DETAILED ACTION
Notice of Pre-AIA or AIA Status
1. The present application is being examined under the pre-AIA first to invent provisions.
Notice to Applicant
2. This communication is in response to the communication filed 9/29/2025. Claims 2-14 and 16-20 are cancelled. Claims 1 and 15 are currently pending.
Claim Rejections - 35 USC § 101
3. 35 U.S.C. 101 reads as follows:
Whoever invents or discovers any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title.
3.1. Claims 1 and 15 are rejected under 35 U.S.C. § 101 because while the claims (1) are to a statutory category (i.e., process, machine, manufacture or composition of matter, the claims (2A1) recite an abstract idea (i.e., a law of nature, a natural phenomenon); (2A2) do not recite additional elements that integrate the abstract idea into a practical application; and (2B) are not directed to significantly more than the abstract idea itself.
In regards to (1), the claims are to a statutory category (i.e., statutory categories including a process, machine, manufacture or composition of matter). In particular, independent claims 1 and 15, and their respective dependent claims are directed, in part, to methods and systems for comparing medical procedure costs to help users understand the cost variation of procedures by mining medical information and determining reimbursement amounts based on medical procedure costs.
In regards to (2A1), the claims, as a whole, recite and are directed to an abstract idea because the claims include one or more limitations that correspond to an abstract idea including mental processes and/or certain methods of organizing human activity which encompasses both certain activity of a single person, certain activity that involves multiple people, and certain activity between a person and a computer. For example, independent claims 1 and 15, as a whole, are directed to mining medical information to determine medical procedure costs and reimbursement amounts based on the procedure costs by gathering medical information, calculating weighted average reimbursements for providers, contractual allowed reimbursement amount, ranking health care service providers, etc. which are human activities and/or interactions and therefore, certain methods of organizing human activity which encompasses both certain activity of a single person, certain activity that involves multiple people, and certain activity between a person and a computer. The dependent claims include all of the limitations of their respective independent claims and thus are directed to the same abstract idea identified for the independent claims but further describe the elements and/or recite field of use limitations.
Furthermore, assuming arguendo, the claims are not directed to certain methods of organizing human activities, the claims, nevertheless, are directed to an abstract idea because the claims, except for certain limitations (* identified below in bold), under the broadest reasonable interpretation, can be reasonably and practically performed in the human mind and/or with pen and paper using observation, evaluation, judgment and/or opinion; and calculating weighted average reimbursements is a mathematical concept. That is, other than reciting the certain additional elements, nothing in the claims precludes the limitations from being practically performed in the mind and/or with pen and paper.
CLAIM 1:
A composite medical information data mining method for providing, based upon accumulated data stored in a database, a weighted average reimbursement information to networked end users to facilitate presentation of costs for performing, by each of a plurality of health care service providers, a medical procedure associated with multiple complexity-based current procedure terminology (CPT) codes, wherein the composite medical information data mining method comprises:
maintaining a table of medical procedure costs, wherein the table comprises a plurality of entries indicating accumulated costs for performing medical procedures by each provider of the plurality of health care service providers, where each entry includes:
a health care service provider and medical procedure CPT identifier combination; and
quantity and cost information for the identifier combination; and
rendering, for a medical procedure for which multiple complexity-level distinct CPT codes exist, a weighted average reimbursement for each provider of the plurality of health care service providers for the medical procedure associated with at least two distinct codes, the weighted average reimbursement for one of the health care service providers being a function of:
a quantity of a provider-type sub-component of the medical procedure performed and
a contractual allowed reimbursement amount for the provider-type sub- component for each of the at least two distinct codes based upon procedure complexity; wherein the weighted average reimbursement for each provider is used to generate, for a requesting end user, a ranking of health care service providers for performing the medical procedure;
wherein the weighted average reimbursement for each provider is used to generate, for a requesting end user, a ranking of health care providers for performing the medical procedure.
