource utilization between the service Window's.
102581 Then the method. continues at step 1360 with the processor 604 performing a test to determine if offering service in an alternative. service window would improve resource utilization, based on the.
evaluation of resource utilization in optional service windows performed by the processor 604 at step 1355. Upon a-determination by the processor 604 at. step 1360 offering service in an alternaiiveservice window would. improve resource utilization, the method continues at step 1365 with the processor 604 adding an optional service window to the service bundle.
102591 Upon a determination by the processor 604 at step 1360 Offering service in an alternative service window would not improve resource utilization; the method continues at step 1370 with the processor 604 adding a prepayment discount determined as a function of relative, service window resource utilization to the service bundle offer. In various embodiments, the.
method may repeat. In some designs, the method May end.
102601 FIG. 14 is a process flow illustrative of an example aspect of patient lifecycle event triggered shopping cart provisioning design.. The method depicted in FIG.. 14 is given from the perspective of an exemplary patient lifecycle event triggered-shopping cart provisioning engine (SCPE) implemented via processor-exeeutattle program -iestructions executing on the SCPE processor 604, depicted in FIG, Si.
In various enibodimenta, the processor 604 iniplementing the process 1400 may be configured in an exemplary system WO as described herein with reference to any. of FIGs. 1, 6, and 9. For example, the depicted process may execute as processor executable program instruetions on process.ot 604 configured in the application server 116, depicted in FIGs. 1, 6, and 9. In various embodiments, the method depicted in FIG. 14 may also be understood as from the perspective of processor-executable program instructions executing on a mobile device operably coupled with the network ISO, depicted at least in FIGs. 1, 0, and 9., In the illustrated embodiment, the SOT executes as program instructionson the processor 604, depicted in FIG. 5. In some embodiments, the SCPE may execute as a cloud service communicatively and operatively coupled with system services, hardware resources, or software elements local to and/or external to the SCPE processor 604 The depicted method 1400 begins at step 1405 with the 'processor 604 constiuuting a shopping. cart based on the service bundle offer predetermined by the processor 604 executing the process 1300, depicted by FIG. 13.
101611 Then, the Method continues Ai Step 1410 with the processor 604 presenting the shopping cart of bundled services to a patient as a function of service. window (for example, a service window may include location, facility, time slot, doctor, or othervariables) and a prepayment discount. The shopping cart of bundled services may be presented to the patient in an email, text message, mobile app, web page, chat window, or automated phone call. Various designs may enable the patient-to select, from among the offered services presented in the shopping cart. In an illustrative example, the shopping cart may offer a choice of service window with some services. For example, given an offered service such as a particular medical procedure; a service window choice. presented to the.
patient with:the medical procedure may include a -choice of location; facility; time slot, doctor, or other optional procedures available within the service window. in some -CaStgy more than one service window may be presented to a patient for selection. The service 'window *choice may include a prepayment discount. More than one prepayment discount amount or prepayment discount percentage may be offered to a patient. The prepayment discount may vary as a function of the service window. The prepayment discount may be determined, as a. function of medical practice resource utilization, medical practice cost per unit time to provide a service in the service window, or medical professional availability during the service. window.

