DETAILED ACTION
Notice of Pre-AIA or AIA Status
1. The present application is being examined under the pre-AIA first to invent provisions.
Continued Examination Under 37 CFR 1.114
2. A request for continued examination under 37 CFR 1.114, including the fee set forth in 37 CFR 1.17(e), was filed in this application after final rejection. Since this application is eligible for continued examination under 37 CFR 1.114, and the fee set forth in 37 CFR 1.17(e) has been timely paid, the finality of the previous Office action has been withdrawn pursuant to 37 CFR 1.114. Applicant's submission filed on 6/17/2026 has been entered.
Notice to Applicant
3. This communication is in response to the communication filed 6/17/2025. Claims 1-18 are cancelled. Claims 19-38 are newly added. Claims 19-38 are currently pending.
Claim Rejections - 35 USC § 101
4. 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.
4.1. Claims 19-38 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 19, 26 and 32, as a whole, are directed to performing a financial analysis of service providers and generating and updating graphical representations of the financial analysis for procedure and profitability optimization by, inter alia, obtaining service provider and insurance-fee information, generating service provider financial analysis information, generating graphical representations of the information, updating the information and graphical representations, 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 19
A computer-implemented system for continually generating and updating graphical representations over a network, the system comprising:
one or more processors;
a network interface configured to communicate with one or more remote computing devices; and
a non-transitory computer-readable medium storing instructions that, when executed by the one or more processors, cause the system to:
electronically import information associated with a service provider on a continual basis;
obtain updated insurance-fee information from an automatically updated database;
generate financial-analysis information associated with the service provider using the electronically imported information and the updated insurance-fee information;
automatically generate a graphical representation of the financial-analysis information;
provide the graphical representation through the network interface to one or more remote computing devices;
detect updates to the insurance-fee information stored within the automatically updated database;
automatically update the financial-analysis information responsive to the detected updates;
automatically regenerate the graphical representation using the updated financial-analysis information; and
automatically provide the regenerated graphical representation through the network interface to the one or more remote computing devices responsive to the detected updates.
CLAIM 20
The system of claim 19, wherein the electronically imported information comprises financial and operational information associated with the service provider.
CLAIM 21
The system of claim 20, wherein the electronically imported information comprises information relating to a plurality of procedures performed by the service provider during a selected period of time.
CLAIM 22
The system of claim 21, wherein the electronically imported information comprises a fee-for-service charge associated with each of the plurality of procedures.
CLAIM 23
The system of claim 21, wherein the electronically imported information comprises a quantity of each of the plurality of procedures performed during the selected period of time.
CLAIM 24
The system of claim 21, wherein the electronically imported information comprises time information associated with performance of the plurality of procedures.
CLAIM 25
The system of claim 21, wherein the financial-analysis information comprises profitability information associated with at least one of the plurality of procedures.
CLAIM 26
A computer-implemented system for generating and providing graphical representations associated with a service provider over a network, the system comprising:
one or more processors; and
a non-transitory computer-readable medium storing instructions that, when executed by the one or more processors, cause the system to:
receive information relating to a plurality of procedures performed by the service provider;
obtain insurance-fee information from an automatically updated database;
generate financial-analysis information using the information relating to the plurality of procedures and the insurance-fee information;
automatically generate a graphical representation of the financial-analysis information;
display the graphical representation;
detect updated insurance-fee information; and
automatically update the graphical representation responsive to the detected updated insurance-fee information.
CLAIM 27
The system of claim 26, wherein the graphical representation comprises a graph depicting weighted profit-or-loss information associated with a plurality of insurance companies.
CLAIM 28
The system of claim 26, wherein the graphical representation comprises a graph depicting insurance income-per-hour information.
CLAIM 29
The system of claim 26, wherein the graphical representation comprises an overall insurance comparison graph.
CLAIM 30
The system of claim 26, wherein the graphical representation comprises a graph depicting income information associated with specific insurance companies.
CLAIM 31
The system of claim 26, wherein the graphical representation is automatically updated responsive to modification of a fee-for-service charge.
