DETAILED ACTION
Notice of Pre-AIA or AIA Status
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
Acknowledgements
This communication is in response to Request for Continued Examination filed on 11/20/2025.
Claims 1, 14, 21 are amended.
Claims 4, 8-10, 16, 18 are canceled.
Claims 1-3, 5-7, 11-15, 17, 19-26 are currently pending and have been examined.
Claims 1-3, 5-7, 11-15, 17, 19-26 have been rejected as follows.
Continued Examination Under 37 CFR 1.114
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and the fee set forth in 37 CFR 1.17(e) has been timely paid, the finality of the previous Office action has been withdrawn pursuant to 37 CFR 1.114.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 11/20/2025 has been entered.
Information Disclosure Statement
The information disclosure statement (IDS) submitted on 10/02/2023 is in compliance with the provisions of 37 CFR 1.97. Accordingly, the information disclosure statement is being considered by the examiner.
Claim Rejections - 35 USC § 101
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.
Claims 1-3, 5-7, 11-15, 17, 19-26 are rejected under 35 U.S.C. 101 because the claimed invention is directed to a judicial exception (i.e., a law of nature, a natural phenomenon, or an abstract idea) without significantly more.
Claims 1, 21 are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea without significantly more. The claim recites a non-transitory medium and method for paying for a medical service.
The limitations of providing […] to a patient, a medical provider, a payor, or a combination thereof; presenting, […], a total cost of a healthcare procedure to the patient, the payor, or a combination thereof; pulling funds for the healthcare procedure prior to the healthcare procedure occurring, wherein the pulled funds equal the total cost; storing the funds in a […] clearing account; identifying completion of the healthcare procedure based at least in part on an indication signal from the medical provider; and releasing the pulled funds from the […] clearing account to the medical provider for the healthcare procedure in response to the indication signal of the completed procedure, is a process that, under the broadest reasonable interpretation, covers certain methods of organizing human activity (i.e., managing personal behavior including following rules or instructions). That is, other than reciting (Claim 1) non-transitory computer-readable medium storing a program including instructions that, when executed by a processor, execute the instructions, the claimed invention amounts to managing personal behavior or interaction between people. For example, but for the non-transitory computer-readable medium storing a program including instructions that, when executed by a processor, execute the instructions and a portal this claim encompasses a person presenting a cost, pulling funds, identifying completion and paying for the procedure. If a claim limitation, under its broadest reasonable interpretation, covers managing personal behavior or interactions between people then it falls within the “certain methods of organizing human activity” grouping of abstract ideas. Accordingly, the claim recites an abstract idea.
Step 2A2
This judicial exception is not integrated into a practical application. In particular, the claim recites the additional element of (claim 1) non-transitory computer-readable medium storing a program including instructions that, when executed by a processor, causes a portal managing apparatus to perform the method that implements the identified abstract idea. The non-transitory computer readable medium and processor is not described by the applicant and is recited at a high-level of generality (i.e., a generic computer performing a generic computer functions of computing, determining, and selecting) such that it amounts no more than mere instructions to apply the exception using a generic computer component. Accordingly, this additional element does not integrate the abstract idea into a practical application because it does not impose any meaningful limits on practicing the abstract idea. The claim is directed to an abstract idea.
This judicial exception is not integrated into a practical application. In particular, the claim recites the additional elements of reciting (Claim 1, 21) a portal. The portal merely generally links the abstract idea to a particular technological environment or field of use. MPEP 2106.04(d)(I) indicates that generally linking an abstract idea to a particular technological environment or field of use cannot provide a practical application. Utilization of the screen equates to saying “apply it.” MPEP 2106.04(d)(I) indicates that merely saying “apply it” or equivalent to the abstract idea cannot provide a practical application. Accordingly, even in combination, this additional element does not integrate the abstract idea into a practical application.
Step 2B
The claim does not include additional elements that are sufficient to amount to significantly more than the judicial exception. As discussed above with respect to integration of the abstract idea into a practical application, the additional element of using a non-transitory computer-readable medium storing a program including instructions that, when executed by a processor, causes a portal managing apparatus to perform the noted steps amounts to no more than mere instructions to apply the exception using a generic computer component. Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept (“significantly more”). Accordingly, even in combination, this additional element does not provide significantly more. As such the claim is not patent eligible.
