| Aetna Inc. Patent applications |
| Patent application number | Title | Published |
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| 20110179404 | SYSTEM AND METHOD FOR CODE AUTOMATION - A system is provided for computer application code automation comprising a code automation computer server configured for presenting an electronic user interface for receiving user input for generating a Structured Query Language (SQL) query, the user input comprising a plurality of SQL tokens, a processor, associated with the code automation computer server, for receiving the plurality of SQL tokens, the processor retrieving from memory and executing computer executable instructions for at least one of: (a) optimizing performance of the SQL query while receiving the user input, and (b) error checking the SQL query while receiving the user input, wherein the processor is adapted for automatically incorporating the generated SQL query into the computer application code and storing the computer application code in a non-transitory computer readable medium. | 07-21-2011 |
| 20110071854 | HEALTH CARE PAYMENT ESTIMATOR - To take into account the various specifics of health care information available to the health plan members and health care providers in the context of estimating the members' out-of-pocket payments, embodiments of the invention are used to provide an electronic health care information system with custom interfaces and underlying processing optimized for the health plan member and health care provider contexts. Embodiments of the health care information system construct a pseudo-claim based on the information gathered via the member or provider interfaces and provide an accurate real-time estimate of the member's out-of-pocket responsibility based on adjudicating the pseudo-claim by taking into account the details of the member's health plan and current benefit levels. | 03-24-2011 |
| 20100169124 | SYSTEM AND METHOD FOR ADMINISTERING HEALTH CARE COST REDUCTION - A system and method for the efficient administration of health care plans, particularly as to the reduction and/or elimination of avoidable medical costs for select individuals who participate in the plan, is disclosed. Existing health care data is processed to determine an indication as to the relative desirability of an intervention in a plan participant's health care regimen. The data is also processed to determine the status of one or more flags, each of which potentially indicates the relative desirability of an intervention in a plan participant's health care regimen. A predictive model is used to determine the status of a flag relating to the likelihood of an insurance plan participant making a disability claim within a certain period of time. The information relating to desirability of an intervention in a plan participant's health care regimen, as well as a plan participant's medical information and claim history, is presented to case managers and/or health care providers in a user-friendly format. | 07-01-2010 |
| 20090210499 | Service Identification And Decomposition For A Health Care Enterprise - In embodiments, a health insurance computer application enterprise system is provided employing a service oriented architecture (SOA) with a service granularity component that dynamically customizes a reusable service based on one or more of user identity element, service data elements, and service action elements parsed from service request parameters. The health insurance enterprise system includes a plurality of applications making use of functionality provided by a reusable service. In an embodiment, the health insurance enterprise system includes a customer service application, a consumer web portal application, and an integrated voice response (IVR) application. The applications provide different channels of communicating health insurance data to various health insurance system constituents by presenting customized views of the data tailored to a given communications method, user access rights, as well as other factors. | 08-20-2009 |
| 20090210256 | System For Real-Time Online Health Care Insurance Underwriting - A system for real-time health care insurance underwriting is described comprising a quotation module, a verification module, and an underwriting module. The quotation module receives user input relating to a user's health status via an online user interface. The verification module verifies the user input against information stored in a database to form a list of inconsistencies and present the user via the online user interface with a request to validate at least some information within the user input. The underwriting module automatically creates a debit score based on one or more of at least a portion of the user input and the validated information and generates an underwriting decision based at least in part on the debit score. The quotation module presents one or more offers to sell insurance to the user via the online user interface, the one or more offers based on the underwriting decision. | 08-20-2009 |
| 20090172695 | Service Bus Architecture - In embodiments, an implementation of a service oriented architecture is provided including an application service bus capable of approximating point-to-point performance by reducing the format transformation of application messages by way of relaying them in a native format when the message format of a consumer application and/or service provider application is supported by the service bus. Preferably, the service bus is capable of supporting multiple message formats and transport protocols and comprises a plurality of components including a Service Initiator module, a Service Terminus module, a Service Locator module, and a Transport module. The service bus provides logical isolation between a consumer application and a provider application by exposing a set of interfaces for relaying service request and service response messages between the applications. | 07-02-2009 |
