Abstract: Methods for reducing fraud in a prescription healthcare program are described herein. The methods generally include registering a service provider with a prescription healthcare provider and issuing a service provider identification code to the service provider and registering an item of the service provider with the prescription healthcare provider to create a registered item and identifying a claim code for each registered item. The item can include at least one service, at least one good and combinations thereof. The method further includes issuing a smart card to an person related to the prescription healthcare program, wherein the smart card has a smart card identification feature to identify the person and using the smart card to determine if the person is the authorized bearer of the smart card and is eligible for benefits from the prescription healthcare program.

Abstract: An inventive process is disclosed for linking credentialing information with a medical malpractice insurance application. The credentialing information is automatically transferred from the credentialing questionnaire to an insurance application, and this credentialing information is then used to generate a medical malpractice insurance policy. The medical malpractice insurance policy is a two year policy, in order to coincide with the required re-credentialing of the healthcare provider. The inventive process also includes linking an information database, not created for insurance purposes, with an insurance application.

Abstract: A new method of dispensing, tracking and managing pharmaceutical product samples by communicatively linking prescribers and pharmacies to a central computing station. The present invention entails utilizing product trial media that is exchanged for actual pharmaceutical product. The media is encoded with information that identifies a particular pharmaceutical trial product, such as by magnetic encoding similar to that used with credit cards. The media is distributed to participating medical doctors or prescribers who then activate the media via the central computing station. The prescriber then transfers the activated media to patients who then present the media to participating pharmacies. Before filling the pharmaceutical trial product identified by the media, the pharmacy validates the media via a link with the central computing station.

Abstract: A system and method for conducting a physician-patient consultation is disclosed wherein the patient is located, at least initially, remotely from the physician. The system includes a first clinic station operable by a physician, a patient station remote from the first clinic station for communicating information relating to the patient, and a second clinic station operable by medical personnel for direct contact with the patient, i.e., conducting a physical examination of the patient. A communications network is also provided which includes a communication link between the first clinic station and the patient station, whereby the fist communication link utilizes an interactive computer network and a second communications link between the second clinic station and the first clinic station. In the method, a first set of patient information is communicated from the patient station to the first clinic station and thus to the physician.

Abstract: An apparatus and method for allocating the resources of an organization in order to optimize the effects of that allocation on the quality of the organization, where the quality is viewed from a customer's perspective. The method includes the steps of acquiring the information required to construct a model of the organization's primary processes as viewed from the perspective of a customer. This information includes customer specific information such as customer inputs to the organization, customer outputs from the organization, and performance measures used by a customer to assess the quality of the outputs of the organization. Organization specific information such as the functional departments or units of the organization, and the inputs and outputs of each unit is also acquired.

Abstract: A method and system for reinforcing regular chiropractic care comprising the establishment and maintenance of a policy of life insurance on a patient as long as the patient keeps each of a series of regularly scheduled, routine visits for chiropractic care. A programmed general purpose computer maintains the schedule, reminds the patient of upcoming appointments, compares the schedule to patient logs to verify that the schedule of appointments are being kept, and authorizes the policies of life insurance with a preselected insurance company, paying the premiums automatically by wire transfer.

Abstract: A central service facility is connected via a network and a uniform service interactive platform to a multiplicity of remotely located diagnostic systems. The diagnostic system is programmed to provide the equipment user with the ability to create an electronic list of non-urgent service tasks to be performed by a field engineer. The task list is transmitted from the diagnostic system to the service center via the network. The service center subsequently transmits the task list to the assigned field engineer via the same network or via any other available communications channel, e.g., a facsimile or wireless communication. Preferably, the task list is provided to the field engineer prior to an on-site visit based upon a call schedule.

Abstract: A router instruction processor for a digital document delivery system 10 interacts with one or more electronic inserts and a bill processing server to function as a general document fulfillment server. The router instruction processor makes use of the electronic inserters and bill processing server to ensure that documents as contained in Send Request objects are presented to their destinations according to sender requirements and recipient preferences. The router instruction processor further ensures the sender requirements are not compromised by recipient preferences to the extent that conflict may arise.

Abstract: A method reducing fraud in a government healthcare program is described herein. The method includes registering a service provider with a healthcare provider and issuing a service provider identification code, registering at least one service of the service provider with the government sponsored healthcare provider and identifying a claim code for each registered service, issuing a code based on data from a biometric reading, a keypad entry with a PIN code, or an electronic signature pad entry to an individual related to a benefits program of the healthcare provider; using the code to determine if the individual is eligible for the healthcare program and performing three transmissions of information to reduce fraud in the systems.

Abstract: A health care information management system uses a pre-existing database of medical specialty claims, such as anesthesia claims, to profile the billing behavior of medical specialist providers, such as anesthesiologists. The software helps the user to determine which of the claims submitted by the providers are within accepted guidelines and industry standards. The software identifies providers who have submitted improper false claims. This is accomplished by comparing submitted claims with a database of histories of prior claims, as well as records of time accumulated data supplied by sources originating from hospitals, physicians and societies. The software incorporates unique triggers, which highlight those claims that indicate possible fraudulent submission. The system develops a profile of a provider's billing behavior and compares it to his peers. The software uses trigger filters to alert the insurance carrier if the provider's billing falls outside of a predetermined norm.