Also, as discussed above with respect to integration of the abstract idea into a practical application, the additional element of a portal was determined to generally link the abstract idea to a particular technological environment or field of use. This has been re-evaluated under the “significantly more” analysis and has also been found insufficient to provide significantly more. MPEP 2106.05(A) indicates that generally linking an abstract idea to a particular technological environment or field of use cannot provide significantly more. MPEP 2106.05(A) indicates that generally linking an abstract idea to a particular technological environment or field of use cannot provide significantly more. Accordingly, even in combination, this additional element does not provide significantly more. As such the claim is not patent eligible.
Dependent Claims
Claims 2-3, 5-7, 11-15, 17, 19-20, 22-26 are similarly rejected because they either further define/narrow the abstract idea and/or do not further limit the claim to a practical application or provide as inventive concept such that the claims are subject matter eligible even when considered individually or as an ordered combination. Claim 2 merely describes confirming pricing. Claims 6-7 merely describes authorizing payment. Claims 11-12, 24 merely describes communicating with a payor, patient, provider or facility. Claim 13-15 merely describes requesting a medical service. Claim 17 merely describes scheduling a medical service. Claims 19, 22 merely describes funding an account. Claim 20 merely describes paying for a procedure. Claim 23 merely describes the total cost. Claim 25 merely describes releasing funds. Claim 26 merely describes scheduling.
Claims 3, 5, 12 describes the additional element of an instant messaging center. The instant messaging center generally links the abstract idea to a particular technological environment or filed of use. Generally linking an abstract idea to a particular technological environment or field of use is insufficient to provide a practical application. Accordingly, even in combination, this additional element does not integrate the abstract idea into a practical application. This has been re-evaluated under the “significantly more” analysis and has also been found insufficient to provide significantly more. MPEP 2106.05(A) indicates that generally linking an abstract idea to a particular technological environment or field of use cannot provide significantly more. As such the claim is not patent eligible. Claim 3 merely describes sharing information. Claim 5 merely describes the cost being based on information shared. Claim 12 merely describes the platform as an instant messaging center.
Claim Rejections - 35 USC § 102
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
The following is a quotation of the appropriate paragraphs of 35 U.S.C. 102 that form the basis for the rejections under this section made in this Office action:
A person shall be entitled to a patent unless –
(a)(1) the claimed invention was patented, described in a printed publication, or in public use, on sale, or otherwise available to the public before the effective filing date of the claimed invention.
Claims 1-3, 6-14, 17-20 are rejected under 35 U.S.C. 102(a)(1) as being anticipated by Pourfallah (US 20120239560) referred to hereinafter as Pourfallah.
CLAIM 1
Pourfallah teaches A non-transitory computer-readable medium storing a program including instructions that, when executed by a processor, causes a portal managing apparatus to: (Pourfallah para 35 teaches a method for facilitating healthcare payment. Para 501 teaches a processor in communication with a memory configured to follow instructions to perform the method. )
display a portal interface for one or more users, including a healthcare provider; (Pourfallah para 44 teaches a portal for a provider. Para 169 teaches a web-based portal may be interacted with by the patient.)
pull funds for a healthcare procedure prior to the healthcare procedure, wherein the funds equal a total cost of the healthcare procedure set prior to the healthcare procedure; (Pourfallah para 41 teaches a prepaid account being funded prior to a knee surgery and upon verification from the insurance provider the funds are transferred to the healthcare provider. See also Fig 6B which shows step 639 of preloading the users Prepaid account according to the cost of the requested medical service prior to receiving medical treatment. Para 174 further teaches loading the prepaid card in an amount equal to the cost required to be paid.)
store the funds in a portal clearing account; (Pourfallah Fig. 5A teaches insurance paying for a partial amount and then patient paying for a partial amount, i.e., depositing funds from a payor and then depositing funds from a patient. Fig. 26 teaches a clearing and settlement system that the funds go to after authorization and before settlement. See also Para 135 for receiving compensation from an insurance company at a terminal.)
identify completion of the healthcare procedure based at least in part on an indication signal from the healthcare provider using the portal interface; and (Pourfallah para 41 teaches upon receiving a medical service at a healthcare provider the healthcare provider will issue a medical bill. Examiner notes that issuing a medical bill upon the service being received is the signal using the portal identifying completion of the healthcare procedure. This is because the billing is performed upon receiving the medical service. Pourfallah para 71 teaches once proof of services rendered has been obtained to the satisfaction of the sharing network, funds that are being held (escrowed) are released and transferred to the provider account.)
