Abstract: A method of fulfilling needs acquired as a result of property and other similar losses, the method involving the steps of directing a person or entity with a need resulting from a loss to a site on a global computer network, interviewing the person or entity at the site to obtain information about the person or entity and the need they have, and analyzing and processing the information to provide the person or entity automatic access at the site to at least one service that will go toward fulfilling the need of the person or entity.

Abstract: Digital assets may be insured against loss. The digital assets may comprise commercial products and/or user-generated data. An insurance product may provide either for monetary reimbursement or replacement (e.g., repurchase) of the digital assets and/or for backup services to backup insured digital assets so that the insured digital assets may be retrieved if the original user copies are lost.

Abstract: A system and method for providing healthcare claims assistance whereby a given healthcare service consumer's healthcare services data relating to a given healthcare service item is obtained and is translated into a description of the services in language, and/or a format, that a typical healthcare service consumer can understand. The healthcare service consumer's healthcare services data is also used to present the healthcare service consumer with a payment calculation display and an explanation of how the healthcare service consumer's portion of the claim amount was calculated. The healthcare services consumer is then provided advice on who to contact and/or how to proceed to resolve any perceived errors and/or obtain more detailed information.

Abstract: The disclosure herein provides methods, systems, and devices for managing, transferring, modifying, converting and/or tracking medical files and/or medical system messages. In certain embodiments, the foregoing may generally be based on requesting medical files at a first medical facility, identifying the requested medical files at a second medical facility, initiating a secure network connection between the first and second medical facility, modifying a header portion of the medical files based on patient identification information created by the first medical facility, and other processing steps.

Abstract: The present invention is to provide a method for computerizing and standardizing medical information, which can provide web screens through terminals to enable doctors, nurses, pharmacists, or the like to immediately online input and read a variety of information created upon treating and caring for patients in a hospital, and can standardize medical information input or represented through the web screens, such as various medical information, nursing information, medicine information and the like.

Abstract: A method and/or system determines a benchmark premium for evaluating an insurance policy for a company. In alternative embodiments, a method and/or system evaluates an insurance policy using a benchmark premium. In one exemplary embodiment, a class action lawsuit frequency distribution, a class action lawsuit severity distribution and/or a non-class action lawsuit loss distribution are determined. A benchmark premium for the company is determined responsive to the class action lawsuit frequency distribution, the class action lawsuit severity distribution and/or the non-class action lawsuit loss distribution.

Abstract: A centralized pharmacy business method includes forming a business alliance between a centralized pharmacy, one or more satellite pharmacists/facility directors, and a shipping service. Optionally, the centralized pharmacy and the shipping service are located “end of runway,” which means that the shipping service is co-located with or in close proximity to the centralized pharmacy. The satellite pharmacists/facility directors may accrue incentives based on recruiting one or more customer bases. Maintenance prescription orders are received and filled by the centralized pharmacy and delivered to the respective customer base. Acute prescription orders are received and filled by the satellite pharmacy of the pharmacists/facility directors near the customer base and may be delivered to the respective customer base.

Abstract: Methods for determining whether a drug is a specialty drug, methods for creating tools to be used in making the determination, and the tools themselves are disclosed. The overall value of a drug depends on the drug's attribute values with respect to each of a set of drug attributes (concerning, e.g., the drug's route of administration, targeted disease, possible adverse reactions, risk of toxicity, cost, need for patient compliance with the treatment regime, and handling, preparation, and/or storage requirements. If the overall value or its partial overall values meet certain criteria, the drug is deemed to be a specialty drug.

Abstract: The development and use of a model to estimate disability insurance exposure for a group of individuals to be underwritten for a coverage period is disclosed. The development of the model includes the use of medical claim data having a plurality of medical claims made by a first model population having at least a respective plurality of first model population members and a disability insurance claim data having a plurality of disability insurance claims made by a second model population having at least a respective plurality of second model population members, which optionally may partially or wholly overlap with the first model population. A clinical medical condition classification system assigns corresponding medical condition causes to the disability insurance claims and the medical claims based on medical condition information.

Abstract: Systems and methods may be provided for claim denial conversion. The systems and methods may include receiving a prescription claim from a pharmacy, where the prescription claim is associated with a drug or other product requested by a customer, routing the prescription claim to a claims processor for adjudication, and receiving, from the claims processor, a denied claim response for the claim request. The systems and methods may further include determining that funding is available to cover at least a portion of a price of the requested drug or other product, converting the denied claim response to an approved claim response upon determination of the available funding, and transmitting the approved claim response to the pharmacy.

Abstract: A method of model development for use in underwriting group life insurance for a policy period includes collecting medical claims data for the group to be underwritten, where each medical claim being related to a particular employee of the group. Morbidity categories are provided that categorize the medical claims in the medical claims data. A conditional probability model is developed and applied to the morbidity categories for each employee in the group using his medical claims, thereby calculating the expected conditional probability for each employee dying during the policy period. For each employee, an estimate of the expected life claim cost is estimated using an index of the life coverage to salary. Combining the expected conditional probability for each employee dying during the policy period with the estimate of the expected claim cost of death gives an estimate of the group's total life exposure.