The prepayment discount may be a prepayment discount valid for prepayment before. a predetermined date.
102621 Then, the method continues at step 1415 with the processor 604 receiving an indication of patient. service selection from the shopping cart of bundled services presented to the patient by the processor 604 at. step 141Ø The. indication-of patient. service selection may be an indication the .patient.
did not select an offered service after a predetermined time period. The indication of patient:service selection may be art indiCatiOn the patient rejected the oMred ser-vices.
102631 Then, the method continues at step 1420 with the processor 604 performing.a testto determine if the patient selected a service. Upon a determination by the processor-604 at step.1420 the patient did.
not select a service, the method continues at step 1425 with the processor 604 optionally adjusting the prepayment discount, and the method continues at step 1405 with the processor 604 constructing a shopping cart based on a. service bundle .offer.
102.641 Upon a determination by the processor 604 at step 1420 the patient.
selected, a service, the method continuesat step. 14.50 with the processor 604 applying the prepayment discount to the -seeded services, and the method continues at step 1435 with the processor 604 accepting payment In various embodiments, the method may repeat.. In some designs, the method may end.
102651 Although various embodiments have been described with reference to the Drawings, other embodiments are possible.
102661 In the Summary above. and. in this Detailed Description,, and the.
Claims below, and in the -accompanying drawings, reference is -made to particular features of various embodiments of. the invention. It is to be understood that the disclosure Ofembodiments of the inventiOn in this specification includes all possible combinations of such particular features. For example, where a particular feature is disclosed in the conteit of a particular aspeet or embodiment of the invention, or a particular claim, that feature can also. be used .. to the extent possible ............................... in combination with and/or in: the context of other particular aspects and embodiments of the-invention, and in the invention generally.
102671 In the present disclosure, various features may be described as being optional, for example, through the use of the verb "may;"; or; through the use of any of the phrases:
"in some embodiments,"
"in some implementations," "in some designs,' "in various embodiments," "in.
various.
implementationµ", "M various designs," "in an illustrative. example," or "for example;" or,. through.the use of parentheses. For the sake of brevity and legibility, the present disclosure does not explicitly recite each and every permutation that may be obtained by choosing from the set of optional features.
However, the present disclosure is to be interpreted as explicitly disclosing all such permutations. For example, a system described as having three optional features may be embodied in sewn different ways, namely With just One of the-three possible features, with any two of the three possiblefeatures or with all three of the three possible features.
102681 In Various embodiments, elements described herein as coupled or connected may have an effectual relationship realizable by a direct connection or indirectly with one or more other intervening elements.
102691 The phrases "connected to," "coupled to" and "in communication with"
refer to any form of interaction between two or moreentitiesõ including mechanical, electrical, magnetic, electromagnetic, fluid, and thermal interaction. Two components may be functionally coupled to each other even though they are not. in direct contact with each. other. The -term "abutting" refers to items that. are in direct Physical contact with each other, although the items may not necessarily be attached together.
102701 In the present disclosure, the term "any" may be understood as number of the respective elements, i.e. as designating one, at least one, at least two, each or all of the respective.
elements. Similarly, the term "any" may be understood as designating any collection(s) of .the respective elements, i.e. as designating one or more collections of the respective elements,: a collection comprising one, at least one, at least two, each or all Of the respective elements. The respective collections need not comprise the same number of elements.
102711 While various. embodiments of the present invention have been disclosed and described in detail herein, it will be apparent to those skilled in the art that. various changes may be made to the configuration, operation, and form of the invention without departing from the spirit and scope thereof.
In particular, it is: noted that the respective features of embodiments of the invention, even those disclosed solely in combination with other features of embodiments of the invention, may be combined in any configuration excepting those readily apparent to the person skilled in the an as nonsensical.
Likewise, use of the singular and plural is solely for the sake of illustration and is not to be interpreted as limiting..
101721 The Abstract is provided to comply with 37 C. F. R. I.72(b), to allow the reader-to quickly ascertain the nature of the technical disclosure and is submitted with the understanding that it-will not be Used to interpretor-litnit the Scope or meaning of the claims.