release the funds from the portal clearing account to the healthcare provider for the healthcare procedure in response to identifying completion of the healthcare procedure. (Pourfallah para 71 teaches once proof of services rendered has been obtained to the satisfaction of the sharing network, funds that are being held (escrowed) are released and transferred to the provider account. Para 41 teaches transferring funds to the healthcare provider after a completed medical service and upon verification. Para 56-57 teach generating a payment authorization request and routing to an insurance provider and an insurance provider reviewing and verifying the requested insurance payment and then sending an insurance payment authorization response to authorize payment. )
CLAIM 2
Pourfallah teaches display a platform for confirming pricing for the healthcare procedure, wherein the total cost is a result of the confirmation. (Pourfallah para 130 teaches a patient confirming a price on the mobile component (portal))
CLAIM 3
Pourfallah teaches display a platform for sharing information through an instant messaging center. (Pourfallah para 41 teaches the patient may receive a bill (information shared) in the form of an email or text message (instant message center). Para 53, 113 describing instant messaging. Para 328 teaches a social tab that facilitates integration of a wallet application with social channels and the user may sign in and then send or receive money through the integrated social channels.)
CLAIM 5
Pourfallah teaches wherein the total cost is based on the information shared within the instant messaging center. (Pourfallah para 130 teaches a patient confirming a price on the mobile component (portal) where the price is the total cost. Para 152 further teaches a total cost being presented to a user using the system. )
CLAIM 6
Pourfallah teaches display a platform for authorizing payment for the healthcare procedure. (Pourfallah para 106 teach a user authorizing payment using the user's smart phone (portal). See also Para 141 where payment is authorized using the mobile device. Fig 4D shows a view of a window (portal) where a user authorizes payment.)
CLAIM 7
Pourfallah teaches display a platform for authorizing the portal to withdraw funds from a payor's account (Pourfallah para 106 teach a user authorizing payment using the user's smart phone (portal). See also Para 141 where payment is authorized using the mobile device. Fig 4D shows a view of a window (portal) where a user authorizes payment. Para 95 teaches a transaction may be authorized to withdraw all necessary funds from a payor's account)
CLAIM 11
Pourfallah teaches display a platform for communications between a healthcare provider, a payor, a patient, and/or a facility. (Pourfallah para 36 teaches communicating with a patient through a mobile device (portal) by giving them a bill. Para teaches 45 teaches communicating with a facility “St John’s Hospital” though a social media (portal). Para 49 teaches using a terminal (portal) to allow a provider to communicate with a provider and a patient.)
CLAIM 12
Pourfallah teaches wherein the platform is an instant messaging center. (Para 134 teaches a provider communicating with an insurance provider (payor) via instant messaging by sending a bill. Para 135 teaches sending a bill as a text message from a physician to a patient. Para 49 teaches using a terminal (portal) to allow a provider to communicate with a provider and a patient.) Para teaches 45 teaches communicating with a facility “St John’s Hospital” though a social media (portal).)
CLAIM 13, 15
Pourfallah teaches display a platform for requesting a healthcare procedure. (Pourfallah para 170 teaches searching a list of providers for eligible providers and then presenting those to the patient when a requested healthcare service is requested. Examiner notes that the providers must be eligible and therefore a search across all providers is necessary in order to determine which providers are eligible and therefore are provided.)
CLAIM 14
Pourfallah teaches display a platform for initiating a search request for the healthcare procedure; and enable a user to select a healthcare provider from a set of search results. (Pourfallah para 170 teaches searching a list of providers for eligible providers and then presenting those to the patient when a requested healthcare service is requested. Para 178 teaches a patient submitting a request for a healthcare provider (i.e., selecting a provider) from the list of recommended providers)
CLAIM 17
Pourfallah teaches display a platform for scheduling the healthcare procedure digitally connecting a payor, a patient, and the healthcare provider. (Pourfallah Para 169 teaches using a web-based portal to schedule a medical service request. Para 170 teaches the determining an eligible provider from a list of contracted providers. Para 178 teaches the patient selecting a provider from the list. Para 41 teaches connecting an insurance provider (payor) to the system. Examiners note the patients are connected to the provider by selecting a provider from a list and patients are connected to the payor by providing their insurance information so that the insurance can be billed.)
