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 .
This is a Final Office Action in response to application 18/230,937 entitled "CREATION AND MANAGEMENT OF ACCOUNTS FOR INSURED PERSONS" filed on March 11, 2026, with claims 1, 3-9, and 11-18 pending.
Status of Claims
Claims 1 and 15 have been amended and are hereby entered.
Claims 2, 10, 13, and 14 are cancelled.
Claims 1, 3-9, and 11-18 are pending and have been examined.
Response to Amendment
The amendment filed March 11, 2026, has been entered. Claims 1, 3-9, and 11-18 remain pending in the application. Applicant’s amendments to the Specification, Drawings, and/or Claims have been noted in response to the Final Office Action mailed April 23, 2025.
Information Disclosure Statement
The information disclosure statement (IDS) submitted on August 7, 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 § 112
The following is a quotation of the first paragraph of 35 U.S.C. 112(a):
(a) IN GENERAL.—The specification shall contain a written description of the invention, and of the manner and process of making and using it, in such full, clear, concise, and exact terms as to enable any person skilled in the art to which it pertains, or with which it is most nearly connected, to make and use the same, and shall set forth the best mode contemplated by the inventor or joint inventor of carrying out the invention.
The following is a quotation of the first paragraph of pre-AIA 35 U.S.C. 112:
The specification shall contain a written description of the invention, and of the manner and process of making and using it, in such full, clear, concise, and exact terms as to enable any person skilled in the art to which it pertains, or with which it is most nearly connected, to make and use the same, and shall set forth the best mode contemplated by the inventor of carrying out his invention.
Claims 1, 3-9, and 11-18 are rejected under 35 U.S.C. 112(a) or 35 U.S.C. 112 (pre-AIA ), first paragraph, as failing to comply with the written description requirement. The claim(s) contains subject matter which was not described in the specification in such a way as to reasonably convey to one skilled in the relevant art that the inventor or a joint inventor, or for applications subject to pre-AIA 35 U.S.C. 112, the inventor(s), at the time the application was filed, had possession of the claimed invention.
Independent Claims 1 and 15 state, “form template”
The Specification never describes a form template. The most similar citation from the Specification reads, [0049] The system has an automated computer vision system configured to identify a type of form completed by a prospective enrollee based on an analysis of a received form and analyze, based on the type of form identified.
A “type of form” is broader than a “form template.”
Therefore, the claims are rejected.
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, 4, 8, 9, 11, and 12-17 are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea without significantly more.
Please see MPEP 2106 for additional information regarding Patent Subject Matter Eligibility Guidance.
Claims 1, 3, 4, 8, 9, 11, and 12-17 are directed to a system, method/process, machine/apparatus, or composition of matter, which are/is one of the statutory categories of invention. (Step 1: YES).
The claimed invention is directed to an abstract idea without significantly more.
Independent Claim 1 recites:
“A system for managing collecting deductibles of insureds, the system comprising:
an … configured to:
receive a plurality of forms completed by a plurality of enrollees, wherein each of the plurality of forms comprises fields arranged according to a form template;
analyze information provided by each enrollee of the plurality of enrollees, as received on each form of the plurality of forms, wherein the information comprises:
an election of insurance coverage offered by a particular insurance company;
an identifier of each enrollee;
and a payment method supplied to cover a cost associated with the election of insurance coverage wherein the automated computer vision system is configured to analyze the information by:
determining an identified stored form template for each form by comparing a digital image of each form to stored form templates;
and extracting the information, …, from the fields of each form at field-specific locations defined by the identified stored form template;
and verify each form comprises an authorization signature;
and …configured to:
establish a primary account associated with the particular insurance company, wherein the primary account is a controlled disbursement account;
receive the information provided by each enrollee of the plurality of enrollees from the … and, in response to receiving the information categorize each enrollee as an out-of-pocket enrollee or an upfront enrollee based on the election of insurance coverage on the form analyzed by the … for each enrollee;
establish a shadow ledger associated with each enrollee underneath the primary account, wherein the shadow ledger tracks funds associated with a threshold deductible amount for each enrollee and is established based on the information received from the …;
charge a payment method provided by each out-of- pocket enrollee of the plurality of enrollees a fee incurred by the out-of-pocket enrollee based on a threshold deductible amount tracked by a shadow ledger for the out-of-pocket enrollee and information provided by the out-of-pocket enrollee;
and transfer a fee incurred by each upfront enrollee from the primary account to an insurance company based on a threshold deductible amount tracked by a shadow ledger for the upfront enrollee and information provided by the upfront enrollee.”
These limitations clearly relate to managing transactions/interactions between consumer, financial institution, and/or insurance provider. These limitations, under their broadest reasonable interpretation, cover performance of the limitation as certain methods of organizing human activity. Specific instances include instructing to "collecting deductibles of insureds", " an election of insurance coverage offered by a particular insurance company", " establish a primary account ... is a controlled disbursement account ", " charge a payment method ", and " transfer a fee incurred " recite a fundamental economic principles or practice and/or commercial or legal interactions. If a claim limitation, under its broadest reasonable interpretation, covers performance of the limitation as a fundamental economic, commercial, or financial action, principle, or practice then it falls within the “Certain Methods of Organizing Human Activity” grouping of abstract ideas. Accordingly, the claim recites an abstract idea. (Step 2A-Prong 1: YES. The claims recite an abstract idea).
This judicial exception is not integrated into a practical application. In particular, the claims recite the additional elements of:
[automated computer vision system] [using optical character recognition ][a processor]:
merely applying computer processing, scanning, and imaging technology as tools to perform an abstract idea
are recited at a high-level of generality (i.e., as a generic processor performing a generic computer function) such that it amounts no more than mere instructions to apply the exception using a generic computer components and/or electronic processes. For example, the Applicant’s Specification reads,
[0022] scanning the form into a computer and emailing and/or uploading the electronic version of the form generated from the scan, or by any other suitable communication method.
[0025] “computer vision comprises an imager (e.g., a camera or scanner, or set of cameras/scanners) for capturing a digital image of the form.”
Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept. The additional elements merely add instructions to implement an abstract idea on a computer, or merely uses a computer as a tool to perform an abstract idea, see MPEP 2106.05(f). Accordingly, these additional elements, when considered separately and as an ordered combination, do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea and are at a high level of generality. Therefore, Claim 1 is directed to an abstract idea without a practical application. (Step 2A-Prong 2: NO. The additional claimed elements are not integrated into a practical application)
Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept. The additional elements merely add instructions to implement an abstract idea on a computer, or merely uses a computer as a tool to perform an abstract idea, see MPEP 2106.05(f). Accordingly, these additional elements, do not change the outcome of the analysis, when considered separately and as an ordered combination. The claim further defines the abstract idea and hence is abstract for the reasons presented above. The claim does not include any additional elements that integrate the abstract idea into a practical application or are sufficient to amount to significantly more than the judicial exception when considered both individually and as an ordered combination. Therefore, the claim is directed to an abstract idea. Thus, the claim is not patent eligible. (Step 2B: NO. The claim does not provide significantly more)
Dependent Claims recite additional elements.
This judicial exception is not integrated into a practical application. In particular, the recited additional elements of
Claim 3: (none found: does not include additional elements and merely narrows the abstract idea)
Claim 4:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
Claim 5: (none found: does not include additional elements and merely narrows the abstract idea)
Claim 6:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
Claim 7:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
Claim 8:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
Claim 9: (none found: does not include additional elements and merely narrows the abstract idea)
Claim 11:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
Claim 12:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
Claim 16:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
Claim 17:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
Claim 18:
“processor”: merely applying computer processing, networking, and display technologies as a tool to perform an abstract idea
are recited at a high-level of generality (i.e., as a generic processor performing a generic computer function) such that it amounts no more than mere instructions to apply the exception using a generic computer components and/or electronic processes. For example, the Applicant’s Specification reads, [0025] “computer vision comprises an imager (e.g., a camera or scanner, or set of cameras/scanners) for capturing a digital image of the form.” Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept. The additional elements merely add instructions to implement an abstract idea on a computer, or merely uses a computer as a tool to perform an abstract idea, see MPEP 2106.05(f). Accordingly, these additional elements, when considered separately and as an ordered combination, do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea and are at a high level of generality. Therefore, the claim is directed to an abstract idea without a practical application. (Step 2A-Prong 2: NO. The additional claimed elements are not integrated into a practical application)
Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept. The additional elements merely add instructions to implement an abstract idea on a computer, or merely uses a computer as a tool to perform an abstract idea, see MPEP 2106.05(f). Accordingly, these additional elements, do not change the outcome of the analysis, when considered separately and as an ordered combination. Dependent claims further define the abstract idea that is present in their respective independent claims and hence are abstract for the reasons presented above. The dependent claims do not include any additional elements that integrate the abstract idea into a practical application or are sufficient to amount to significantly more than the judicial exception when considered both individually and as an ordered combination. Therefore, the dependent claims are directed to an abstract idea. Thus, the dependent claims are not patent eligible. (Step 2B: NO. The claims do not provide significantly more)
Independent Claim 15 recites:
“A method for managing collecting deductibles of insureds, the method comprising:
establishing a primary account associated with a particular insurance company, wherein the primary account is a controlled disbursement account;
maintaining a balance in the primary account equivalent to a sum of fees incurred by insurance coverage plans sponsored by the particular insurance company;
receiving information provided by a plurality of enrollees via a plurality of forms from …, wherein the information has been extracted from each form of the plurality of forms, analyzed, and verified by …, wherein the information comprises:
an election of insurance coverage offered by the particular insurance company;
an identifier of the prospective enrollee;
and a payment method supplied to cover a cost associated with the election of insurance coverage,_and wherein receiving the information comprises:
receiving, …, a plurality of forms completed by a plurality of enrollees, wherein each of the plurality of forms comprises fields arranged according to a form template; and
analyzing, …, the forms by:
determining an identified stored form template for each form by comparing a digital image of each form to stored form templates;
and extracting the information, …, from the fields of each form at field-specific locations defined by the identified stored form template;
categorizing, …, each enrollee as an out-of-pocket enrollee or an upfront enrollee based on the election of insurance coverage on the form analyzed …for each enrollee;
establishing, …, based on the information received, a shadow ledger associated with each enrollee underneath the primary account, wherein the shadow ledger tracks funds associated with a threshold deductible amount for each enrollee and is established based on the information received …;
charging, …, a payment method provided by an out-of-pocket enrollee of the plurality of enrollees a fee incurred by the out-of-pocket enrollee based on a threshold deductible amount tracked by a shadow ledger for the out-of-pocket enrollee and information provided by the out-of-pocket enrollee; and
transferring, …, a fee incurred by an upfront enrollee from the primary account to an insurance company based on a threshold deductible amount tracked by a shadow ledger for the upfront enrollee and information provided by the upfront enrollee.”
These limitations clearly relate to managing transactions/interactions between consumer, financial institution, and/or insurance provider. These limitations, under their broadest reasonable interpretation, cover performance of the limitation as certain methods of organizing human activity. Specific instances include instructing to "collecting deductibles of insureds", " an election of insurance coverage offered by a particular insurance company", " establish a primary account ... is a controlled disbursement account ", " charge a payment method ", and " transfer a fee incurred " recite a fundamental economic principles or practice and/or commercial or legal interactions. If a claim limitation, under its broadest reasonable interpretation, covers performance of the limitation as a fundamental economic, commercial, or financial action, principle, or practice then it falls within the “Certain Methods of Organizing Human Activity” grouping of abstract ideas. Accordingly, the claim recites an abstract idea. (Step 2A-Prong 1: YES. The claims recite an abstract idea).
This judicial exception is not integrated into a practical application. In particular, the claims recite the additional elements of:
[automated computer vision system][ by the automated computer vision system][using optical character recognition][ by the programmed processor]:
merely applying computer processing, scanning, and imaging technology as tools to perform an abstract idea
are recited at a high-level of generality (i.e., as a generic processor performing a generic computer function) such that it amounts no more than mere instructions to apply the exception using a generic computer components and/or electronic processes. For example, the Applicant’s Specification reads, [0025] “computer vision comprises an imager (e.g., a camera or scanner, or set of cameras/scanners) for capturing a digital image of the form.” Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept. The additional elements merely add instructions to implement an abstract idea on a computer, or merely uses a computer as a tool to perform an abstract idea, see MPEP 2106.05(f). Accordingly, these additional elements, when considered separately and as an ordered combination, do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea and are at a high level of generality. Therefore, Claim 15 is directed to an abstract idea without a practical application. (Step 2A-Prong 2: NO. The additional claimed elements are not integrated into a practical application)
Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept. The additional elements merely add instructions to implement an abstract idea on a computer, or merely uses a computer as a tool to perform an abstract idea, see MPEP 2106.05(f). Accordingly, these additional elements, do not change the outcome of the analysis, when considered separately and as an ordered combination. The claim further defines the abstract idea and hence is abstract for the reasons presented above. The claim does not include any additional elements that integrate the abstract idea into a practical application or are sufficient to amount to significantly more than the judicial exception when considered both individually and as an ordered combination. Therefore, the claim is directed to an abstract idea. Thus, the claim is not patent eligible. (Step 2B: NO. The claim does not provide significantly more)
Claim Rejections - 35 USC § 103
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 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 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action:
A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made.