| 20090171903 | Business Rules Externalization System - A business rules externalization system is provided for centrally storing, compiling, and distributing computer readable business rules employed by a plurality of multi-tiered applications executing the rules in native application code. The system includes a rule database for centrally storing the rules in a standardized format, including multiple versions of a given rule or set of rules. The rule externalization system employs a rule object module to declare and store the rules in a standardized format. When an application encounters a trigger point, it interfaces with a rule object module to request the desired rules. The rule object module queries the rule database for the appropriate version of the requested rules and passes the standardized rules to a compiler module. The rule compiler module translates each rule into application-specific computer executable code or format and returns native code-based rules to the rule object module for transmission to the calling application. | 07-02-2009 |
| 20090171692 | Online Health Care Consumer Portal - An online health care consumer portal for accessing one or more health-related services by a health care consumer. The consumer portal includes an authentication module for identifying the health care consumer upon receiving an online identification token, and a database for maintaining health care information comprising a plurality of health records. The consumer portal also includes a rules engine module for applying a set of rules to the one or more health records corresponding to the consumer to determine an impairment profile of the health care consumer based on the health records corresponding to the health care consumer and an online user interface for providing access to the health-related services. The online user interface is configurable from a default configuration to a second configuration upon identification by the authentication module, the second configuration adapted to facilitate use of the online user interface according to the impairment profile. | 07-02-2009 |
| 20090132289 | SYSTEM AND METHOD FOR FACILITATING HEALTH SAVINGS ACCOUNT PAYMENTS - Ways are provided for a health care organization (HCO) to facilitate payments from a tax-advantaged medical savings account, such as an HSA account, in conjunction with claim processing, by way of automatically debiting an HSA account and providing an integrated claim payment adjustment functionality to eliminate underpayments and/or overpayments for the HSA and health plan balances. A claim processing module reprocesses the claim to adjust the respective balances in one or more of the following ways: (a) HCO crediting the HSA account to eliminate the overpayment from the HSA, (b) HCO issuing a collection request to the health care provider to adjust for overpayment of the HCO balance, (c) HCO issuing a second payment to the health care provider to adjust for the underpayment of the HCO balance, and (d) HCO rebalancing the member and HCO-responsible portions of the claim. | 05-21-2009 |
| 20090089083 | SYSTEM AND METHOD FOR MANAGING HEALTH CARE COMPLEXITY VIA AN INTERACTIVE HEALTH MAP INTERFACE - To empower a member to make informed health care decisions, a health care organization (HCO) graphically presents the member with a manageable closed universe of health care information via an online interactive visual interface. The online interactive interface comprises a custom category node display of member health care data based on analyzing the member profile in light of the overall health care data taxonomy built by the HCO. Upon identifying the subset of relevant health care data categories, HCO initiates the display of the identified categories by way of a dynamically linked category node interface. To enhance the member's understanding of the relationships between the category nodes, the HCO preferably employs a ring node topology by displaying the online interface as a closed network or map, such as by locating each category node along one or more closed, loop-shaped wireframes, which connect the interrelated categories. | 04-02-2009 |
| 20090043606 | MEDICAL MANAGEMENT MODELER AND ASSOCIATED METHODS - A method and system for determining custom population Return on Investment (ROI) forecasted savings estimates for use in evaluating the desirability of active health care management programs and the depth of penetration of such programs. The method and system further include a graphical user interface and returns a statistical confidence of the predicted savings or loss. | 02-12-2009 |
| 20080197185 | METHOD OF PROMOTING HEALTH AND WELLNESS THROUGH CARD BASED REWARDS PROGRAM - A system and method are described whereby a health care organization (HCO) cooperates with a financial organization by promoting enrollment and use of a financial product or service that includes terms having incentives related to health care expenditures. In one embodiment, the financial product or service is a credit card program including incentives related to health care expenses. The HCO identifies and selects a group of consumers suitable to receive promotional information related to the credit card program. Preferably, the credit card program is associated with the HCO via a co-branding arrangement. The HCO obtains revenue from the financial organization based on consumer's use of the credit card and, optionally, based on new enrollments. Although a consumer can use the credit card to pay for any product or service, the incentives are applied when the card is used in connection with products or services related to health care. | 08-21-2008 |
