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 10/6/2025. Claims 1-18 are currently amended. Claims 1-18 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 1-18 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, 8 and 14, and their respective dependent claims are directed, in part, to program products for implementing methods for determining procedure profitability from dynamic updates.
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 mathematical concepts, 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, 8 and 14, as a whole, are directed to determining procedure profitability from dynamic updates by receiving information on procedures performed by a provider for a patient, analyzing procedure pricing, etc. to optimize profitability 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 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. That is, other than reciting the certain additional elements, nothing in the claims precludes the limitations from being practically performed in the mind.
CLAIM 1:
A system for continually providing a dynamic and interactive graphical representation over a network, the system comprising:
computer device comprising:
one or more processors;
a computer-readable non-transitory medium;
one or more other computer devices remote from the first device and in communication with the first computer device via a network;
the computer-readable, non-transitory medium of the first computer device storing instructions thereon that, when executed by the at least one processor, cause the at least one processor to:
identify a chosen period of time;
receive dynamic update information from the one or more computing devices over the network, on a continual basis and for the chosen period of time, about a set of chosen procedures performed by a provider, wherein the received information includes a reported time required for the provider to perform each of the chosen procedures, a fee for service charge for each of the chosen procedures, differing dynamic fees schedules that are each individually specific to any of a variety of multiple insurance companies, indicating what each individual insurance company is currently willing to pay for each of the chosen procedures under each of the differing dynamic fee schedules; and a number of each of the chosen procedures that are performed by the provider in the chosen period;
receive a first dynamic fee schedule from an automatically updated database;
receive a second dynamic fee schedule from the automatically updated database;
generate a weighted percent for each of the chosen procedures in the chosen period;
generate a net profitability report for each of the chosen procedures that are performed by the provider in the chosen period;
continually determine a profitability for each of the chosen procedures under the fee for service charge and under the differing dynamic fee schedules, the net profitability for each of the chosen procedures performed by the provider in the chosen period by the weighted percent for each of the chosen procedures;
responsive to detecting an updated net profitability for at least one of the chosen procedures, and the net profitability for each of the chosen procedures performed by the provider in the chosen period, automatically generate a dynamic and interactive graphical representation to identify and control for inefficiencies by providing a selection of at least one of: (i) procedures performed by the provider, (ii) instrumentation and/or materials used by the provider, (iii) payment options accepted by the provider, (iv) procedure pricing, (v) insurance selection, and (vi) billing procedures used by the provider;
provide over the network, the dynamic graphical representation to an electronic display of the one or more other computer devices; and
provide over the network, the dynamic graphical representation and provided the updates to the dynamic graphical representation to an electronic display of one or more other computer devices responsive to a change to the fee for service charge for any of the chosen procedures.
CLAIM 2:
The system of claim 1, wherein the time required for the provider to perform each of the chosen procedures excludes time spent by personnel of the provider to perform each of the chosen procedures.
CLAIM 3:
The system of claim 1, wherein the computer program code means is further comprised of executable code for implementing a step for automatically alerting a user where the provider’s fee for service charge for any of the procedures is lower than a corresponding dynamic fee that the insurance company is currently willing to pay.
CLAIM 4:
The computer program product of claim 1, wherein the computer-readable, non-transitory medium stores instructions that, when executed by the at least one processor, cause the at least one processor to determine an overall profitability of the provider during the chosen period from the insurance company.
CLAIM 5:
The system of claim 1, wherein the received dynamic update received dynamic update information further comprises at least two of: a reported gross income earned by the provider during the chosen period, actual expenses accrued by the provider during the chosen period, a total amount of time worked by the provider during the chosen period, and a gross income earned by the provider during the chosen period from the insurance company.