The factual inquiries set forth in Graham v. John Deere Co., 383 U.S. 1, 148 USPQ 459 (1966), that are applied for establishing a background for determining obviousness under 35 U.S.C. 103 are summarized as follows:
1. Determining the scope and contents of the prior art.
2. Ascertaining the differences between the prior art and the claims at issue.
3. Resolving the level of ordinary skill in the pertinent art.
4. Considering objective evidence present in the application indicating obviousness or nonobviousness.
Claims 1, 3, 4, 8, 9, 11, 12, and 15-17 are rejected under 35 U.S.C. 103 as being unpatentable over Pourfallah (“EVENT-TRIGGERED BUSINESS-TO-BUSINESS ELECTRONIC PAYMENT PROCESSING APPARATUSES, METHODS AND SYSTEMS”, U.S. Patent Number: US 9760871 B1), in view of Hoffman (“ACCOUNT ADMINISTRATION PLANS AND SYSTEMS”, U.S. Publication Number: US 20060212378 A1),in view of Pilzer (“SYSTEM AND METHOD FOR ADMINISTERING A GROUP BENEFIT PLAN”, U.S. Publication Number: US 20080281641 A1),in view of Fasoli (“SINGLE ENTRY COMBINED FUNCTIONALITY”, U.S. Publication Number: US 20210125287 A1), in view of Chang (“UNSUPERVISED REMOVAL OF TEXT FROM IMAGES USING LINEAR PROGRAMMING FOR OPTIMAL FILTER DESIGN”, U.S. Patent Number: US 10657369 B1).
Regarding Claim 1,
Pourfallah teaches,
A system for managing collecting deductibles of insureds, the system comprising:
(Pourfallah [Abstract] receiving a first payment request... transmitting a second payment request to an insurance provider
Pourfallah [Col 84, Lines 41-44] to pay the balance due bill from the healthcare provider; (c) a remaining deductible contribution amount to a healthcare-relates account amount for a specific year;
Pourfallah [Col 1, Lines 55-58] The consumer may fill an insurance claim form and mail it to his insurance provider)
wherein each of the plurality of forms comprises fields
(Pourfallah [Col 139, Lines 46-50] the information server would provide a Web form accessible by a Web browser. Entries made into supplied fields in the Web form are tagged as having been entered into the particular fields)
analyze information provided by each enrollee of the plurality of enrollees, as received on each form of the plurality of forms,
(Pourfallah [Col 50, Lines 18-24] may perform an OCR procedure to obtain item information.... adopt OCR software such as, but not limited to OmniPage, OCRFeeder, Scantron, Java OCR, and/or the like to extract information from a bill image...may perform bill analysis
Pourfallah [Col 84, Lines 37-40] user has access for payment of the balance due bill. The equations are subjected to computer analysis
Pourfallah [Col 1, Lines 55-58] The consumer may fill an insurance claim form and mail it to his insurance provider)
wherein the information comprises: an election of insurance coverage offered by a particular insurance company; an identifier of each enrollee; and a payment method supplied to cover a cost associated with the election of insurance coverage;
(Pourfallah [Col 5, Lines 20-30] a user to engage a restricted-use account...A restricted-use account may be a financial account having funds that can only be used for payment of approved ...services (e.g., healthcare treatment, physical examination, etc.). .... one or more health reimbursement accounts (HRA), one or more government insurance programs (i.e., Medicare or Medicaid)
Pourfallah [Col 6, Lines 53-56] the user may load insurance information 119 (e.g., user name, insurance program number, group number, insurance carrier, etc.))
and verify each form comprises an authorization signature;
(Pourfallah [Abstract] purchase item information inputs or purchase receipt inputs via B2B-PAY components into restricted-use account payment settlement outputs.
Pourfallah [Col 136, Lines 54-55] ensuring secure transactions with a digital signature
Pourfallah [Col 142, Lines 5-8] digital certificates (e.g., X.509 authentication framework), digital signatures, dual signatures, enveloping)
and a processor configured to: establish a primary account associated with the particular insurance company, wherein the primary account is a controlled disbursement account;
(Pourfallah [Col 131, Lines 33-35] such processors 2403 may be referred to as central processing units (CPU)
Pourfallah [Col 59, Lines 35-38] Upon establishing the ... account, the B2B-PAY may call payment processing to adjust an available limit with the payment instruction amount
Pourfallah [Col 42, Lines 11-16] a patient may register with the B2B-PAY by providing his personal profile information (e.g., name, address, employer, insurance plan, personal income, etc.), healthcare payment information (e.g., FSA, HSA, etc.)
Pourfallah [Col 5, Lines 20-30] a user to engage a restricted-use account...A restricted-use account may be a financial account having funds that can only be used for payment of approved ...services (e.g., healthcare treatment, physical examination, etc.). .... one or more health reimbursement accounts (HRA), one or more government insurance programs (i.e., Medicare or Medicaid))
receive the information provided by each enrollee of the plurality of enrollees from the automated computer vision system
(Pourfallah [Col 81, Line 45] users may obtain a medical bill
Pourfallah [Col 33, Lines 8-9] a snap bill image, etc., by performing an optical character recognition (OCR) procedure.