102731 In the present disclosure, any method or apparatus embodiment may be devoid of one or more.
process steps or cOmponents, In the present disclosure, embodiments employing negative. limitations .are -expressly disclosed and considered a part of this disclosure.
102741 The term "comprises" and grammatical equivalents thereof are used herein to mean that. -other components, ingredients, steps, among others, are optionally present.. For example, an embodiment "comprising" (or "whieh comprises") oompOrtents A, B and C can consist of (i.e., contain only) components A. B and C. or can contain not only components A, B, and C but also contain .one or more other components.
102751 Where reference is made -herein to .a method comprising two or more defined steps, the defined steps can be earned out. in any order or simultaneously (except Where the context. excludes that possibility), and the method can include one or more other steps -which are carried out before any of the defined steps, between two of the defined steps, or after all the defined steps (except where the context excludes that possibility).
102761 Recitation. in a claim, of the term "first" with respect to a feature or element does not necessarily imply the. existence of a second or additional such feature or element.
102771 Reference throughout this, specification to "an.embodiinent" or "the embodiment" means. that a particular feature, . Structure, Or characteristie described in connectiOn with that embodiment is included in at least one embodiment. Thusõ the quoted phrases, Or variations thereof; as recited throughout this specification are not necessarily all referring to the same embodiment.
102781 -Similarly, it. should be=appreciated that in the above .description of embodiments, various features are sometimes grouped together in a single embodiment,. Figure, or description thereof for the purpose of streamlining the disclosure. This method. of disclosure, however, is not to be interpreted as reflecting an intention that any, claim in this:or any application claiming priority to- this application require more features than those expressly recited in that claim. Rather, as the following elairris.reflect, inventive aspects- may lie in a combination of fewer than all features of any single foregoing disclosed embodiment. Thus, the claims following this Detailed Description are hereby expressly incorporated into this Detailed Description, With each claim standing on its own as a separate. embodiment. This -disclosure includes all permutations of the independent: elainiSwith their dependent daints.
102791 Aspects of exemplary embodiments of the present invention described herein .can be implemented using One or more program modules and data storage units. As Used herein, the 'term "modules", "program modules", "components", "systems", "tools", "utilities", and the. like, include.
routines, programs, Objects, components, data :stnictures, and instructions,, or instructions sets, and so forth that perform particular tasks or implement particular abstract data types. As can be. appreciated, the, modules, refer to computer-related entities that can be implemented as software, hardware, firmware, and/or other suitable components that provide the described functionality, and which may be loaded into memory of a machine embodying an. exemplary embodiment of' the present invention.
Aspects of the modules may be written in a variety of programming languages, such as C, C++, Java, etc. The functionality provided by modules used for aspects of exemplary embodiments described herein can. b.c combined.and/or further partitioned..
102801 As used "herein, the terms "data storage unit,* "data store", "storage unit", and the like can refer to any suitable. memory -device that may be. used for storing data, including Manual files, machine readable files, and databases. The modules and/or storage units can all he implemented and run on the same computing system (for example, the exemplary computer system illustrated in FIG. 5 and described below) or they can be implemented and run on different computing systems. For example, one or modules can be implemented on a personal computer operated by a user while other modules can be implemented on a remote server and accessed via a network.
102811 According to an embodiment of the. present invention, the system and method may: be accomplished through. the use a one or Mote Computing devices. As depicted, for example, at least in Ms. 1, 2 5, 6, and .9, one of -ordinary skill in the aft would. appreciate that an exemplary system appropriate for use with embodiments in .accordance with the present appl 'cation may generally include one or more of a Central processing Unit (CPU), Random Access Memory (RAM), a storage medium (eg:, hard disk drive, solid state drive,: flash memory, cloud- storage), an operating system. (OS), :one or more application software, a. -display element, one or more communications moans, or one or more input/output devices/means. Examples of computing. devices usable with embodiments of the present invention include, but are not limited to, proprietary computing devices, personal_ computers mobile computing devices, tablet PCs, mini-PCs, servers, or any combination thereof.
The term computing device may also describe two or more computing-devices communicatively linked in a manner as to distribute and share one or more resources, such as clustered computing devices and server banks/farms. One of ordinary skill in the art would understand that any number of computing devices could be used, and embodiments of the present invention are contemplated for use with any computing device.