Abstract: The invention is a method for reducing fraud in a healthcare program by registering a service provider with a private healthcare provider and issuing a service provider identification codes, registering at least one service of the service provider with the private healthcare provider and identifying a claim code for each registered service; issuing a smart card to an individual related to a benefits program of the private healthcare provider wherein the individual has an identification code and the smart card has a feature to identify the individual; using the smart card to determine if the individual is the authorized card bearer and is eligible for the healthcare program; using the smart card to determine if a service provider is preauthorized to provide a registered product under the private healthcare provider program; and using the smart card to facilitate a transmission between the service provider and the private healthcare provider.

Abstract: The invention is a method for accelerating the provision of funds to a service provider for medical insurance using a smart card by a person obtaining medical insurance coverage from an insurer and obtaining a contract from the service provider, creating a smart card, using the smart card to see if the user is eligible for funds, to see if the medical service is preauthorized, and to see if service provider is preauthorized, transmitting acknowledgment of services from service provider to insurer, transmitting amount from insurer to service provider, transmitting acknowledgement of amount from service provider to insurer, and transferring payment quickly from insurer to service provider.

Abstract: The method for reducing fraud in a non-health government benefit program entails by registering a service provider with a non-health government agency and issuing a service provider identification code, registering at least one service of the service provider with the non-health government agency and identifying a claim code for each registered service; issuing a smart card to an individual related to a benefits program of the non-health government agency wherein the individual has an identification code and the smart card has a feature to identify the individual; using the smart card to determine if the individual is the authorized card bearer and is eligible for the non-health government benefit program; using the smart card to determine if a service provider is preauthorized to provide a registered product under the non-health government program; and using the smart card to facilitate a transmission between the service provider and the non-health government agency.

Abstract: A support system for making decisions on medical treatment plans or test plans includes using a decision tree having branches that represent actions to be selected in deciding the medical treatment plans or test plans for a person to be inspected and events that may possibly occur as a result of the selected actions, and calculating expectations of the actions to be selected in accordance with occurrence probabilities with which the respective events occur and utility values which reflect intentions of the person to be inspected on the events. The occurrence probabilities of the branches are renewable in accordance with attribute information of the person to be inspected.

Abstract: An insurance policy and insurance method for providing financial assurance for decommissioning a nuclear power plant using insurance is described. In one embodiment, a financial product, such as a decommissioning insurance policy, provides financial assurance for the decommissioning of a nuclear power facility, and provides, in exchange for payment of a premium, for an insurer to pay actual decommissioning expenses for the nuclear power facility between a policy inception date and a policy termination date. In another embodiment, the insurance policy includes a premium that is based on an adjusted sum of costs and expenses that is equalized over a plurality of scenarios, where each scenario is based on the decommission starting, e.g., in a different year.

Abstract: A system and method for tracking, monitoring, and supporting self-procurement of an individual for the purchase of a home. As a self-procuring principal (SPP), the individual would be entitled to the real estate commission payable to licensed real estate agents. To aid the SPP in his self-procurement activities, the system provides information to the SPP of property listings that match the SRP's search criteria. The system also provides comparable sales information of other homes in the area, school district reports, environmental hazard reports, and automated offer drafting assistance. If the SPP wants to view a property, the system coordinates such viewing by contacting chaperones to provide the showing of the property. The SPP's self-procuring activities are tracked by the system for inclusion in the SPP's loan file. The report certifies that the SPP has indeed represented and procured himself, and thus, is entitled to the real estate commission.

Abstract: A method and system for allowing a user to select a healthcare services package is disclosed where a central server generally receives personal information data from the user over the Internet regarding the user's preferences with respect to healthcare service providers and the user's sponsor, i.e., the party responsible for paying for all or part of the user's healthcare costs (such as an employer, an insurance company or the user himself). The server thereafter provides a list comprising a plurality of healthcare service providers and information regarding the healthcare service providers (e.g., specialty, rate, location, hospital affiliation, etc.) to the user for selection by the user of a healthcare services panel. Once the server has received the selected healthcare services panel from the user comprising at least one of the listed healthcare service providers, the server determines a healthcare services package.

Abstract: An apparatus and method for automatically optimizing a strategy of a decision management system. More specifically, a computer-implemented decision management system applies a strategy to determine actions to be taken, monitors performance based on the taken actions, and refines the strategy in accordance with the monitored performance. An end user of the system selects a part of the strategy for optimization, and selects criteria for optimizing the selected part of the strategy. The decision management system then automatically optimizes the selected part of the strategy in accordance with the selected criteria. The end user can decide whether or not to implement the optimized strategy in production.

Abstract: An economic security and financial planning method and system are disclosed. Their purpose is to calculate a household's highest sustainable living standard and determine the amount of saving and life insurance needed to finance and guarantee that living standard and subject to a) the household's preferences about changes over time in its living standard, b) the household's current and projected future demographic composition, c) the household's current and projected future economic resources, d) the household's borrowing constraints, e) the household's housing plans, and f) the household's need to make special expenditures, including bequests. The method and system are also designed to do contingent planning—to take into account the economic resources and special expenditure needs of survivors.

Abstract: A method of matching projects and workers using both both mandatory, or binary, characteristics and quantitative characteristics is described. The projects and workers have a number of characteristics that are symmetric. For example, the project has an activity characteristic that defines what is to be done and the worker has an activity characteristic describing what she/he wants to do. Project creators and workers can request matching workers and projects, respectively. The matching process itself occurs in two stages. In the first stage, the mandatory characteristics are considered. Only workers, or projects, meeting the mandatory characteristics are selected for further evaluation at the next stage. At the second stage, the quantitative characteristics are evaluated for the workers, or projects. The result is a subset of the total number of workers, or projects, matching the project criterion, or worker needs, ranked based on the quantitative characteristics.