Pourfallah [Col 50, Lines 16-19] upon receiving bill image information, the B2B-PAY server 320 may perform an OCR procedure to obtain item information)
tracks funds associated with a threshold deductible amount for each enrollee and is established based on the information received from the automated computer vision system;
(Pourfallah [Col 83, Lines 42-45] a remaining deductible contribution amount to a healthcare-relates account amount for a specific year; (d) a government insurance prepaid account; (e) a private insurance deductible information
Pourfallah [Col 90, Lines 58-62] accounts according to code provisions as provided by various business rules. The available deductibles and required deductibles for each of the one or more benefit plans can be found in one or more databases
Pourfallah [Col 50, Lines 18-24] may perform an OCR procedure to obtain item information.... adopt OCR software such as, but not limited to OmniPage, OCRFeeder, Scantron, Java OCR, and/or the like to extract information from a bill image...may perform bill analysis)
Pourfallah does not teach an automated computer vision system configured to: receive a plurality of forms completed by a plurality of enrollees; according to a form template; wherein the automated computer vision system is configured to analyze the information by: determining an identified stored form template for each form by comparing a digital image of each form to stored form templates; and extracting the information, using optical character recognition, from the fields of each form at field-specific locations defined by the identified stored form template; charge a payment method provided by each out-of- pocket enrollee of the plurality of enrollees a fee incurred by the out-of-pocket enrollee based on a threshold deductible amount tracked; in response to receiving the information categorize each enrollee as an out-of-pocket enrollee or an upfront enrollee based on the election of insurance coverage on the form analyzed by the automated computer vision system for each enrollee; and transfer a fee incurred by each upfront enrollee from the primary account to an insurance company based on a threshold deductible amount; in response to receiving the information categorize each enrollee as an out-of-pocket enrollee or an upfront enrollee based on the election of insurance coverage on the form analyzed by the automated computer vision system for each enrollee; establish a shadow ledger associated with each enrollee underneath the primary account, wherein the shadow ledger; by a shadow ledger for the out-of-pocket enrollee and information provided by the out-of-pocket enrollee; tracked by a shadow ledger for the upfront enrollee and information provided by the upfront enrollee.
Hoffman teaches,
establish a shadow ledger associated with each enrollee underneath the primary account, wherein the shadow ledger;
(Hoffman [0140] send instructions to the custodial account manager to move a specific portion of the established HSA to specified sub-accounts that are selected based solely (or at least primarily) on the discretion of the account holder.
Hoffman [0138] Each of these investment sub-accounts may be maintained by the custodian that administers the HSA
Hoffman [0037] the HSA is used to track the various transactions)
by a shadow ledger for the out-of-pocket enrollee and information provided by the out-of-pocket enrollee;
(Hoffman [0140] send instructions to the custodial account manager to move a specific portion of the established HSA to specified sub-accounts that are selected based solely (or at least primarily) on the discretion of the account holder.
Hoffman [0035] an HSA includes a transaction account and one or more investment sub-accounts....so that any funds being deposited into, or withdrawn from, the various investment sub-accounts must pass through the transaction account
Hoffman [0148] the account holder's out-of-pocket cost for the services.)
tracked by a shadow ledger for the upfront enrollee and information provided by the upfront enrollee.
(Hoffman [0140] send instructions to the custodial account manager to move a specific portion of the established HSA to specified sub-accounts that are selected based solely (or at least primarily) on the discretion of the account holder.
Hoffman [0035] an HSA includes a transaction account and one or more investment sub-accounts....so that any funds being deposited into, or withdrawn from, the various investment sub-accounts must pass through the transaction account)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the sub-accounts of Hoffman whereby “the transaction account and investment sub-accounts are structured so that any funds being deposited into, or withdrawn from, the various investment sub-accounts must pass through the transaction account” (Hoffman [0035]). The modification would have been obvious, because it is merely applying a known technique (i.e. sub-accounts) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “allowing the account holder to invest money from their HSA in one or more investment sub-accounts (such as money market accounts or mutual funds).” Hoffman [0138])
Hoffman does not teach an automated computer vision system configured to: receive a plurality of forms completed by a plurality of enrollees; according to a form template; wherein the automated computer vision system is configured to analyze the information by: determining an identified stored form template for each form by comparing a digital image of each form to stored form templates; and extracting the information, using optical character recognition, from the fields of each form at field-specific locations defined by the identified stored form template; charge a payment method provided by each out-of- pocket enrollee of the plurality of enrollees a fee incurred by the out-of-pocket enrollee based on a threshold deductible amount tracked; and transfer a fee incurred by each upfront enrollee from the primary account to an insurance company based on a threshold deductible amount; in response to receiving the information categorize each enrollee as an out-of-pocket enrollee or an upfront enrollee based on the election of insurance coverage on the form analyzed by the automated computer vision system for each enrollee;
Pilzer teaches,
an automated computer vision system configured to: receive a plurality of forms completed by a plurality of enrollees
(Pilzer [0056] selections made during the sign-up process...election forms, claim submission forms, documentation submission cover sheets
Pilzer [0070] Documents received by mail are scanned and uploaded 336 to the database/website server 28, which scans the document
Pilzer [Abstract] receive data for enrolling a participant)
charge a payment method provided by each out-of- pocket enrollee of the plurality of enrollees a fee incurred by the out-of-pocket enrollee based on a threshold deductible amount tracked
(Pilzer [0052] automatic scheduled fee deductions 164 include any applicable fees for the bundled products ... fees covering administration costs of the group benefit plan may be included in automatic scheduled fee deductions
Pilzer [0055] billing information may be used to pay fees associated with the group plan
Pilzer [0033] using the HRA to reimburse premiums for those policies and also any out-of-pocket medical expenses
Pilzer [0075] If the applicable plan design includes a Plan Year Maximum amount that applies to this claim's submission 446, the amount by which the remaining claim amount exceeds the remaining Plan Year Maximum amount (if any) may be calculated.)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the fee collection of Pilzer whereby “billing information may be used to pay fees” (Pilzer [0055]). The modification would have been obvious, because it is merely applying a known technique (i.e. fee collection) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “automatic scheduled fee deductions” Pilzer [0048])
Pilzer does not teach according to a form template; wherein the automated computer vision system is configured to analyze the information by: determining an identified stored form template for each form by comparing a digital image of each form to stored form templates; and extracting the information, using optical character recognition, from the fields of each form at field-specific locations defined by the identified stored form template; transfer a fee incurred by each upfront enrollee from the primary account to an insurance company based on a threshold deductible amount; in response to receiving the information categorize each enrollee as an out-of-pocket enrollee or an upfront enrollee based on the election of insurance coverage on the form analyzed by the automated computer vision system for each enrollee;
Fasoli teaches,
transfer a fee incurred by each upfront enrollee from the primary account to an insurance company based on a threshold deductible amount;
(Fasoli [0021] after a medical procedure ... the user 102 may be required to provide full payment for the medical procedure or...debit/bank account. For certain users, this may be difficult, particularly procedures or acts that can be financially burdensome to users upfront.
Fasoli [0029] if the maximum deductible... is greater than the maximum line of credit amount that can be offered to the user ... provide the user 202 with an option to allow the user 202 to apply for a line of credit corresponding to the maximum line of credit amount.