CLAIM 19
Pourfallah teaches deposit all funds from a payor and a patient into a portal clearing account. (Pourfallah Fig. 5A teaches insurance paying for a partial amount and then patient paying for a partial amount, i.e., depositing funds from a payor and then depositing funds from a patient. Fig. 26 teaches a clearing and settlement system that the funds go to after authorization and before settlement. See also Para 135 for receiving compensation from an insurance company at a terminal.)
CLAIM 20
Pourfallah teaches release the funds to all involved healthcare providers immediately upon completion of the healthcare procedure. (Pourfallah Para 95 teaches paying providers after completing the medical service)
CLAIM 21
Pourfallah teaches A method of arranging, completing, and paying for healthcare services, the method comprising: (Pourfallah para 35 teaches a method for facilitating healthcare payment. Para 501 teaches a processor in communication with a memory configured to follow instructions to perform the method. )
providing a portal to a patient, a medical provider, a payor, or a combination thereof; (Pourfallah para 44 teaches a portal for a provider. Para 169 teaches a web-based portal may be interacted with by the patient.)
presenting, via the portal, a total cost of a healthcare procedure to the patient, the payor, or a combination thereof; (Pourfallah para 44 teaches a portal and generation of a medical bill with the user amount due being presented to the patient. )
pulling funds for the healthcare procedure prior to the healthcare procedure occurring, wherein the pulled funds equal the total cost; (Pourfallah para 41 teaches a prepaid account being funded prior to a knee surgery and upon verification from the insurance provider the funds are transferred to the healthcare provider. See also Fig 6B which shows step 639 of preloading the users Prepaid account according to the cost of the requested medical service prior to receiving medical treatment. Para 174 further teaches loading the prepaid card in an amount equal to the cost required to be paid.)
store the funds in a portal clearing account; (Pourfallah Fig. 5A teaches insurance paying for a partial amount and then patient paying for a partial amount, i.e., depositing funds from a payor and then depositing funds from a patient. Fig. 26 teaches a clearing and settlement system that the funds go to after authorization and before settlement. See also Para 135 for receiving compensation from an insurance company at a terminal.)
identifying completion of the healthcare procedure based at least in part on an indication from the medical provider; and (Pourfallah para 41 teaches upon receiving a medical service at a healthcare provider the healthcare provider will issue a medical bill. Examiner notes that issuing a medical bill upon the service being received is the signal using the portal identifying completion of the healthcare procedure. This is because the billing is performed upon receiving the medical service. Pourfallah para 71 teaches once proof of services rendered has been obtained to the satisfaction of the sharing network, funds that are being held (escrowed) are released and transferred to the provider account.)
releasing the pulled funds from the poral clearing account to the medical provider for the healthcare procedure in response to the indication signal of the completed procedure. (Pourfallah para 71 teaches once proof of services rendered has been obtained to the satisfaction of the sharing network, funds that are being held (escrowed) are released and transferred to the provider account. Para 41 teaches transferring funds to the healthcare provider after a completed medical service and upon verification. Para 56-57 teach generating a payment authorization request and routing to an insurance provider and an insurance provider reviewing and verifying the requested insurance payment and then sending an insurance payment authorization response to authorize payment. )
CLAIM 22
Pourfallah teaches pulling the funds from the payor and/or the patient based at least in part on an authorization from the payor and the patient to do so; and (Pourfallah para 106 teach a user authorizing payment using the user's smart phone (portal). See also Para 141 where payment is authorized using the mobile device. Fig 4D shows a view of a window (portal) where a user authorizes payment.)