CLAIM 15:
A computer based system configured to mine composite medical information data for providing, based upon accumulated data stored in a database, a weighted average reimbursement information to networked end users to facilitate presentation of costs for performing, by each of a plurality of health care service providers, a medical procedure associated with multiple complexity-based current procedure terminology (CPT) codes,
wherein the computer based system comprises:
a processor; and
a non-transitory computer-readable medium including computer-executable instructions that, when executed by the processor, facilitate carrying out a composite medical information data mining method comprising:
maintaining a table of medical procedure costs, wherein the table comprises a plurality of entries indicating accumulated costs for performing medical procedures by each provider of the plurality of health care service providers, where each entry includes:
a health care service provider and medical procedure CPT identifier combination; and quantity and cost information for the identifier combination; and
rendering, for a medical procedure for which multiple complexity-level distinct CPT codes exist, a weighted average reimbursement for each provider of the plurality of health care service providers for the medical procedure associated with at least two distinct codes, the weighted average reimbursement for one of the health care service providers being a function of:
a quantity of a provider-type sub-component of the medical procedure performed and
a contractual allowed reimbursement amount for the provider-type sub- component for each of the at least two distinct codes based upon procedure complexity; wherein the weighted average reimbursement for each provider is used to generate, for a requesting end user, a ranking of health care service providers for performing the medical procedure,
wherein the weighted average reimbursement for each provider is used to generate, for a requesting end user, the ranking of health care service providers for performing the medical procedure.
* The limitations that are not in bold are abstract and/or can be reasonably and practically performed in the human mind and/or with pen paper. The limitations that are in bold are considered “additional elements” that are further analyzed below in subsequent steps of the 101 analysis.
In regards to (2A2), the claims do not recite additional elements that integrate the abstract idea into a practical application. The additional elements in the claims (i.e., * identified above in bold) do not integrate the abstract idea into a practical application because the additional elements merely add insignificant extra-solution activity to the abstract idea; merely link the use of the judicial exception to a particular technological environment or field of use; and/or simply append technologies and functions, specified at a high level of generality, to the abstract idea (i.e., the additional elements do not amount to more than a recitation of the words “apply it” (or an equivalent) or are more than mere instructions to implement an abstract idea or other exception on a computer).
Here, the additional elements (e.g., database, computer, processor, medium, etc.) are recited at a high-level of generality such that it amounts to no more than mere instructions to apply the abstract idea using generic computer technologies. Moreover, the claims recite “A computer based system configured to”, “executed by the processor”, etc. devoid of any meaningful technological improvement details and thus, further evidence the additional elements are merely being used to leverage generic technologies to automate what otherwise could be done manually. Accordingly, the additional elements do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea.
Furthermore, the additional elements do not recite improvements to the functioning of a computer, or to any other technology or technical field—the additional elements merely recite general purpose computer technology; the additional elements do not recite applying or using a judicial exception to effect a particular treatment or prophylaxis for disease or medical condition—there is no actual administration of a particular treatment; the additional elements do not recite applying the judicial exception with, or by use of, a particular machine—the additional elements merely recite general purpose computer technology; the additional elements do not recite limitations effecting a transformation or reduction of a particular article to a different state or thing—the additional elements do not recite transformation such as a rubber mold process; the additional elements do not recite applying or using the judicial exception in some other meaningful way beyond generally linking the use of the judicial exception to a particular technological environment—the additional elements merely leverage general purpose computer technology to link the abstract idea to a technological environment.
In regards to (2B), the claims, individually, as a whole and in combination with one another, do not include additional elements that are sufficient to amount to significantly more than the judicial exception because the additional elements or combination of elements in the claims, other than the abstract idea per se, amount to no more than a recitation of (A) a generic computer structure(s) that serves to perform computer functions that serve to merely link the abstract idea to a particular technological environment (i.e., computers); and/or (B) functions that are well-understood, routine, and conventional activities previously known to the pertinent industry.
Here, as discussed above with respect to integration of the abstract idea into a practical application, the additional elements amount to no more than mere instructions to apply the exception using generic computer technologies. Mere instructions to apply an exception using generic computer technologies cannot provide an inventive concept.