CLAIM 6:
The system of claim 1, wherein the computer-readable, non-transitory medium stores instructions that, when executed by the at least one processor, cause the at least one processor to check the received dynamic update information for correctness by at least one of:
i) determining, by the processor, a freedom time multiplier for each of the chosen procedures by dividing the reported time required for each of the chosen procedures by a calculated time spent on each of the chosen procedures during the chosen period;
ii) determine a factored volume for each of the chosen procedures by multiplying the number of each of the chosen procedures that are reported to have been performed by the provider in the chosen period by an adjusted amount of time that it takes the provider to perform the each of the chosen procedures, wherein the adjusted amount of time is calculated by multiplying the reported time required for the provider to perform each of the chosen procedures by the freedom time multiplier corresponding to each of the chosen procedures; and
iii) determine a total possible income the provider could have earned during the chosen period based on the provider’s fee for service charge for each of the chosen procedures and comparing the total possible income against a reported gross income of the provider during the chosen period.
CLAIM 7:
The system of claim 5, wherein the computer-readable, non-transitory medium stores instructions that, when executed by the at least one processor, cause the at least one processor to identify a calculated gross income and identifying a potential cause of a discrepancy between the calculated gross income and the reported gross income earned by the provider in during the chosen period.
CLAIM 8:
A system for implementing within a computer system a method for determining efficiencies from dynamic updates, the computer program product comprising:
one or more processors;
a computer-readable, non-transitory medium storing instructions thereon that, when executed by the at least one processor, cause the at least one processor to perform the steps comprising:
identify a chosen period of time;
receive information over a network from one or more remote computer systems, on a continual basis and for the chosen period of time, about a set of chosen procedures performed by a provider, wherein the received information includes a reported time required to perform each of the chosen procedures, a fee for service charge for each of the chosen procedures, differing dynamic fee schedules that are each individually specific to any of a variety of multiple insurance companies, indicating what each individual insurance company is willing to pay for each of the chosen procedures under each of the differing dynamic fee schedules, a number of each of the chosen procedures that are reported to have been performed by the provider in the chosen period, and a reported gross income of the provider during the chosen period;
receive a first dynamic fee schedule from an external automatically updated database;
receive a second dynamic fee schedule from the external automatically updated database;
checking the received information for correctness by at least one of:
i) generating a freedom time multiplier for each of the chosen procedures by dividing the reported time required for each of the chosen procedures by a calculated time spent on each of the chosen procedures during the chosen period;
ii) determining a factored volume for each of the chosen procedures;
iii) determining a total possible income the provider could have earned during the chosen period based on the provider’s fee for service charge for each of the chosen procedures and comparing the total possible income against the reported gross income of the provider during the chosen period;
determine an overall expense amount per hour accrued by the practice;
determine an overall income per hour earned through each insurance company; and
compare the overall expense per hour to the overall income per hour earned through the insurance company to calculate an hourly profit/loss associated with the insurance company; and
responsive to detecting an updated hourly profitability associated with each insurance company, automatically provide to the one or more remote computer systems, a dynamic and interactive graphical representation to reduce the inefficiencies in the provider’s practice by providing an interactive selection of at least one of: (i) procedures performed by the provider, (ii) instrumentation and/or materials used by the provider, (iii) payment options accepted by the provider, (iv) procedure pricing, and (v) billing procedures used by the provider; and
provide, by the processor and over the network, automatic update the dynamic graphical representation responsive to a change to the fee for service charge for any of the chosen procedures.
CLAIM 9:
The system of claim 8, wherein computer-readable, non-transitory medium stores instructions that, when executed by the at least one processor, cause the at least one processor to automatically alert a user where the fee for service charge for any of the chosen procedures is lower than a corresponding fee identified in at least one of the first dynamic fee schedule and the second dynamic fee schedule.
CLAIM 10:
The system of claim 8, wherein the time required for the provider to perform each of the chosen procedures excludes time spent by personnel of the provider to perform each of the chosen procedures.
CLAIM 11:
The system of claim 8, wherein the reported gross income of the provider during the chosen period excludes personal cash management income.
CLAIM 12:
The system of claim 8, wherein computer-readable, non-transitory medium stores instructions that, when executed by the at least one processor, cause the at least one processor to identify a calculated gross income and identifying a potential cause of a discrepancy between the calculated gross income and the reported gross income earned by the provider in the chosen period.