CLAIM 32
A computer-implemented system comprising:
one or more processors;
a network interface configured to communicate with one or more remote computing systems; and
a non-transitory computer-readable medium storing instructions that, when executed by the one or more processors, cause the system to:
electronically import information relating to a selected set of procedures performed by a service provider during a selected period of time;
receive dynamic insurance-fee information;
store the dynamic insurance-fee information within an automatically updated database;
determine a weighted percentage corresponding to each procedure by dividing a quantity associated with the procedure by a total quantity of procedures in the selected set of procedures;
calculate a profitability value associated with each procedure;
determine weighted profitability information by applying the weighted percentage to the profitability value associated with each procedure;
detect updates to the dynamic insurance-fee information;
automatically update the weighted profitability information responsive to the detected updates; and
generate output identifying profitability changes resulting from the detected updates.
CLAIM 33
The system of claim 32, wherein the electronically imported information comprises reported gross income information associated with the selected period of time.
CLAIM 34
The system of claim 32, wherein the electronically imported information comprises expense information associated with the selected period of time.
CLAIM 35
The system of claim 32, wherein calculating the profitability value associated with each procedure comprises determining a profit-or-loss value associated with the procedure.
CLAIM 36
The system of claim 32, wherein the weighted profitability information comprises a weighted net profit margin.
CLAIM 37
The system of claim 32, wherein calculating the profitability value associated with each procedure comprises using a fee-for-service charge and the dynamic insurance-fee information.
CLAIM 38
The system of claim 32, wherein the generated output comprises an automatically generated recommendation identifying at least one of procedure selection, insurance participation, procedure pricing, billing procedures, payment options, instrumentation selection, or material selection.
* 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.
Furthermore, claims 32, 35, 36, and 37 also recite and are directed to mathematical concepts. For example, claim 32 recites calculating a profitability value, determining weighted profitability information; claim 35 recites calculating the profitability value associated by determining a profit-or-loss value; claim 36 recites determining weighted profitability information by determining a weighted net profit margin; and claim 37 recites calculating the profitability value using fee-for-service charge and dynamic insurance-fee information. These are mathematical concepts thereby rendering these claims abstract.
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.
5.1. Claims 19-37 are rejected under 35 U.S.C. 103(a) as being unpatentable over Brookhart (US 8484043), in view of Crane (US 5748907).
CLAIM 19
Brookhart teaches a computer-implemented system for continually generating and updating graphical representations over a network (Brookhart: abstract), the system comprising:
one or more processors (Brookhart: abstract; col. 4, lns. 30-49 “computer network system”; FIGS. 1; Claim 2 “computer processor”);
non-transitory computer-readable medium storing instructions that, when executed by the one or more processors, cause the system to (Brookhart: abstract; col. 4, lns. 30-49 “computer network system”; FIGS. 1; Claim 2 “computer processor”, Claim 12 “non-transitory computer readable medium”);
a network interface configured to communicate with one or more remote computing devices (Brookhart: abstract; col. 4, lns. 30-49 “computer network system”; FIGS. 1; Claim 2 “computer processor”); and
generate financial-analysis information associated with the service provider using the electronically imported information and the updated insurance-fee information (Brookhart: abstract; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period” and “Payer Fee File”; FIGS. 1-14G);
automatically generate a graphical representation of the financial-analysis information (Brookhart: abstract; col. 14, lns. 24-27 “automated processes”, col. 3, lns. 50-57 “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G);
provide the graphical representation through the network interface to one or more computing devices (Brookhart: abstract; col. 4, lns. 33-51 “present invention can be realized as methods or systems in hardware, software, or a combination of hardware and software of a computer system, including a computer network system. The present invention can be realized in a centralized fashion in one computer system or in a distributed fashion where different elements are spread across several computer systems”);
automatically update the financial-analysis information responsive to the detected updates (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period” and “Payer Fee File” and “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G);
automatically regenerate the graphical representation using the updated financial-analysis information (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period” and “Payer Fee File” and “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G); and
automatically provide the regenerated graphical representation through the network interface to the one or more remote computing devices responsive to the detected updates (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period” and “Payer Fee File” and “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G).