depositing the funds from the payor and/or the patient into a portal clearing account. (Pourfallah Fig. 5A teaches insurance paying for a partial amount and then patient paying for a partial amount, i.e., depositing funds from a payor and then depositing funds from a patient. At least Para 106, 141, 147, 202, and Fig. 26 teaches a clearing and settlement system that the funds go to after authorization and before settlement)
CLAIM 23
Pourfallah teaches wherein the total cost is set by the medical provider in advance of the healthcare procedure. (Pourfallah para 152 teaches two options for a total cost set by two different providers before the procedure being presented to a user. Para 170 also teaches querying a list of contracted providers for cost. )
CLAIM 24
Pourfallah teaches wherein the total cost is based at least in part on communications between the patient, the medical provider, the payor, or a combination thereof in the portal. (Pourfallah para 152 teaches two options for a total cost set by two different providers before the procedure being presented to a user. Para 170 also teaches querying a list of contracted providers for cost. Para 159 further teaches an estimated cost being presented to the user based on the availability information from providers, insurance plan and sponsor information. Para 151 further teaches a cost being presented based on a potential rebate if the patient elects to receive medical service at an international provider at lower cost.)
CLAIM 25
Pourfallah teaches wherein releasing the pulled funds comprises: releasing the funds to all involved medical providers immediately upon completion of the healthcare procedure. (Pourfallah para 41 teaches transferring funds to the healthcare provider after a completed medical service)
CLAIM 26
Pourfallah teaches scheduling the healthcare procedure prior to pulling the funds. (Para 169 teaches using a web-based portal to schedule a medical service request. para 41 teaches transferring funds to the healthcare provider after a completed medical service.)
Prior Art Made of Record and Not Relied Upon
The prior art made of record and not relied upon is considered pertinent to applicant's disclosure.
US 20200372554 Meggs
[0010] In some example embodiments, the processor may be further configured to receive escrow requests issued by the healthcare providers for funding prior to performing healthcare services, and establish virtual bill accounts for payment sharing for each of the escrow requests. In another example configuration, the processor may be further configured to receive loan requests for portions of the member healthcare bills not shared by the other members, allocate and publish the loan requests for repayment with interest to sharing accounts of at least some of the members of the VSE platform, and electronically transfer the loan payments and repayments between the member sharing accounts.
US 20100049563 Lopez
[0027] A method of using the interactive computer-implemented website system 100 for allowing customers to guarantee payment to service providers after services have been satisfactorily rendered described above, comprises the steps of first receiving, from a computer of a customer 20, a command informing the system 100 that a contract has been entered with a specific service provider and a money transfer for the benefit of a specific service provider upon the satisfactory completion of the service contracted for. Then, receiving, from a computer of the specific service provider 22, a message that the service contracted for has been completed. Next, transmitting, to the computer of the customer 20, a request for release of payment if the service contracted for is satisfactory, if the service is not satisfactory then a request to schedule binding arbitration regarding payment for the service. Then, receiving, from the computer of the customer 20, the request whether or not to make payment to the service provider or to schedule binding arbitration. And lastly, if the computer of the customer 20 requests that payment be made to service provider, then making payment to service provider, if computer of the customer 20 requests binding arbitration, then selecting a specific arbitrator to arbitrate dispute.
Response to Arguments Regarding U.S.C. 101 Rejection
Applicant argues pg. 8-9:
The claims do not recite a method of organizing human activity because the amended claims specifically require technological processes that are not directed to managing personal behavior including following rules or instructions, including at least: " Portal Interface Technology: The requirement to "display a portal interface for one or more users, including a healthcare provider" necessitates computer-implemented user interface technology that is not relevant to managing personal behavior. " Electronic Clearing Account Management: The requirement to "store the funds in a portal clearing account" requires electronic account management and fund custody that is not relevant to managing personal behavior. " Electronic Signal Detection and Processing: The requirement to "identify completion of the healthcare procedure based at least in part on an indication signal from the healthcare provider using the portal interface" requires real-time electronic signal processing and automated system integration. " Automated Fund Release: The requirement to "release the funds from the portal clearing account to the healthcare provider for the healthcare procedure in response to identifying completion" requires automated electronic fund transfers with timing precision that is not relevant to managing personal behavior. For at least the reasons above, the amended claims are not directed to managing personal behavior or other methods of organizing human activity. Rather, they recite a specific, computer- implemented architecture that departs from conventional healthcare payment workflows and cannot be reasonably characterized as an equivalent process performed by a human. These elements were neither present in conventional post-procedure billing processes nor would they exist in a purely human-run analogue, which lacks the claimed pre-funding escrow, signal-driven automation, and system-level integration. Accordingly, the claims do not "recite" an abstract idea under Step 2A, Prong 1, and withdrawal of the 35 U.S.C. § 101 rejection is respectfully requested.