CLAIM 13:
The system of claim 8, wherein the step of checking the received information for correctness comprises at least one of: calculating, by the processor, a total expense for each of the chosen procedures during the chosen period, calculating, by the processor, a revenue earned during the chosen period for each of the chosen procedures, calculating, by the processor, a total possible income earned during the chosen period by the provider for each of the chosen procedures, and calculating, by the processor, an adjusted net un-weighted profit/loss for each of the chosen procedures during the chosen period.
CLAIM 14:
A system a method for determining efficiencies from dynamic updates, the computer program product comprising:
one or more processors;
a computer-readable, non-transitory medium storing instructions thereon that, when executed by the at least one processor, cause the at least one processor to perform the steps comprising:
identify a chosen period of time;
receive dynamic update information, from one or more remote computer systems over a network on a continual basis and for the chosen period of time, about a subset of chosen procedures selected from all procedures performed by a provider, wherein the received dynamic update information includes a reported time required to perform each of the chosen procedures, a fee for service charge for each of the chosen procedures; differing dynamic fee schedules that are each individually specific to any of a variety of multiple insurance companies, indicating what each individual insurance company is willing to pay for each of the chosen procedures; and a number of each of the chosen procedures that are performed by the provider in the chosen period;
receive a first dynamic fee schedule from an external automatically updated database;
receive a second dynamic fee schedule from the external automatically updated database;
generate a weighted percent for each of the chosen procedures in the chosen period by a total number of all of the chosen procedures that are performed by the provider in the chosen period;
generate a net profitability report for each of the chosen procedures that are performed by the provider in the chosen period;
continually determine a net profitability for each of the chosen procedures under the fee for service charge and under the differing dynamic fee schedules, the net profitability for each of the chosen procedures performed by the provider in the chosen period by the weighted percent of each of the chosen procedures; and
responsive to detecting an updated net profitability for at least one of the chosen procedures, and the net profitability for each of the chosen procedures performed by the provider in the chosen period, automatically generate a dynamic and interactive graphical representation to identify and control for inefficiencies by providing an interactive selection of at least one of: (i) procedures performed by the provider, (ii) instrumentation and/or materials used by the provider, (iii) payment options accepted by the provider, (iv) procedure pricing, (v) insurance selection, and (iv) billing procedures used by the provider;
provide over the network, the dynamic graphical representation to an electronic display of the one or more other computer devices; and
provide over the network, automatic updates to the dynamic graphical representation and provide the updates to the dynamic graphical representation to an electronic display of the one or more of the other computer devices responsive to a change to the fee for service charge for any of the chosen procedures.
CLAIM 15:
The system of claim 14, wherein the received dynamic update information further comprises at least two of: a reported gross income earned by the provider during the chosen period, actual expenses accrued by the provider during the chosen period, a total amount of time worked by the provider during the chosen period, and a gross income earned by the provider during the chosen period from the insurance company.
CLAIM 16:
The system of claim 14, wherein computer-readable, non-transitory medium stores instructions that, when executed by the at least one processor, cause the at least one processor to automatically alert a user where the fee for service charge for any of the procedures is lower than a corresponding fee in at least one of the first dynamic fee schedule and the second dynamic fee schedule.
CLAIM 17:
The system of claim 15, wherein computer-readable, non-transitory medium stores instructions that, when executed by the at least one processor, cause the at least one processor to identify, by the processor, a calculated gross income and identifying a potential cause of a discrepancy between the calculated gross income and the reported gross income earned by the provider in during the chosen period.
CLAIM 18:
The system of claim 14, wherein computer-readable, non-transitory medium stores instructions that, when executed by the at least one processor, cause the at least one processor to check the received dynamic update information for correctness by at least one of:
i) determining a freedom time multiplier for each of the chosen procedures by dividing the reported time required for each of the chosen procedures by a calculated time spent on each of the chosen procedures during the chosen period;
ii) determining a factored volume for each of the chosen procedures by multiplying the number of each of the chosen procedures that are reported to have been performed by the provider in the chosen period by an adjusted amount of time that it takes the provider to perform the each of the chosen procedures, wherein the adjusted amount of time is calculated by multiplying the reported time required for the provider to perform each of the chosen procedures by the freedom time multiplier corresponding to each the chosen procedures; and
iii) determining a total possible income the provider could have earned during the chosen period based on the fee for service charge for each of the chosen procedures and comparing the total possible income against a reported gross income of the provider during the chosen period.
