Abstract: A method, system, and computer program product to provide a single platform to unify benefits, claims, membership, billing, and servicing. One embodiment provides a computer program-assisted system to provide a single point source for host benefits management having a centralized benefit data manager (BDM); a selector communicatively connected to said BDM to allow a user to view, select, and assemble benefit components from BDM; an editor communicatively connected to the BDM allows the ability to define and update benefit components and variables for benefit and payment policies; a read-only explainer communicatively connected to the BDM provides understandable “read-only” descriptions of benefits available; and a connector communicatively connected to the BDM as an interface layer to exchange electronic benefit data with all system processes, including external claims systems. The connector can translate rules from a user's natural language to computer code language.
Type:
Application
Filed:
September 26, 2008
Publication date:
April 15, 2010
Applicant:
BLUE CROSS BLUE SHIELD OF MICHIGAN
Inventors:
Donghui Li, Brenda Heinen, Mike Guiette, Jeff Hostetler