Examiner responds:
The Examiner respectfully disagrees. MPEP 2106. 04(a)(2)(II) states that a claimed invention is directed to certain methods of organizing human activity if the identified claim elements contain limitations that encompass fundamental economic principles or practices, commercial or legal interactions, or managing personal behavior or relationships or interactions between people (including social activities, teaching, and following rules or instructions). The Examiner submits that the identified claim elements represent a series of rules or instructions that a person or persons, with or without the aid of a computer, would follow for presenting a cost, pulling funds, storing funds, identifying completion and paying for the procedure. Because the claim elements fall under a series of rules or instructions that a person or persons would follow for presenting a cost, pulling funds, identifying completion and paying for the procedure, the claimed invention is directed to an abstract idea.
Examiner notes MPEP 2106. 04(a)(2)(II)(B) Commercial or Legal obligations. "Commercial interactions" or "legal interactions" include agreements in the form of contracts, legal obligations, advertising, marketing or sales activities or behaviors, and business relations. Examiner submits pulling funds, storing funds, identifying completion and in response to completion releasing funds to be clearly a commercial/legal obligation.
Applicant argues pg. 9-10:
Even if the claims were found to recite a judicial exception, which Applicant does not concede, they are not "directed to" that exception because they integrate it into a practical application, yielding significant technical benefits specifically recited in the amended claims. The October Update to the 2019 PEG states, and the recent Ex Parte Desjardins decision affirms, "... if the additional [claim] limitations reflect an improvement in the functioning of a computer, or an improvement to another technology or technical field, the claim integrates the judicial exception into a practical application and thus imposes a meaningful limit on the judicial exception. No further analysis is required." See also Ex Parte Desjardins et al., Appeal 2024-000567.
"Portal Interface Integration: Amended claim l's requirement to "display a portal interface for one or more users, including a healthcare provider" creates a single platform that technically integrates disparate healthcare parties (patient, provider, payor) in a unified communication and authorization system.
"Electronic Clearing Account Technology: Amended claim l's requirement to "store the funds in a portal clearing account" implements an electronic escrow mechanism not present in conventional systems, eliminating months-long payment delays through automated pre- funding and immediate release capability.
"Electronic Signal-Based Automation: Amended claim l's requirement to "identify completion of the healthcare procedure based at least in part on an indication signal from the healthcare provider using the portal interface" enables automated, real-time monitoring of procedure status without manual intervention.
“Automated Payment Release: Amended claim l's requirement to "release the funds from the portal clearing account to the healthcare provider for the healthcare procedure in response to identifying completion" provides immediate electronic payment release upon provider confirmation, eliminating complex billing inefficiencies and revenue cycle management.
These technical benefits are described in the specification (see, e.g., [0023], [0032], [0059], [0077]-[0079], [0087]-[0089]) and are specifically reflected in the technical elements of claim 1.
In sum, even assuming arguendo that the claims recite a judicial exception, the amended claims integrate any such exception into a practical application that improves computer functionality and a specific technical field-computerized healthcare payment orchestration. The claimed architecture does not merely apply generic computers to a business practice; it leverages a coordinated set of interdependent technical operations (portal-based multi-party integration, electronic pre-funding via a portal clearing account, real-time detection of provider-generated indication signals, and automated fund release) to achieve capabilities that conventional human- administered workflows cannot replicate. These claim-recited mechanisms depart from and improve upon traditional post-procedure billing by introducing pre-funded escrow with signal- driven automation and system-level integration, yielding immediate, deterministic settlement without manual reconciliation. Under the October 2019 PEG and as affirmed in Ex Parte Desjardins, these additional limitations constitute improvements to computer functionality and to the healthcare payment technology field, thereby integrating any alleged exception into a practical application and imposing a meaningful limit on it. No further analysis is required, and withdrawal of the 35 U.S.C. § 101 rejection is respectfully requested.
Examiner responds:
The Examiner respectfully disagrees. MPEP 2106.04(d)(1) states that a practical application may be present where the claimed invention improves the functioning of a computer. See also MPEP 2106.05(a)(I). The technological environment of Applicant’s claim is a general-purpose computer. Applicant has not identified nor can the Examiner locate any physical improvement to the functioning of the computer that results from the implementation of Applicant’s claim. There is no indication that the computer is made to run faster, more efficiently, or utilize less power. In fact, the computer may be caused to operate slower and less efficiently through the implementation of Applicant’s claimed invention; we do not know. Because there is no improvement to the function of the computer, a practical application is not present.