Brookhart does not appear to explicitly teach the following:
electronically import information associated with a service provider on a continual basis;
obtain updated insurance-fee information from an automatically updated database;
remote computing devices;
detect updates to the insurance-fee information stored within the automatically updated database.
Crane, however, teaches the following:
electronically import information associated with a service provider on a continual basis (Crane: abstract; col. 4, ln. 31-col. 6, ln. 39, col. 8., ln. 51-col. 9, ln. 8 “includes a master processor for continuously and automatically receiving a plurality of sensed real-time inputs related to a facility”; FIGS. 1-3);
obtain updated insurance-fee information from an automatically updated database (Crane: abstract; col. 4, ln. 31-col. 6, ln. 39, col. 8., ln. 51-col. 9, ln. 8 “includes a master processor for continuously and automatically receiving a plurality of sensed real-time inputs related to a facility”, col. 19, lns. 47-63 “insurance rates are stored”; FIGS. 1-3);
remote computing devices (Crane: abstract; col. 14, lns. 1-9 “remote processors”; FIGS. 1-3);
detect updates to the insurance-fee information stored within the automatically updated database (Crane: abstract; col. 4, ln. 31-col. 6, ln. 39, col. 8., ln. 51-col. 9, ln. 8 “includes a master processor for continuously and automatically receiving a plurality of sensed real-time inputs related to a facility”, col. 19, lns. 47-63 “insurance rates are stored”; FIGS. 1-3).
It would have been obvious to one of ordinary skill in the art, at the time of applicant’s invention, to include the medical facility and business automatic interactive dynamic real-time management with financial analysis features, as taught by Crane, with the method and system for medical procedure activity-based costing and margin analysis, as taught by Brookhart, with the motivation of facilitating operational efficiency (Crane: abstract; col. 1, ln. 10-col. 2, ln. 53; and col. 4, lns. 32-40).
CLAIM 20
Brookhart teaches the system of claim 19, wherein the electronically imported information comprises financial and operational information associated with the service provider (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; col. 3, ln. 40-col. 4, ln. 12; FIGS. 1-14G).
CLAIM 21
Brookhart teaches the system of claim 20, wherein the electronically imported information comprises information relating to a plurality of procedures performed by the service provider during a selected period of time (Brookhart: abstract “Procedure volumes”; col. 5, lns. “rendered during a designated timeframe, referred to as the Reference Period”; FIGS. 7B, 11A-12H).
CLAIM 22
Brookhart teaches the system of claim 21, wherein the electronically imported information comprises a fee-for-service charge associated with each of the plurality of procedures (Brookhart: abstract “procedure costs”; FIGS. 5A-6).
CLAIM 23
Brookhart teaches the system of claim 21, wherein the electronically imported information comprises a quantity of each of the plurality of procedures performed during the selected period of time (Brookhart: abstract “procedure volumes”; FIGS. 5A-6).
CLAIM 24
Brookhart teaches the system of claim 21, wherein the electronically imported information comprises time information associated with performance of the plurality of procedures (Brookhart: abstract; col. 5, lns. “rendered during a designated timeframe, referred to as the Reference Period”; FIGS. FIGS. 5A-6, 7B, 11A-12H).
CLAIM 25
Brookhart teaches the system of claim 21, wherein the financial-analysis information comprises profitability information associated with at least one of the plurality of procedures (Brookhart: abstract; “procedure margin analysis”; col. 3, ln. 40-col. 4, ln. 12 “PLM Procedure margin”; FIGS. 1-14G).