Fasoli [0062] The payment system may aggregate these payments and deduct any applicable fees)
in response to receiving the information categorize each enrollee as an out-of-pocket enrollee or an upfront enrollee based on the election of insurance coverage on the form analyzed by the automated computer vision system for each enrollee;
(Fasoli [0038] the user 202 may present its payment instrument 220 at a point-of-sale, which is used to determine the user's medical coverage...can be used identify policy data and coverage in real-time (reducing the user's out-of-pocket costs) .... to determine the user's coverage and, based on the aforementioned information, the user's patient responsibility. The user's patient data can be identified by the system automatically and/or in real-time with presentation of the payment instrument 220 (e.g., swipe, key entry, scan, etc.) at the point-of-sale (e.g., doctor's office, hospital, pharmacy, etc.).
Fasoli [0021] after a medical procedure ... the user 102 may be required to provide full payment for the medical procedure or...debit/bank account. For certain users, this may be difficult, particularly procedures or acts that can be financially burdensome to users upfront.
Examiner notes the system detects from the medical coverage policy whether the user is classified as out-of-pocket or upfront payment)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the user categorization of Fasoli “which is used to determine the user's medical coverage...can be used identify policy data and coverage in real-time” (Fasoli [0038]). The modification would have been obvious, because it is merely applying a known technique (i.e. user categorization) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “reducing the user's out-of-pocket costs” Fasoli [0038])
Fasoli does not teach (fields arranged) according to a form template; wherein the automated computer vision system is configured to analyze the information by: determining an identified stored form template for each form by comparing a digital image of each form to stored form templates; and extracting the information, using optical character recognition, from the fields of each form at field-specific locations defined by the identified stored form template;
Chang teaches,
(fields arranged) according to a form template; wherein the automated computer vision system is configured to analyze the information by: determining an identified stored form template for each form by comparing a digital image of each form to stored form templates; and extracting the information, using optical character recognition, from the fields of each form at field-specific locations defined by the identified stored form template;
(Chang [Col 5, Lines 35-40] the image of the form may be identified by matching a known template of a form. The known template may be stored in a database of known templates. ....may identify the reconstructed image to be a W-2 form
Chang [Col 5, Lines 43-52] may use the high-frequency components (i.e., content elements) ... of the image to reconstruct the image of the form so that the reconstructed image includes the content elements. An OCR engine can be used to process text from a particular location on the image of the form....may map the content elements of the form into fields of a known form template in a database.)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the form template of Chang “a known template of a form” (Chang [Col 5, Lines 35-36]). The modification would have been obvious, because it is merely applying a known technique (i.e. form template) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “may identify the reconstructed image to be a W-2 form” Chang [Col 5, Lines 39-40])
Regarding Claim 3,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 1 as described earlier.
Pourfallah teaches,
also reflects a transaction history of any fee incurred by the prospective enrollee during the coverage period.
(Pourfallah [Col 130, Line 63] also calculates fees, charges
Pourfallah [Col 99, Lines 31-32] with historical information on the user's prior purchases
Pourfallah [Col 130, Line 63] also calculates fees, charges
Pourfallah [Col 106, Lines 38-40] history mode 1561 to view a history of prior purchases and perform various actions on those prior purchases. For example, a user may query on receipts of past transactions
Pourfallah [Col 65, Lines 18-19] more than half a year to the end date to his FSA)
Pourfallah does not teach wherein the shadow ledger.
Hoffman teaches,
wherein the shadow ledger
(Hoffman [0140] send instructions to the custodial account manager to move a specific portion of the established HSA to specified sub-accounts that are selected based solely (or at least primarily) on the discretion of the account holder.)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the sub-accounts of Hoffman whereby “the transaction account and investment sub-accounts are structured so that any funds being deposited into, or withdrawn from, the various investment sub-accounts must pass through the transaction account” (Hoffman [0035]). The modification would have been obvious, because it is merely applying a known technique (i.e. sub-accounts) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “allowing the account holder to invest money from their HSA in one or more investment sub-accounts (such as money market accounts or mutual funds).” Hoffman [0138])
Regarding Claim 4,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 1 as described earlier.
Pourfallah teaches,
wherein the processor prevents the payment method provided by the out-of-pocket enrollee from being charged in instances where the threshold deductible amount
(Pourfallah [Col 43, Lines 39-41] the B2B-PAY may verify and/or limit the payment if the purchasing amount of such drugs has exceeded a pre-specified maximum amount.
Pourfallah [Col 59, Lines 41-43] when the payment amount exceeds the maximum limit, the B2B-PAY may reject the payment request.
Pourfallah [Col 83, Lines 42-44] a remaining deductible contribution amount to a healthcare-relates account amount for a specific year;)
…. has been reached.
(Pourfallah [Col 59, Lines 60-62] when the payment amount exceeds the maximum limit)
Pourfallah does not teach tracked by the shadow ledger for the out-of-pocket enrollee
Hoffman teaches,
tracked by the shadow ledger for the out-of-pocket enrollee
(Hoffman [0140] send instructions to the custodial account manager to move a specific portion of the established HSA to specified sub-accounts that are selected based solely (or at least primarily) on the discretion of the account holder.
Hoffman [0138] Each of these investment sub-accounts may be maintained by the custodian that administers the HSA
Hoffman [0037] the HSA is used to track the various transactions
Hoffman[0148] information regarding a particular expenditure ...the account holder's out-of-pocket cost for the services
Hoffman [0145] the beginning balance of the HSA account; (2) the total credits associated with the account; (3) the total debits associated with the account;)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the sub-accounts of Hoffman whereby “the transaction account and investment sub-accounts are structured so that any funds being deposited into, or withdrawn from, the various investment sub-accounts must pass through the transaction account” (Hoffman [0035]). The modification would have been obvious, because it is merely applying a known technique (i.e. sub-accounts) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “allowing the account holder to invest money from their HSA in one or more investment sub-accounts (such as money market accounts or mutual funds).” Hoffman [0138])
Regarding Claim 8,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 1 as described earlier.
Pourfallah teaches,
wherein the processor is further configured to store the payment method provided by the out-of-pocket enrollee in an encrypted database.
(Pourfallah [Col 5, Lines 20-30] a user to engage a restricted-use account...A restricted-use account may be a financial account having funds that can only be used for payment of approved ...services (e.g., healthcare treatment, physical examination, etc.). .... one or more health reimbursement accounts (HRA), one or more government insurance programs (i.e., Medicare or Medicaid)
Pourfallah [Col 142, Lines 52-55] The B2B-PAY database component 2419 may be embodied in a database and its stored data. The database is a stored program component, which is executed by the CPU
Pourfallah [Col 145, Line 66 to COl 146, Line 15] The B2B-PAY component enabling access of information between nodes may be developed by employing standard development tools...Apache components,...database adapters...the B2B-PAY server employs a cryptographic server to encrypt and decrypt communications)
Regarding Claim 9,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 1 as described earlier.