MPEP 2106.04(d)(1) states “the word ‘improvements’ in the context of this consideration is limited to improvements to the functioning of a computer or any other technology/technical field, whether in Step 2A Prong Two or in Step 2B.” Here, there is no improvement to the computer nor is there an improvement to another technology. The claimed invention is using a computer as a tool and any improvement present is an improvement to the abstract idea of, to paraphrase, pull funds, store funds, identify completion and release funds.
Examiner notes the portal interface merely generally links the abstract idea to a particular technological environment or field of use. MPEP 2106.04(d)(I) indicates that generally linking an abstract idea to a particular technological environment or field of use cannot provide a practical application. Utilization of the screen equates to saying “apply it.” MPEP 2106.04(d)(I) indicates that merely saying “apply it” or equivalent to the abstract idea cannot provide a practical application. Accordingly, even in combination, this additional element does not integrate the abstract idea into a practical application.
Applicant argues pg. 11:
III. The Pending Claims Recite Additional Elements That Amount to "Significantly More" Than Any Alleged Abstract Idea Under Step 2B
Even if the claims were determined to recite an abstract idea, which Applicant does not concede, the specific technical elements in the claims recite additional elements that amount to "significantly more" than any alleged judicial exception.
USPTO Example 34 (BASCOM) Analogy Like in the allowable claims in Example 34 of the USPTO Patent Eligibility Guidance (PEG), which is based on the BASCOM case, the specific combination of elements in claim 1 provides a technology-based solution to a specific problem in the prior art healthcare system. In Example 34, the system connects users, ISPs, and content providers to solve content filtering limitations. Here, claim l's portal interface, clearing account, and electronic signal processing connect patients, providers, and payors, solving healthcare coordination and payment problems through a customized, non-conventional escrow mechanism.
USPTO Example 35 (ATM Transaction) Analogy Amended claim l's electronic completion signal and automated fund release parallels the allowed ATM transaction authorization claims in USPTO Example 35, where a specific electronic signal (e.g., PIN entry, biometric scan) triggers an otherwise locked financial transaction. Here, the "indication signal from the healthcare provider using the portal interface" triggers the automated "release the funds from the portal clearing account."
Taken together, the claim's portal-based multi-party integration, pre-funded portal clearing account, real-time provider indication signal, and automated release of escrowed funds constitute a non-conventional, ordered combination that solves a specific healthcare payment coordination problem, much like the allowable claims in BASCOM's filtering architecture and the allowable claims in Example 35's ATM signal-gated authorization. This architecture is not well-understood, routine, or conventional in the healthcare domain and would not be achieved by a human or a generic computer performing business rules.
Applicant submits dependent claims 2-3, 5-7,11-15, 17, 19-20, and 22-26 depend from eligible independent claims 1 and 21, and therefore, are eligible for at least the same reasons. Additionally, the dependent claims each recite additional subject matter that is eligible. At least for the foregoing reasons, Applicant respectfully requests reconsideration and withdrawal of the rejection of claims 1-3, 5-7, 11-15, 17 and 19-26 under 35 U.S.C. § 101.
Examiner responds:
The Examiner respectfully disagrees. MPEP 2106.05(d) states: “Another consideration when determining whether a claim recites significantly more than a judicial exception is whether the additional element(s) are well-understood, routine, conventional activities previously known to the industry (emphasis added).” Further, MPEP 2106.05(I) states: “As made clear by the courts, 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 (internal quotations omitted, emphasis original).” As such, it is only the additional elements identified by the Examiner to not be part of the abstract idea that are analyzed to determine whether they represent well-understood, routine, conventional activities in the field of the invention.
In that regard, MPEP 2106.05(d)(I) indicates that in determining whether the additional elements represent are well-understood, routine, conventional activities, the Examiner should consider whether the additional elements (1) provide an improvement to the technological environment to which the claim is confined, (2) whether the additional elements are mere instructions to apply the judicial exception, or (3) whether the additional elements represent insignificant extra-solution activity. The additional elements of the claims do not provide significantly more based on this inquiry.