CLAIM 26
Brookhart teaches a computer-implemented system for generating and providing graphical representations associated with a service provider over a network (Brookhart: abstract), the system comprising:
one or more processors (Brookhart: abstract; col. 4, lns. 30-49 “computer network system”; FIGS. 1; Claim 2 “computer processor”);
non-transitory computer-readable medium storing instructions that, when executed by the one or more processors, cause the system to (Brookhart: abstract; col. 4, lns. 30-49 “computer network system”; FIGS. 1; Claim 2 “computer processor”, Claim 12 “non-transitory computer readable medium”);
receive information relating to a plurality of procedures performed by the service provider (Brookhart: abstract “Procedure volumes”; col. 5, lns. “rendered during a designated timeframe, referred to as the Reference Period”; FIGS. 7B, 11A-12H);
generate financial-analysis information using the information relating to the plurality of procedures and the insurance-fee information (Brookhart: abstract; col. 14, lns. 24-27 “automated processes”, col. 3, lns. 50-57 “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G);
automatically generate a graphical representation of the financial-analysis information; display the graphical representation (Brookhart: abstract; col. 14, lns. 24-27 “automated processes”, col. 3, lns. 50-57 “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G);
automatically update the graphical representation responsive to the detected updated insurance-fee information (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period” and “Payer Fee File” and “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G).
Brookhart does not appear to explicitly teach the following:
obtain insurance-fee information from an automatically updated database; and
detect updated insurance-fee information.
Crane, however, teaches the following:
obtain updated insurance-fee information from an automatically updated database (Crane: abstract; col. 4, ln. 31-col. 6, ln. 39, col. 8., ln. 51-col. 9, ln. 8 “includes a master processor for continuously and automatically receiving a plurality of sensed real-time inputs related to a facility”, col. 19, lns. 47-63 “insurance rates are stored”; FIGS. 1-3);
detect updated insurance-fee information (Crane: abstract; col. 4, ln. 31-col. 6, ln. 39, col. 8., ln. 51-col. 9, ln. 8 “includes a master processor for continuously and automatically receiving a plurality of sensed real-time inputs related to a facility”, col. 19, lns. 47-63 “insurance rates are stored”; FIGS. 1-3).
It would have been obvious to one of ordinary skill in the art, at the time of applicant’s invention, to include the medical facility and business automatic interactive dynamic real-time management with financial analysis features, as taught by Crane, with the method and system for medical procedure activity-based costing and margin analysis, as taught by Brookhart, with the motivation of facilitating operational efficiency (Crane: abstract; col. 1, ln. 10-col. 2, ln. 53; and col. 4, lns. 32-40).
CLAIM 27
Brookhart teaches the system of claim 26, wherein the graphical representation comprises a graph depicting weighted profit-or-loss information associated with a plurality of insurance companies (Brookhart: abstract “Payer fees are integrated and analyzed to determine such values as Procedure volumes, Procedure costs, Procedure Margins, Payer Margins and Percent Payer Margins. The results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; FIGS. 1-14G).
CLAIM 28
Brookhart does not appear to explicitly teach the system of claim 26, wherein the graphical representation comprises a graph depicting insurance income-per-hour information.
Crane, however, teaches wherein the graphical representation comprises a graph depicting insurance income-per-hour information (Crane: abstract; col. 19, ln. 47-col. 20, ln. 30 “operating and labor cost, etc., and there is the invoicing of services, tests, medication, then there is the dollar receivables for the hour, day, week, month, etc.”).
The motivation to include the teachings of Crane with the teachings of Brookhart is the same as that of claim 26 above and is incorporated herein.
CLAIM 29
Brookhart teaches the system of claim 26, wherein the graphical representation comprises an overall insurance comparison graph (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; FIGS. 12E).
CLAIM 30
Brookhart teaches the system of claim 26, wherein the graphical representation comprises a graph depicting income information associated with specific insurance companies (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; FIGS. 12E).
CLAIM 31
Brookhart teaches the system of claim 26, wherein the graphical representation is automatically updated responsive to modification of a fee-for-service charge (Brookhart: abstract; col. 14, lns. 24-27 “automated processes”, col. 3, lns. 50-57 “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G).