Pourfallah teaches,
wherein the primary account is a bank account.
(Pourfallah [Claim 1] account details of a first bank account)
Regarding Claim 11,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 1 as described earlier.
Pourfallah does not teach wherein the processor is further configured to cause a statement to be communicated to each enrollee of the plurality of enrollees reflective of an activity summary associated with shadow ledger.
Hoffman teaches,
wherein the processor is further configured to cause a statement to be communicated to each enrollee of the plurality of enrollees reflective of an activity summary associated with shadow ledger.
(Hoffman [0052] the system also stores, within the claim vault, an electronic summary of the claim. This electronic claim summary may be electronically associated with the corresponding electronic copy of the related supporting documentation and then stored
Hoffman [0140] send instructions to the custodial account manager to move a specific portion of the established HSA to specified sub-accounts that are selected based solely (or at least primarily) on the discretion of the account holder.
Hoffman [0138] Each of these investment sub-accounts may be maintained by the custodian that administers the HSA
Hoffman [0037] the HSA is used to track the various transactions)
Regarding Claim 12,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 1 as described earlier.
Pourfallah teaches,
wherein the processor is further configured to store the information provided by each enrollee of the plurality of enrollees in an encrypted manner.
(Pourfallah [Col 141, Line 60 to Col 142, Line 35] A cryptographic server component 2420 is a stored program component that is executed by a CPU 2403, cryptographic processor 2426, cryptographic processor interface 2427, cryptographic processor device 2428, and/or the like. Cryptographic processor interfaces will allow for expedition of encryption and/or decryption requests by the cryptographic component;... The cryptographic component supports encryption schemes)
Claim 15 is rejected on the same basis as Claim 1 with the added limitation of “maintaining a balance in the primary account equivalent to a sum of fees incurred by insurance coverage plans sponsored by the particular insurance company.”
(Pourfallah [Col 130, Lines 64-66] system 2344 collects financial and non-financial information and distributes reports....calculates fees, charges and settlement totals and produces reports to help with reconciliation.
Pourfallah [0148] Primary Account
Pourfallah [0036] communication may include a balance due bill of a healthcare provider for healthcare to a user.... derives an optimized payment of the balance due
Pourfallah [0123] indicate a reimbursement account in the reimbursement request ...an account for deposit of the reimbursed funds.... may configure an account for reimbursement purpose...may automatically deposit reimbursed funds into the account
Pourfallah [0157] server may engage in an insurance adjudication process with the insurance provider)
Regarding Claim 16,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 1 as described earlier.
Pourfallah does not teach wherein the processor is further configured to:
detect a particular shadow ledger associated with a particular enrollee; and automatically generate a statement associated with the particular shadow ledger based on the detection.
Hoffman teaches,
wherein the processor is further configured to: detect a particular shadow ledger associated with a particular enrollee; and automatically generate a statement associated with the particular shadow ledger based on the detection.
(Hoffman [Abstract] determine whether the particular claim is properly reimbursable from the health savings account
Hoffman [0148] information regarding a particular expenditure into the system ... Such information may include, for example: (1) a reference number for the expenditure; (2) the date that related health services were received; (3) the name of the patient
Hoffman [0037] an account administration system associated with the HSA is used to track the various transactions associated with the HSA, and for generating various reports related to the HSA. In certain embodiments of the invention, the account administration system includes an HSA account valuation tool that is adapted to assess the monetary value of each account (including investment sub-accounts))
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the form identification of Hoffman whereby “This form identifies the PSP by name and provides the PSP's address and contact information” (Hoffman [0077]). The modification would have been obvious, because it is merely applying a known technique (i.e. form identification) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “allowing the account holder to invest money from their HSA in one or more investment sub-accounts (such as money market accounts or mutual funds).” Hoffman [0138])
Regarding Claim 17,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 16 as described earlier.
Pourfallah does not teach wherein the processor is further configured to:
communicate the statement associated with the particular shadow ledger to the particular enrollee based on the detection.
Hoffman teaches,
wherein the processor is further configured to:
communicate the statement associated with the particular shadow ledger to the particular enrollee based on the detection.
(Hoffman [0047] the account administration system is configured to then transmit a reminder to the account holder (e.g., via a paper letter or e-mail)... as part of the corresponding claim documentation record
Hoffman [0037] an account administration system associated with the HSA is used to track the various transactions associated with the HSA, and for generating various reports)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the form identification of Hoffman whereby “This form identifies the PSP by name and provides the PSP's address and contact information” (Hoffman [0077]). The modification would have been obvious, because it is merely applying a known technique (i.e. form identification) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “allowing the account holder to invest money from their HSA in one or more investment sub-accounts (such as money market accounts or mutual funds).” Hoffman [0138])
Claim 5 is rejected under 35 U.S.C. 103 as being unpatentable over Pourfallah, Hoffman, Pilzer, Fasoli, and Chang in view of Slen (“PHARMACY PERSONAL CARE ACCOUNT”, U.S. Publication Number: US 20110153353 A1).
Regarding Claim 5,
Pourfallah and Hoffman teach the insurance account management of Claim 1 as described earlier.
Pourfallah does not teach wherein a ledger balance of the shadow ledger established for each enrollee underneath the primary account is zero prior to a start of the coverage period.
Hoffman teaches,
shadow ledger established for each enrollee underneath the primary account
(Hoffman [0035] the transaction account and investment sub-accounts are structured so that any funds being deposited into, or withdrawn from, the various investment sub-accounts must pass through the transaction account.)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the sub-accounts of Hoffman whereby “the transaction account and investment sub-accounts are structured so that any funds being deposited into, or withdrawn from, the various investment sub-accounts must pass through the transaction account” (Hoffman [0035]). The modification would have been obvious, because it is merely applying a known technique (i.e. sub-accounts) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “allowing the account holder to invest money from their HSA in one or more investment sub-accounts (such as money market accounts or mutual funds).” Hoffman [0138])
Hoffman does not teach wherein a ledger balance… is zero prior to a start of the coverage period.
Slen teaches,
wherein a ledger balance… is zero prior to a start of the coverage period.