Moreover, paragraphs [0026]-[0027] of applicant's specification (US 2012/0078651) recites that the system/method is implemented using networked computer and server systems which are well-known general purpose or generic-type computers and/or technologies. The use of generic computer components recited at a high level of generality to process information through an unspecified processor/computer does not impose any meaningful limit on the computer implementation of the abstract idea. Thus, taken alone, the additional elements do not amount to significantly more than the above-identified judicial exception (the abstract idea). Looking at the limitations as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely provide conventional computer implementation.
Furthermore, the additional elements are merely well-known general purpose computers, components and/or technologies that receive, transmit, store, display, generate and otherwise process information which are akin to functions that courts consider well-understood, routine, and conventional activities previously known to the pertinent industry, such as, performing repetitive calculations; receiving or transmitting data over a network; electronic recordkeeping; retrieving and storing information in memory; and sorting information (See, for example, MPEP § 2106).
Therefore, the claims are not patent-eligible under 35 U.S.C. § 101.
Response to Arguments
4. Applicant's arguments filed 9/29/2025 have been fully considered but they are not persuasive. Applicant’s arguments will be addressed hereinbelow in the order in which they appear in the response filed 9/29/2025.
4.1. Applicant argues, on pages 5-7 of the response, that the claims are patent-eligible under 101 because the claims are directed to a technological improvement; and the claims are directed to a constructed database and operations that provide a “weighted average” cost which is a new type of data only made possible using the claimed configuration of technology that provides a technological solution to a technological problem.
In response, it is respectfully reiterated that the pending claims are not directed to solving a technological problem per se, rather the pending claims are attempting to solve a problem rooted in a business process (i.e., comparing medical procedure costs to help users understand the cost variation of procedures by mining medical information and determining reimbursement amounts based on medical procedure costs) by using well-known general purpose computers to automate calculations, comparisons, etc. Moreover, the alleged improvements of the pending claims pertain to the abstract idea itself, rather than improvements to the technology (i.e., computer technology or computer field). For example, the claims recite a general-purpose computer technology (e.g., computer, processor, etc.) without any limitations claiming that the general-purpose computer has been improved, such as, by making the general-purpose computer operate faster, improving the general-purpose computer's data storage capabilities, etc. In other words, the focus of the pending claims is not on an improvement in computers as tools, but on certain abstract ideas that use computers as tools.
Moreover, the “‘novelty’ of any element or steps in a process, or even of the process itself, is of no relevance in determining whether the subject matter of a claim falls within the § 101 categories of possibly patentable subject matter.” Intellectual Ventures I v. Symantec Corp., 838 F.3d 1307, 1315, 120 USPQ2d 1353, 1358 (Fed. Cir. 2016) (quoting Diamond v. Diehr, 450 U.S. at 188–89, 209 USPQ at 9). See also Synopsys, Inc. v. Mentor Graphics Corp., 839 F.3d 1138, 1151, 120 USPQ2d 1473, 1483 (Fed. Cir. 2016) (“a claim for a new abstract idea is still an abstract idea. The search for a § 101 inventive concept is thus distinct from demonstrating § 102 novelty.”). See, for example, MPEP § 2106.05.
As such, it is respectfully submitted that the claims are directed to an abstract idea, the abstract idea is not integrated into a practical application, the additional elements do not integrate the abstract idea into a practical application and thus, are not patent-eligible under 35 U.S.C. § 101.
Conclusion
5. THIS ACTION IS MADE FINAL. Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a).
A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action.
Any inquiry concerning this communication or earlier communications from the examiner should be directed to Michael Tomaszewski whose telephone number is (313)446-4863. The examiner can normally be reached M-F 5:30 am - 2:30 pm.
Examiner interviews are available via telephone, in-person, and video conferencing using a USPTO supplied web-based collaboration tool. To schedule an interview, applicant is encouraged to use the USPTO Automated Interview Request (AIR) at http://www.uspto.gov/interviewpractice.
If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Peter H Choi can be reached at (469) 295-9171. The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300.
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/MICHAEL TOMASZEWSKI/Primary Examiner, Art Unit 3681