CLAIM 32
Brookhart teaches a computer-implemented system (Brookhart: abstract) comprising:
one or more processors (Brookhart: abstract; col. 4, lns. 30-49 “computer network system”; FIGS. 1; Claim 2 “computer processor”);
a network interface configured to communicate with one or more remote computing devices (Brookhart: abstract; col. 4, lns. 30-49 “computer network system”; FIGS. 1; Claim 2 “computer processor”); and
non-transitory computer-readable medium storing instructions that, when executed by the one or more processors, cause the system to (Brookhart: abstract; col. 4, lns. 30-49 “computer network system”; FIGS. 1; Claim 2 “computer processor”, Claim 12 “non-transitory computer readable medium”);
electronically import information relating to selected procedures performed by a service provider during a selected period of time (Brookhart: abstract “Procedure volumes”; col. 5, lns. “rendered during a designated timeframe, referred to as the Reference Period”; FIGS. 7B, 11A-12H);
determine a weighted percentage corresponding to each procedure by dividing a quantity associated with the procedure by a total quantity of procedures in the selected set of procedures (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer” and “procedure volumes”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period”; FIGS. 1-14G);
calculate a profitability value associated with each procedure (Brookhart: abstract; “procedure margin analysis”; col. 3, ln. 40-col. 4, ln. 12 “PLM Procedure margin”; FIGS. 1-14G);
determine weighted profitability information by applying the weighted percentage to the profitability value associated with each procedure (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer” and “procedure volumes”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period”; FIGS. 1-14G);
automatically update the weighted profitability information responsive to the detected updates (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period” and “Payer Fee File” and “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G); and
generate output identifying profitability changes resulting from the detected updates (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period” and “Payer Fee File” and “outputs an analysis in a predetermined table or graph”; FIGS. 1-14G).
Brookhart does not appear to explicitly teach the following:
receiving dynamic insurance-fee information;
store the dynamic insurance-fee information within an automatically updated database; and
detect updates to the dynamic insurance-fee information.
Crane, however, teaches the following:
receiving dynamic insurance-fee information (Crane: abstract; col. 4, ln. 31-col. 6, ln. 39, col. 8., ln. 51-col. 9, ln. 8 “includes a master processor for continuously and automatically receiving a plurality of sensed real-time inputs related to a facility”, col. 19, lns. 47-63 “insurance rates are stored”; FIGS. 1-3);
store the dynamic insurance-fee information within an automatically updated database (Crane: abstract; col. 4, ln. 31-col. 6, ln. 39, col. 8., ln. 51-col. 9, ln. 8 “includes a master processor for continuously and automatically receiving a plurality of sensed real-time inputs related to a facility”, col. 19, lns. 47-63 “insurance rates are stored”; FIGS. 1-3);
detect updates to the dynamic insurance-fee information (Crane: abstract; col. 4, ln. 31-col. 6, ln. 39, col. 8., ln. 51-col. 9, ln. 8 “includes a master processor for continuously and automatically receiving a plurality of sensed real-time inputs related to a facility”, col. 19, lns. 47-63 “insurance rates are stored”; FIGS. 1-3).
It would have been obvious to one of ordinary skill in the art, at the time of applicant’s invention, to include the medical facility and business automatic interactive dynamic real-time management with financial analysis features, as taught by Crane, with the method and system for medical procedure activity-based costing and margin analysis, as taught by Brookhart, with the motivation of facilitating operational efficiency (Crane: abstract; col. 1, ln. 10-col. 2, ln. 53; and col. 4, lns. 32-40).
CLAIM 33
Brookhart teaches the system of claim 32, wherein the electronically imported information comprises reported gross income information associated with the selected period of time (Brookhart: abstract “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer”; col. 4, lns. 60-67 “practice costs or income from activities”; col. 7, lns. 23-40 “income statement”; FIGS. 1-14G).
CLAIM 34
Brookhart teaches the system of claim 32, wherein the electronically imported information comprises expense information associated with the selected period of time (Brookhart: abstract; col.3, ln. 40-col. 4, ln. 12 “practice expense”; FIGS. 1-14G).
CLAIM 35
Brookhart teaches the system of claim 32, wherein calculating the profitability value associated with each procedure comprises determining a profit-or-loss value associated with the procedure (Brookhart: abstract; “procedure margin analysis”; col. 3, ln. 40-col. 4, ln. 12 “PLM Procedure margin”; FIGS. 1-14G).
