Abstract: A system and method of processing a health insurance claim are provided. According to the method, transaction data is received that has been transmitted from a third party computer via an open communication channel with the third party computer. The transaction data relates to a health insurance transaction and includes at least a unique identifier for a beneficiary of a health insurance plan to whom the health insurance transaction relates and details of a transaction that is being requested to be processed. The transaction is processed while the communication channel remains open to ascertain if the transaction is an allowable transaction. In response to the transaction submitted, a message is transmitted via the open communication channel to the third party computer wherein the message indicates that the transaction has been processed and that the transaction is an allowable transaction with or without patient collection or that the transaction is not an allowable transaction.
Inventors:
Sharon Dawn Law, Michele Read, Helen Mary Kruger, Jennifer Anne Noble Luckhoff, Willemina Jacoba Du Plessis, Willem Jacobus Schoeman, Clint Wesley Odendaal, Jacobus Johannes Olwagen, Harriet Sam Hung, Pieter Lodewickus Vermeulen, Sanet Kock, Wendy Joy Hanan