MISSION STATEMENT

To supply the global market with a simple solution to process, track, and coordinate medical and dental claims.

THE SITUATION

Currently, the process for submitting medical and dental claims is neither efficient nor consumer friendly. The claimant needs to retrieve claim information for each service rendered to determine what residual balance to submit to the alternate insurance provider for full reimbursement according to coverage limits. The claimant needs to be very organized: keep track of receipts, claim payments, and any unpaid balances. The current method is time consuming as it requires the manual tracking of medical and/or dental claims. Manual tracking increases the likelihood for missed opportunities for full reimbursement of medical and/or dental services rendered. The current method requires much duplication when coordinating, tracking, and processing each claim resulting in feelings of frustration. Consumers want to easily access and retrieve their healthcare benefit information in order to process expenses/claims to their insurance providers. 'The Service' will address all the problems mentioned above by providing convenience and saving time for consumers.   

PRODUCT DESCRIPTION

‘The Service’ is applicable for persons whom are single with one insurance provider to multiple family members with one or more insurance providers. This electronic service will allow a claimant to save time coordinating medical and/or dental claims between more than one insurance provider. The claimant will need to link all insurance provider plan details and bank / credit card information to ‘The Service’ so healthcare services rendered can be automatically processed. ‘The Service' will track and generate a report outlining key details surrounding submitted claims and payments.  

Below is a list of unique features key stakeholders can expect to receive from ‘The Service’:  

 

Claimant: 

✔ Real-time access 

• Informed knowledge of what services are covered according to claimant’s healthcare benefit plan at all times 
• Up-to-date access to healthcare submissions and claim history at any given time 
• Remaining balance of healthcare benefits available for use prior to expiration date 
• Alert provided by ‘The Service’ when the medical and/or dental plan limits are being approached to prevent the claimant from incurring an “out-of-pocket” expense 

 

✔ Saves time by simplifying the processing, tracking and coordination of healthcare claims   

• Automated process offered by ‘The Service’ simplifies tracking of healthcare claims on behalf of the claimant:  
• Healthcare claims are automatically processed to primary insurance providers upon payment  
• Residual balances remaining from primary insurance provider are automatically coordinated by ‘The Service’ for a claimant and their family members with multiple insurance providers 
• Automated process by ‘The Service’ increases efficiency by eliminating the duplication of information required by the claimant to submit to secondary insurance provider  
• No manual labor needed to keep track of healthcare claims   
• Less worry on losing any potentially lost healthcare receipts and claiming any residual balances due to automated service 
• Report generated with all associated paper work for annual tax filing  
• Time gained to spend on other things other than managing healthcare claims! 

 

✔ Improved access to healthcare provider 

• Claimant can opt for direct communication with a healthcare provider when available, i.e. exercises to complete, book future medical/ dental appointments 
• Claimants can book appointment directly with healthcare provider through shared calendar 
• Search for a new healthcare provider that is registered with ‘The Service’ to receive the benefits of automated healthcare receipt submission   

 

✔ Financial wellness options  

• Upon annual re-enrolment of health benefits for the claimant, the insurance provider will be notified by ‘The Service’ what healthcare benefit package option maximizes coverage based on the previous year’s history of medical and/or dental expenses incurred. This feature will help increase the claimant’s knowledge of their and/or family’s healthcare needs and allow for clear options to select at re-enrolment 
• The Service’ provides the claimant the option to connect with a third-party financial consultant to review their family’s healthcare portfolio (healthcare needs and benefit plan) in relation to their overall financial picture. With the claimant’s input, the financial consultant will put together a comprehensive financial plan. From the help of a financial consultant recommendations can be made to better inform the claimant on how to address their healthcare needs while simultaneously meeting overall financial planning goals.

 

Healthcare Provider: 

✔ Reduced operational costs 

• Significantly reduce paper/ printer ink costs as transactions are all automated; receipt of service sent electronically from the medical practitioner to ‘The Service’ 
• No merchant devices needed for claimants registered with ‘The Service’ as their payment for services are automatically processed through the debit/credit card used during registration with ‘The Service’   
   

✔ Retain and increase client base 

• Increase in customer satisfaction through easy automation of healthcare claim submission from healthcare provider to insurance company when registered with ‘The Service’ 
• Healthcare provider can access claimant’s history of services rendered to highlight opportunities for additional treatment when applicable and/or necessary to aid in customer retention 
• Option for healthcare provider to opt for direct communication with a claimant, i.e. questions about historical services rendered, exercises to complete, book future medical/ dental appointments. Claimants can book appointment directly with healthcare provider through shared calendar.  
• Generate a larger client base when registered with ‘The Service’ as healthcare provider’s practice will be highlighted for claimants looking for a new healthcare provider  
     

✔ Increase operational efficiency 

• Automated audit history (per claimant) generated for the healthcare provider to use for accounting and tax filing  

 

Employer: 

✔ Increase in employee satisfaction when employers can offer their employees’ healthcare benefits 

• ‘The Service’ will provide recommendations to companies on the benefit levels of healthcare plans to offer their employees 
• ‘The Service’ will consult with the primary insurance providers and businesses to expand and/or optimize the level of healthcare coverage per claimant 
• ‘The Service’ will provide an incentive for those businesses who have a certain percentage of employees registered with ‘The Service’ (i.e. benefit credits) 

 

Insurance Provider(s): 

✔ Insurance provider given opportunities from ‘The Service’ of any opportunities that will benefit the claimant resulting in greater business 

• Upon annual re-enrolment of health benefits for the claimant, the insurance provider will be notified by ‘The Service’ what healthcare benefit package option maximizes coverage based on the previous year’s history of medical and/or dental expenses incurred. This feature will allow the claimant clear options to select at re-enrolment.   
• ‘The Service’ will connect employers with insurance provider to offer healthcare benefits to employees 

 

Financial Institutions:

✔ Increase in client base as ‘The Service’ provides lead opportunities  

• The Service" will provide the claimant the option for a financial consultant to review their entire healthcare benefit plan (medical, dental, insurance, etc.) and/or conduct financial planning, i.e. a health check on cash flow, investments, insurance polices, debt levels, and estate needs  
  

OBJECTIVES

The developers of 'The Service' are offering to license the manufacturing and distribution rights to qualified organizations. These organizations should be capable of producing the product and/or accessing the appropriate markets with the product.

INTELLECTUAL PROPERTY PROTECTION

'The Service' is the subject of Patent Pending in the United States & Canada. Other territories are being considered on an as needed basis.

CONTACT INFORMATION

Innovative Licensing & Promotion, Inc. is the exclusive licensing agent representing the developers of 'The Service'

Innovative Licensing & Promotion, Inc.

Attn: Jim Churko

VP, Licensing Operations

45 O’Connor Street, Suite 1150

Ottawa, ON Canada K1P 1A4

Phone: 647-360-7700

Email: licensing@2innovative.net

Website: www.2innovative.net