Taking these in turn, whether the additional elements of the claim provide an improvement was analyzed/addressed in the 2A2 analysis as either no improvement was present. The technological environment to which the claims are confined (a general-purpose computer performing generic computer functions) is recited at a high level of generality and has been found by the courts to be insufficient to provide a practical application (see MPEP 2106.05(d)(II); Alice Corp.). None of the additional elements of the claim were found to represent extra-solution activity and thus no well-understood, routine, conventional analysis is required. As such, when viewed either individually or as an ordered combination, the additional elements do not provide significantly more to the abstract idea and the claims are not subject matter eligible.
Response to Arguments Regarding U.S.C. 102 Rejection
Applicant argues pg. 12-13
First, regarding the escrow versus prepaid account structure, Pourfallah discusses a conventional prepaid account (like an FSA/HSA card) that the patient uses to pay bills after procedures are completed. Pourfallah at para. [0041] states, "upon the user receiving medical service at a healthcare provider, the healthcare provider 110 may issue a medical bill," indicating traditional post-procedure billing. In contrast, the amended claims require "store the funds in a portal clearing account" which represents an escrow-like mechanism that holds funds in trust pending completion confirmation, fundamentally different from a patient-controlled prepaid account.
Examiner responds:
The amended claims require "store the funds in a portal clearing account" which is interpreted under the broadest reasonable interpretation which is analogous to loading a prepaid card in which funds are held in an escrow-like mechanism in trust pending completion confirmation. Pourfallah para 41 teaches a prepaid account being funded prior to a knee surgery. See also Fig 6B which shows step 639 of preloading the users Prepaid account according to the cost of the requested medical service prior to receiving medical treatment. Para 174 further teaches loading the prepaid card in an amount equal to the cost required to be paid. See claim 1 rejection above. Examiner interprets “pull[ing] funds for a healthcare procedure prior to the healthcare procedure, wherein the funds equal a total cost of the healthcare procedure set prior to the healthcare procedure” using the broadest reasonable interpretation which includes the loading of a prepaid card before the procedure.
Applicant argues pg. 13
Second, there is a critical distinction between completion signals and bill generation. Pourfallah at para. [0041] teaches that providers "will issue a medical bill" after service completion, which describes traditional billing document generation, not a system completion signal. The amended claims, however, require "identify completion... based at least in part on an indication signal from the healthcare provider using the portal interface," which represents a specific electronic signal generated through the portal system to trigger automated processes.
Examiner responds:
The amended claims require " identify completion... based at least in part on an indication signal from the healthcare provider using the portal interface " which is interpreted under the broadest reasonable interpretation where an indication signal is analogous to issuing of a medical bill after a service is complete. Pourfallah para 41 teaches upon receiving a medical service at a healthcare provider the healthcare provider will issue a medical bill. Examiner notes that issuing a medical bill upon the service being received is the signal using the portal identifying completion of the healthcare procedure. This is because the billing is performed upon receiving the medical service. Pourfallah para 71 teaches once proof of services rendered has been obtained to the satisfaction of the sharing network, funds that are being held (escrowed) are released and transferred to the provider account.
Applicant argues pg. 14
Third, the systems differ in their approach to automated release versus payment processing. Pourfallah describes conventional payment processing where patients use prepaid funds to pay bills after they are generated. The amended claims require "release the funds from the portal clearing account to the healthcare provider" in direct response to the completion signal, which represents an automated escrow release mechanism.
Examiner responds:
The amended claims require “release the funds from the portal clearing account to the healthcare provider for the healthcare procedure in response to identifying completion of the healthcare procedure.” Examiner uses the broadest reasonable interpretation. Pourfallah para 71 teaches once proof of services rendered has been obtained to the satisfaction of the sharing network, funds that are being held (escrowed) are released and transferred to the provider account. Para 41 teaches transferring funds to the healthcare provider after a completed medical service and upon verification. Para 56-57 teach generating a payment authorization request and routing to an insurance provider and an insurance provider reviewing and verifying the requested insurance payment and then sending an insurance payment authorization response to authorize payment.
Conclusion
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/A.K.T./Examiner, Art Unit 3687
/MAMON OBEID/Supervisory Patent Examiner, Art Unit 3687