* The limitations that are not in bold are not 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., computer program product, computer system, computer-readable non-transitory medium, one or more second computer systems, processor, network, automatically, 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 “by a processor”, “executable code for implementing steps”, etc. devoid of any meaningful technological 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 [0021]-[0032] of applicant's published application (US 2020/0051191) recites that the system/method is implemented using a computer device which may be a general-purpose or special-purpose computer. For example, computer device 10 may be a personal computer, a notebook computer, a personal digital assistant ("PDA") or other hand-held device, a workstation, a minicomputer, a mainframe, a supercomputer, a multi-processor system, a network computer, a processor-based consumer electronic device, or the like, 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 5/21/2025 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 5/21/2025.
4.1. Applicant argues, on pages 15-20 of the response, that the claims are not directed to an abstract idea and assuming, arguendo, that the claims do recite an abstract idea, they integrate the purported abstract idea into a practical application and recite an inventive concept that is significantly more.
In response, it is respectfully reiterated that Applicant’s invention is directed to systems and methods for providing financial analyses to service providers by determining the profitability or loss associated with certain procedures and certain insurance companies which is an abstract idea—providing financial analyses to service providers is a human activity. Moreover, the system and method receive information from providers, such as, a chosen time and procedures performed by a provider, the time required for a provider to perform the procedures, the fee charged by the provider for providing the service, billing procedures, fee schedules, etc.; generates profitability reports; identifies provider inefficiencies; and displays the information to a user, such as a provider. These are all human interactions and/or activities and thus, an abstract idea under the grouping of certain methods of organizing human activities which encompasses both certain activity of a single person, certain activity that involves multiple people, and certain activity between a person and a computer. Moreover, the claims recite steps that can be reasonably and practically performed in the human mind and/or with pen and paper using observation, evaluation, judgment and/or opinion. For example, nothing precludes a human from receiving information, analyzing information, calculating net profitability, identifying inefficiencies, generating reports, and displaying information using the human mind and/or pen and paper, as set forth section 3.1., supra—merely automating these steps is insufficient to render the claims non-abstract. Thus, the claims are directed to and recite an abstract idea under the groupings of certain methods of organizing human activity and mental processes. While the claims may also include limitations that cannot be reasonably and practically performed in the human mind and/or with pen and paper, such as, inter alia, automatically generating a dynamic and interactive graphical representation, these are additional elements that do not render the claims non-abstract and are analyzed in subsequent prongs of the 101-analysis, as set forth in section 3.1., supra.
It is also respectfully reiterated that the additional elements are insufficient to integrate the abstract idea into a practical limitation 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). For example, receiving and analyzing information relating to provider procedure times, costs, and the like are merely data processing steps (i.e., extra-solution activity) performed to generate and display provider performance and operational details, as further detailed in section 3.1., supra. Furthermore, the additional elements (i.e., network, processors, computer device, program, interface, etc.) are generic computer technologies recited at a high-level of generality and implemented to automate what otherwise could be done by a human and 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) as further detailed in section 4, supra. Moreover, the claims do not appear to recite any limitations evidencing a technological improvement to the additional elements. 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
Lastly, it is respectfully reiterated that the amended pending claims are not directed to a technological improvement per se. Rather, 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; and aside from the incidental use of well-known computer technology (e.g., computer, program, interface, etc.) to, for example, automate well-known manual activities (i.e., process/analyze/display information, determine inefficiencies, calculate net profitability, etc.), the claimed invention could be reasonably and practically performed with pen and paper and/or in the human mind.
As such, it is respectfully submitted that the pending amended claims, as a whole, are directed to an abstract idea, the abstract idea is not integrated into a practical application, the additional elements do not amount to significantly more than the abstract idea itself, and therefore, the pending claims are not patent-eligible under 35 U.S.C. § 101 for the reasons set forth above, in section 3, supra, and in previous office actions.
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.
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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