(Slen [0145] HRA, FSA or HSA accounts on behalf of the subscribers
Slen [0205] employees selecting the new plan...allow for an initial account balance of zero and the subsequent accumulation of monetary credits throughout a given plan year.)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the account management of Slen to “apply at least one monetary credit from said personal care account to the cost of an allowed product or service.” (Slen [Claim 6]). The modification would have been obvious, because it is merely applying a known technique (i.e. account management) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “allowances for each of said products or services comprising a maximum amount” Slen [Claim 13])
Claims 6, 7, and 18 are rejected under 35 U.S.C. 103 as being unpatentable over Pourfallah, Hoffman, Pilzer, Fasoli, Chang, and Slen in view of Brown (“SYSTEMS AND METHODS FOR ACCOUNT PROCESSING”, U.S. Publication Number: US 20140278580 A1).
Regarding Claim 6,
Pourfallah, Hoffman, Pilzer, Fasoli, Chang, and Slen teach the insurance account management of Claim 5 as described earlier.
Pourfallah does not teach the processor is further configured to determine that the threshold deductible amount tracked by the shadow ledger for the out-of- pocket enrollee has already been paid.
Brown teaches,
the processor is further configured to determine that the threshold deductible amount tracked by the shadow ledger for the out-of- pocket enrollee has already been paid.
(Brown [0049] to a traditional flexible spending account (FSA) or health savings account (HSA).
Brown [0085] determining whether the participant has met an out-of-pocket maximum under the participant's plan. If the out-of-pocket maximum was met, then the credit transaction can be allocated to plan payments
Brown [0098] Once the deductible is met, the co-insurance benefit will apply, such as up to the plan-specified maximum out-of-pocket)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the threshold deductible amount of Brown for “a deductible … the insured participant is required to contribute an amount toward their care before the insurer will pay a portion.” (Brown [0003]). The modification would have been obvious, because it is merely applying a known technique (i.e. threshold deductible amount) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “premium plan module 530 can include … information about a deductible” Brown [0070])
Regarding Claim 7,
Pourfallah, Hoffman, Pilzer, Fasoli, Chang, Slen, and Brown teach the insurance account management of Claim 6 as described earlier.
Pourfallah does not teach wherein the processor is further configured to prevent overpayment from the payment method based on the determination that the threshold deductible amount tracked by the shadow ledger for the out-of- pocket enrollee has already been paid.
Brown teaches,
wherein the processor is further configured to prevent overpayment from the payment method based on the determination that the threshold deductible amount tracked by the shadow ledger for the out-of- pocket enrollee has already been paid.
(Brown [0049] to a traditional flexible spending account (FSA) or health savings account (HSA).
Brown [0085] determining whether the participant has met an out-of-pocket maximum under the participant's plan. If the out-of-pocket maximum was met, then the credit transaction can be allocated to plan payments
Brown [0003] To be covered by a health insurance plan, an individual (and sometimes the individual's employer) can be required to pay the insurer in the form of a premium, such as monthly, annually, or at one or more other times.
Examiner interprets this as saying if payment is made toward an already satisfied out-of-pocket maximum, those funds are redirected to the reoccurring premium)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the threshold deductible amount of Brown for “a deductible … the insured participant is required to contribute an amount toward their care before the insurer will pay a portion.” (Brown [0003]). The modification would have been obvious, because it is merely applying a known technique (i.e. threshold deductible amount) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “premium plan module 530 can include … information about a deductible” Brown [0070])
Regarding Claim 18,
Pourfallah, Hoffman, Pilzer, Fasoli, and Chang teach the insurance account management of Claim 1 as described earlier.
Pourfallah teaches,
deposit the deductible for the coverage period in the primary account.
(Pourfallah [Col 83, Lines 42-44] a remaining deductible contribution amount to a healthcare-relates account amount for a specific year
Pourfallah [Col 16, Lines 53-55] may process the payment and deposit the insured amount 2036 b to the healthcare provider's bank account
Pourfallah [Col 144, Lines 26-28] deposit_amount, batch_id, transaction_id, clear_flag, deposit_account)
Pourfallah does not teach wherein the processor is further configured to: cause a payment method provided by the upfront enrollee to be charged for a deductible for a coverage period based on information provided by the upfront enrollee.
Brown teaches,
wherein the processor is further configured to: cause a payment method provided by the upfront enrollee to be charged for a deductible for a coverage period based on information provided by the upfront enrollee.
(Brown [0003] Some health insurance plans operate under a deductible and the insured participant is required to contribute an amount toward their care before the insurer will pay a portion.
Brown [0049] amounts that are prepaid by a plan are referred to herein as First Dollar amounts, such as including funds in a First Dollar account, and amounts that are prepaid by a participant are referred to herein as Second Dollar amounts, such as including funds in a Second Dollar account.
Brown [0070] an ancillary participant payment account (e.g., a second dollar account), or a line-of-credit account.
Brown [0077] a participant co-insurance amount can be funded from any ancillary account balances, such as a second dollar account, or from a participant line-of-credit account.
Brown [0091] the Health Care Allowance account can include a second dollar, cash-like account, such as can be funded by the participant..)
It is prima facie obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to have modified the insurance account administration of Pourfallah to incorporate the threshold deductible amount of Brown for “a deductible … the insured participant is required to contribute an amount toward their care before the insurer will pay a portion.” (Brown [0003]). The modification would have been obvious, because it is merely applying a known technique (i.e. threshold deductible amount) to a known concept (i.e. insurance account administration) ready for improvement to yield predictable result (i.e. “premium plan module 530 can include … information about a deductible” Brown [0070])
Response to Remarks
Applicant's arguments filed on March 11, 2026, have been fully considered and Examiner’s remarks to Applicant’s amendments follow.
Response Remarks on Claim Rejections - 35 USC § 101
The Applicant states:
“They recite a specific, interdependent two-component machine architecture in which a template-based computer vision pipeline feeds structured enrollee data into a shadow ledger framework …That is not an abstract idea; … the claims are directed to a technical data-processing pipeline under Step 2A, Prong, 1 that converts unstructured enrollment form images into structured machine- readable enrollee records through template identification and field-specific OCR extraction, which are then used by the processor to drive automated ledger reconciliation operations."