102.821 Throughout this disclosure and elsewhere, block diagrams and.
flowchart illustrations depict methods, apparatuses (i.e,, -systems), and computer program products: Each element of the block diagrams and flowchart illustrations, as well as each respective combination of elements in the block diagrams and flowchart illustrations, illustrates a function of the methods, apparatuses; and computer program products. Any and all such functions ("depicted functions") can be implemented by computer program instructions; by special-puipose, hardware-based computer systems; by combinations of special purpose hardware -and computer instructions; by 'combinations of general purpose hardware and computer instructions; and so on --- any and all of which may be generally referred to herein as a "circuit'- "module," or "system.' 102831 While the foregoing datwingS and description may set forth functional aspects of the disclosed wstems, no particular arrangement of software, for implementing these functional aspects shOuld be inferred from .thcsc descriptions -unless explicitly stated. or otherwise clear from the context:
102841 Each element' in flowchart illustrations may depict a step, or group of steps, of a computer-implemented method. Further, each step may contain one or more sub-steps. For the purpose of illustration, these steps (as well as any and all other steps identified and described above) are presented in order. It will be understood that an embodiment can contain an alternate order of the steps adapted to a particular application of a technique disclosed herein. All such variations and modifications are intended to fall within the scope of this ditclosure. The depiction and description of steps in any particular order is not intended to exclude embodiments having the steps in a different order, unless required by a particular application, explicitly stated, or otherwise Clear from the context.
[02851 Traditionally, .a computer program Consists- cif a sequence of COMpUtational Instructions or program instructions. It will be appreciated that a programmableapparattis computing device) can receive such a computer program and, by processing the computational instructions thereof, produce a further technical effect.
102861 .A programmable apparatus may include one or more microprocessors, microcontrollers, embedded microcontrollers, programmable digital signal. processors, programmable devices, programmable gate arrays, programmable array logic, memory devices, application specific integrated circuits, or the like, which can be suitably employed or configured to process computer program instructions, execute computer logic, store computer data, and so on.
Throughout this disclosure and elsewhere a computer can include any and all suitable combinations of at least one general purpose computer, special-purpose computer, programmable data processing apparatus, processor, processor architecture; and so on.
102871 it will be understood that a computer can include a computer-readable storage medium and that this medium may be 'internal or external, removable, and replaceable, or fixed. It Will also be understood that a computer can include a Basic Input/output System (BIOS), firmware, an operating system, a database, or the like that can include, interface with, or support the software and hardware described herein.
102881 Regardless of the type of computer program or computer involved, a computer program can be loaded onto a computer to produce a particular machine that can perform any and all of the depicted functions. This particular machine provides a means for carrying out any and all of the depicted functions.
102891 The elements depicted in flowchart illustrations and block diagrams throughout the figures imply logical boundaries between the. elements. However, according to software or 'hardware engineering practices, the-depicted elements and the-functions thereof may he implemented as parts of a monolithic software structure, as standalone software modules, or as modules that employ external routines, code, services, and se forth, or any combinatiOn ofthese. All such implementations are within the scope of the present disclosure.
102901 Unless explicitly stated or otherwise clear from the context, the verbs "execute" and "processr are used interchangeably to indicate execute, process, interpret, compile, assemble, link, load; any and all combinations of the foregoing; or the like. Therefore, embodiments that execute or process computer program instructions, computer-executable code, or the like can suitably act..
upon the insmdfwe code in. any and all of' the ways just-described.
102911 While the invention has been described in detail with reference. to exemplary embodiments, it will be understood by those skilled in the art that various changes arid alternations may be made and equivalents may be substituted for elements thereof without .departing fron the scope of the invention as-defined by the appended -claims. In addition, many modifications. may be made to adapt a particular application or material to the teachings of the invention without departing from the. essential scope thereof.
102921 -Variations described for exemplary .emboditnents of the present invention can be realized in any -combination desirable for each particular application. Thus particular limitations, end/or embodiment enhancements described herein, which may have particular limitations need be implemented in methods, systems, and/or apparatuses including one or more concepts describe with relation to exerriplaty embodiments of the present invention, 102931 Therefore, it is intended that the invention not be limited to the particular embodiments disclosed as the best mode contemplated for carrying out this invention, but that the invention will include all embodiments falling within the scope of the present application as set forth in the following claims, wherein reference to an element in the singular, such tts by use of the article "a" c/r. -"an" is not intended to mean "one and only one" unless specifically so stated, but rather one or more." Moreover, no claim element is to be construed under the oroYisions of 35 U.S.C. 112, sixth paragraph, unless the element is expressly recited using the phrak "means for or -"step for.
These following claims should be Mutt ____ -Lied to maintain the proper protection for thepresent invention.