Abstract: A system and method for conducting surveys, and, more particularly, an at least partially automated and efficient system and method for collecting, processing, and displaying customer satisfaction survey information that enables a product or service provider to evaluate the quality of goods and/or services received based on ratings and reports obtained by performing surveys of customers, employees, and/or staff. The system utilizes an execution platform using a clinical process improvement methodology. The system provides the execution platform with software scripts implementing the clinical improvement process, using drill-down questioning techniques and verbatim comments tailored to the survey participants comments and/or status information to gain insights into the participants' reasons for their opinions. The system obtains raw survey data and processes that data into useful survey information, such as graphs and charts, for presenting to survey consumers (i.e., system users) who may be remotely located.

Abstract: A computer-implemented system and method for integrating data from a plurality of biomedical development phases. The system and method include a database that stores data collected from the biomedical development phases. The database further includes a metadata data structure that describes the data collected during a biomedical development phase. At least one graphical user interface collects data during the biomedical development phase. The structure of the graphical user interface is defined based at least in part upon the metadata data structure so that the graphical user interface collects data points as well as metadata that is to be stored within the metadata data structure. The metadata describes the collected data points, and at least a portion of the metadata data structure is determined based upon an issue that arises in a subsequent biomedical development phase.

Abstract: The present invention is a system and method for management of consumer services such as health care services which combines new financial structure for health insurance and health benefit plan, payment methods, health plan design, benefit development algorithms, unique procurement methods for health care benefits with and without application to an individual consumer's personal state of health, and is integrated with financial services and asset management products, and benefits for an individual consumer's future medical and/or retirement savings, for healthcare needs. The method and system employs a combination of the defined benefit and defined contribution approaches which combination is referred to herein as “defined-care.

Abstract: A system and method for modeling healthcare utilization based on usage data from physician claims, hospital claims, and pharmacy claims. The method includes extracting from a claims file the portion of the data from a base period that is relevant to modeling healthcare utilization in a target period by computing a utilization score based on the usage data. The models may be used concurrently by calibrating them with the base period equal to the target period and they may be also be used prospectively by calibrating the models with the target period representing a future time period.

Abstract: A health information package that a person carries with him at all times with all his health data, and enables him to grant caregivers instant access to all or any part of his health data, whenever the information is needed, at all points of care anywhere in the world, in computer readable and eye readable forms. A database management software program is contained in a portable computer readable storage device of the package. A blank data recording form and an updated health overview, organized by body organ systems, problems, types and sub-types of data can be printed when desired. With the package, any standard personal computer can be used to record, update, link, integrate and display health data from birth to death. The owner has absolute control on the availability, completeness, accuracy, integrity, privacy, confidentiality, security, backups and access to his health data that are stored on the package.

Abstract: This invention provides methods and systems for providing an insurance policy having an inflation protection option that is computed at least partially based on information useful in offering a long term care insurance policy to an individual and at least partially based on the option for the individual to purchase additional coverage at a subsequent premium that is computed based at least partially on the individual's age at a date, which date is other than the date the option to purchase the additional coverage is offered, such as the date the policy issued.

Abstract: Methods for insurance of online presence (202) and/or data (200) are described. An insurer (302) contracts with an insured entity (304) in an agreement (308) under which a premium (310) is paid for insurance coverage. The premium is calculated (306) using a pure premium method (400) or a loss ratio premium method (402), in a manner that depends on factors such as expected virus scan results (404), expected data recovery time (406), expected geographic spread (408), use of multiple recovery methods (410), and other information regarding the insured entity's business and the technical protection services (206) to be used. In some embodiments, the technical protection services are provided under the agreement by a third party technical services provider (300). Systems, signals, and configured media are also described.

Abstract: A method of providing insurance (including professional malpractice liability insurance) to consumers against unfavorable outcomes resulting from services, and a method of rating risks associated with services. In the first preferred embodiment, a policy limit is chosen by a patient (or other consumer), a premium based on the policy limit is paid by the patient, and if malpractice is committed by a health care provider (or other professional), the patient is compensated up to the amount of the policy limit. The patient signs an agreement that the liability of the health care provider for malpractice will not exceed the policy limit. Only then are medical services provided. Risk factors are evaluated for the patient, the doctor, hospital or other health care provider, and the procedures that are to be performed, and are used to determine the amount of the premium, taking into account the policy limit chosen by the patient.

Abstract: The present invention relates to a system and method for providing a web-based graphical user interface to a legacy insurance data process system to increase the functionality and ease of use in issuing insurance quotes and policies, providing insurance information and other insurance related services. The system and method integrate use of Internet technology in business work flows, provide dynamic data entry for insurance coverage packages and pricing programs, offer easy access to value-added products and services, and enable local printing of professional insurance applications, proposals and forms to facilitate immediate delivery of professional-quality proposals to customers.