Examiner responds:
A “pipeline (that) feeds structured enrollee data into a shadow ledger framework” and “converts unstructured enrollment form images into structured machine-readable enrollee records through template identification and field-specific … extraction, … to drive automated ledger reconciliation operations” amounts to gathering, sharing, and manipulation of data expresses an Abstract Idea [Intellectual Ventures I v. Capital One Fin. Corp., 850 F.3d 1332, 121 USPQ2d 1940 (Fed. Cir. 2017) “collecting, displaying, and manipulating data” was considered part of the abstract idea], and Selecting A Particular Data Source or Type Of Data To Be Manipulated [Selecting information, based on types of information and availability of information in a power-grid environment, for collection, analysis and display, Electric Power Group, LLC v. Alstom S.A., 830 F.3d 1350, 1354-55, 119 USPQ2d 1739, 1742 (Fed. Cir. 2016)]
The additional elements of “computer vision ... OCR ... used by the processor” utilize generic computer components. For example, the Applicant’s Specification reads in generalities:
[0022] scanning the form into a computer and emailing and/or uploading the electronic version of the form generated from the scan, or by any other suitable communication method.
[0025] “computer vision comprises an imager (e.g., a camera or scanner, or set of cameras/scanners) for capturing a digital image of the form.”
The additional elements are recited at a high-level of generality (i.e., as a generic processor performing a generic computer function) such that it amounts no more than mere instructions to apply the exception using a generic computer component. Accordingly, these additional elements, when considered separately and as an ordered combination, do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea and are at a high level of generality.
The Applicant states:
“the system achieves two concrete technical results that would not be achievable by a system performing generic document scanning or data entry: (1) increased extraction accuracy, because the system extracts data only from the specific field locations defined by the identified template for that form type rather than attempting to locate fields heuristically; and (2) reduced processing time, because the template-match output immediately directs the OCR engine to the correct field locations without iterative search… This integrated architecture solves a concrete, real-world operational problem that the Office Action has not acknowledged: enabling a third-party financial institution to manage deductible collection on behalf of multiple insurance companies, across a large and heterogeneous enrollee population, in a way that is scalable, automated, and reconcilable without requiring individual bank accounts for each enrollee. "
Examiner responds:
Neither the Specification nor Claims explicitly mention “increased extraction accuracy” nor “reduced processing time.”
The acts of “enabling a third-party financial institution to manage deductible collection on behalf of multiple insurance companies, across a large and heterogeneous enrollee population, in a way that is scalable, automated, and reconcilable without requiring individual bank accounts for each enrollee” express certain methods of organizing human activity and recites a fundamental economic principles or practice and/or commercial or legal interactions. Accordingly, the claims recites an abstract idea.
Therefore, the rejection under 35 USC § 101 remains.
Response Remarks on Claim Rejections - 35 USC § 103
Applicant's amendments required the application of new/additional prior art.
New prior art includes:
Chang (“UNSUPERVISED REMOVAL OF TEXT FROM IMAGES USING LINEAR PROGRAMMING FOR OPTIMAL FILTER DESIGN”, U.S. Patent Number: US 10657369 B1).
Applicant’s remarks regarding the rejection made under 35 USC § 103 are rendered moot by the introduction of additional prior art.
Therefore, the rejection under 35 USC § 103 remains.
Prior Art Cited But Not Applied
The prior art made of record and not relied upon is considered pertinent to applicant's disclosure:
Pourfallah (“Restricted-use account payment administration apparatuses, methods and systems”, U.S. Publication Number: US 20120253852 A1) teaches receiving a restricted-use account reimbursement request including receipt information related to a purchase transaction from a user; obtaining purchase item information from the receipt information included in the restricted-use account reimbursement request; identifying a restricted-use account of the user; determining a purchase item is eligible for the restricted-account usage; determining a reimbursement amount associated with the purchase item form the purchase item information; generating a reimbursement authorization request message including the purchase item information and the reimbursement amount; transmitting the reimbursement authorization request message to a restricted-account issuer for approval; and transacting the reimbursement amount from the restricted-use account to a user financial account upon the restricted-account issuer approval.
Kenna (“INTEGRATED NESTED ACCOUNT FINANCIAL SYSTEM WITH MEDICAL SAVINGS SUBACCOUNT”, U.S. Patent Number: US 7133840 B1) proposes a system for managing a plurality of accounts, each the accounts being separated into a master account and at least one subaccount associated therewith, and at least one of the subaccount being a medical saving account (MSA). Each subaccount incorporates a subset of features available for the master account, the features corresponding to the specific needs dictated by the purpose of the subaccount. The purpose of a subaccount, in addition to being an MSA, can include regular payments (e.g., mortgage and other loans), credit/debit card, retirement account, and the like.
Mahadkar (“HEALTHCARE PREPAID PAYMENT PLATFORM APPARATUSES, METHODS AND SYSTEMS”, U.S. Publication Number: 20140379361 A1) transforms patient insurance information, and healthcare procedure schedule information inputs via HPP-Platform components into medical claim settlement outputs. In one embodiment, a healthcare insurance pre-authorization request including healthcare procedure schedule information and user insurance information; receiving an indication of insurance approval of an insured amount from an insurance provider; loading an insurance approved amount into a prepaid account of the user prior to the healthcare procedure; receiving a payment request using the loaded prepaid account towards a medical bill after the healthcare procedure is performed; transferring the loaded insurance approved amount in the prepaid account to a healthcare provider in response to the payment request; and generating a transaction record including the pre-approved amount and the transferred amount.
Dibiasi (“HEALTHCARE DEBIT CARD LINKED TO HEALTHCARE-RELATED AND NON-HEALTHCARE-RELATED FINANCIAL ACCOUNTS”, U.S. Publication 11797933 B2) proposes a healthcare financial payment system and method are disclosed in which a debit card which may be used by a cardholder to pay for medical products and services is linked with a healthcare-related financial account associated with the cardholder as well as with a non-healthcare-related financial account belonging to the cardholder. The healthcare-related financial account associated with the cardholder may be a Flexible Spending Arrangement (FSA), a Health Savings Account (HSA), or a health reimbursement arrangement (HRA), and the non-healthcare-related financial account associated with the cardholder may be a bank checking or savings account or a credit card. Any expenses for medical goods and services which are not covered by the cardholder's medical insurance may be paid from the cardholder's healthcare-related financial account if the medical goods or services are eligible and if there are funds remaining in the healthcare-related financial account, with any remaining costs being paid for from or charged to the cardholder's non-healthcare-related financial account.
Conclusion
Applicant's amendment necessitated the new ground(s) of rejection presented in this Office action. Accordingly, THIS ACTION IS MADE FINAL. See MPEP § 706.07(a). 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 extension fee 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 date of this final action.
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/C.E./Examiner, Art Unit 3695
/CHRISTINE M Tran/Supervisory Patent Examiner, Art Unit 3695
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