Claims

What is claimed is:

1. A method comprising:
receiving, by a processor, an electronic message comprising an EHR (Electronic Health Record) encoding updated patient medical data;
determining, by the processor, the current patient lifecycle state based on the EHR;
determining, by the processor, if a patient lifecycle event occurred, based on the processor comparing a historical patient lifecycle state with the current patient lifecycle state; and in response to a determination by the processor that a patient lifecycle event occurred:
determining, by the processor, medical services to be offered to the patient, wherein the medical services are not contraindicated for the patient based on the lifecycle event and the patient medical history determined by the processor as a function of the EHR;
presenting, by the processor in a user interface, the medical services to be offered to the patient for selection as a function of available service location and available service time;
and automatically presenting, by the processor in the user interface, the selected services to the patient for prepayment.

2. The method of claim 1, wherein method further comprises scheduling, by the processor, the selected medical services based on the processor associating an available service location and an available service time with a patient selected service location and a patient selected service time.

3. The method of claim 2, wherein scheduling the selected medical services further comprises sending the selected medical services to a hospital to be scheduled by the hospital based on associating an available service location and an available service time with a patient selected service location and a patient selected service time.

4. The method of claim 1, wherein the patient lifecycle event further comprises patient service scheduled.

5. The method of claim 1, wherein the patient lifecycle event further comprises doctor's order issued.

6. The method of claim 1, wherein the medical services appropriate to the patient further comprise a medical service determined as a function of the patient lifecycle event.

7. The method of claim 1, wherein the medical services to be offered to the patient further comprise a medical service bundle based on medical facility utilization determined as a function of time.

8. The method of claim 7, wherein the method further comprises sending, by the processor, the medical service bundle to the patient in a shopping cart format rendered in an email or text message.

9. The method of claim 1, wherein the method further comprises offering, by the processor, the patient a discount for prepayment.

10. A method comprising:
receiving, by a processor, an electronic message comprising an EHR (Electronic Health Record) encoding updated patient medical data;
determining, by the processor, the current patient lifecycle state based on the EHR; determining, by the processor, if a patient lifecycle event occurred, based on comparing a historical patient lifecycle state with the current patient lifecycle state; and in response to a determination by the processor that a patient lifecycle event occurred:
determining, by the processor, medical services to be offered to the patient, wherein the medical services are not contraindicated for the patient based on the lifecycle event and the patient medical history determined by the processor as a function of the EHR, wherein the medical services to be offered to the patient are determined by the processor as a function of the patient lifecycle event, and wherein the medical services to be offered to the patient further comprise a medical service bundle based on medical facility utilization determined by the processor as a function of time;
presenting, by the processor, the medical services to be offered to the patient in a shopping cart format rendered in an email or text message to the patient for selection as a function of available service location and available service time;
scheduling, by the processor, the medical services selected by the patient based on the processor associating an available service location and an available service time with a patient selected service location and a patient selected service time; and automatically presenting, by the processor, the scheduled services to the patient with a discount offered for prepayment before a predetermined date.

11. The method of claim 10, wherein the patient lifecycle event is patient service scheduled, and wherein the medical service bundle further comprises a follow-up medical service medically indicated by the patient service scheduled.

1 2. The method of claim 10, wherein historical patient lifecycle state is new patient, and the current patient lifecycle state is well patient.
1 3 . The method of claim 10, wherein the patient lifecycle event is one of: doctor's order issued, patient service scheduled, patient admitted, patient discharged, patient diagnosed, patient diagnosis changed, patient medical condition changed, patient age threshold reached, patient life expectancy changed, patient =count balance due changed, or patient insurance changed.
1 4. The method of claim 10, wherein scheduling the medical services further comprises sending the selected medical services to a hospital to be scheduled by the hospital.