CLAIM 36
Brookhart system of claim 32, wherein the weighted profitability information comprises a weighted net profit margin (Brookhart: abstract “margin analysis”, “results are presented in meaningful reports, tables and graphs, including representations by Practice, Provider, Procedure, and Payer” and “procedure volumes”; col. 3, ln. 39-col. 4, ln. 12 “calculation of Relative Value Units (RVUs) from CMS' Resource Based Relative Value Scale (RBRVS) by including all valid services in the determination of medical practice outputs, permitting the selection of RVU weights from CMS-published RVU weight tables, including Location of Service as an attribute of service output, calculating Modifier-adjusted RVU values, and recognizing all of these effects in the calculation of the PLM RVUs that represent the practice's services during the Reference Period”; FIGS. 1-14G).
CLAIM 37
Brookhart teaches the system of claim 32, wherein calculating the profitability value associated with each procedure comprises using a fee-for-service charge and the dynamic insurance-fee information (Brookhart: abstract “procedure costs”; FIGS. 5A-6).
5.2. Claim 38 is rejected under 35 U.S.C. 103(a) as being unpatentable over Brookhart (US 8484043), in view of Crane (US 5748907), and further in view of Mintz (US 2004/0243438).
CLAIM 38
Brookhart and Crane do not appear to explicitly teach the system of claim 32, wherein the generated output comprises an automatically generated recommendation identifying at least one of procedure selection, insurance participation, procedure pricing, billing procedures, payment options, instrumentation selection, or material selection.
Mintz, however, teaches wherein the generated output comprises an automatically generated recommendation identifying at least one of procedure selection, insurance participation, procedure pricing, billing procedures, payment options, instrumentation selection, or material selection (Mintz: abstract; ¶¶ [0088] “module enables the user to view all the products where recommendations exist, and view the specific suggestion that can be made to help lower cost”; FIGS. 1-17).
It would have been obvious to one of ordinary skill in the art, at the time of applicant’s invention, to include the method and system for cost analysis and benchmarking in the healthcare industry, as taught by Mintz, with the medical facility and business automatic interactive dynamic real-time management with financial analysis features, as taught by Crane, with the method and system for medical procedure activity-based costing and margin analysis, as taught by Brookhart, with the motivation of improving cost-effectiveness in healthcare (Mintz: abstract; ¶¶ [0006]-[0020]).
Response to Arguments
6. Applicant's arguments filed 6/17/2026 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 6/17/2026.
6.1. New prior art has been applied to the newly added claims. As such, applicant's remarks with regard to the application of the cited prior art to the amended claims are addressed in the Office Action above.
Relevant Non-Cited Prior Art
7. The following discovered prior art was not cited in this rejection but may be relevant:
Atallah (US 2002/0120468) – teaches a method and apparatus for providing financial analysis for medical procedures
Masahiko et al. (JP 2005004260) – teaches a hospital management system that outputs statistical data for supporting hospital management; features include, inter alia, profit and loss statements, graphical representations, etc.
Lewis et al. (US 2008/0059248) – teaches methods, program product, and systems for healthcare practice management; features include, inter alia, suggests/recommends alternative medical procedures to reduce costs, etc.
Siegrist, Jr. et al. (US 5652842) – teaches analysis and reporting of performance of service providers
Conclusion
8. 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.
Information regarding the status of published or unpublished applications may be obtained from Patent Center. Unpublished application information in Patent Center is available to registered users. To file and manage patent submissions in Patent Center, visit: https://patentcenter.uspto.gov. Visit https://www.uspto.gov/patents/apply/patent-center for more information about Patent Center and https://www.uspto.gov/patents/docx for information about filing in DOCX format. For additional questions, contact the Electronic Business Center (EBC) at 866-217-9197 (toll-free). If you would like assistance from a USPTO Customer Service Representative, call 800-786-9199 (IN USA OR CANADA) or 571-272-1000.
/MICHAEL TOMASZEWSKI/Primary Examiner, Art Unit 3681
Prosecution Insights