DETAILED ACTION Status of the Claims
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA . The following is in response to a Request for Continued Examination dated December 16, 2025. Claims 1,4, 6-8, 11-13 and 16-18 are amended. Claims 1, 4, 6-8, 11-3 and 16-18 are pending. All pending claims are examined.
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and the fee set forth in 37 CFR 1.17(e) has been timely paid, the finality of the previous Office action has been withdrawn pursuant to 37 CFR 1.114.
Response to Arguments
101 Rejection Analysis
101 Analysis
In line with the "2019 Revised Patent Subject Matter Eligibility Guidance," which explains how we must analyze patent-eligibility questions under the judicial exception to 35 U.S.C. § 101. 84 Fed. Reg. 50-57 ("Revised Guidance"), the first step of Alice (i.e., Office Step 2A) consists of two prongs. In Prong One, we must determine whether the claim recites a judicial exception, i.e., an abstract idea, a law of nature, or a natural phenomenon. 84 Fed. Reg. at 54 (Section III.A. I.). If it does not, the claim is patent eligible. Id.
An abstract idea must fall within one of the enumerated groupings of abstract ideas in the Revised Guidance or be a "tentative abstract idea, "with the latter situation predicted to be rare. Id. at 51-52 (Section I, enumerating three groupings of abstract ideas), 54 (Section III.A. I., describing Step 2A Prong One), 56-57 (Section III.D., explaining the identification of claims directed to a tentative abstract idea).
If a claim does recite a judicial exception, the next is Step 2A Prong Two, in which we must determine if the "claim as a whole integrates the recited judicial exception into a practical application of the exception." Id. at 54 (Section II.A.2.) If it does, the claim is patent eligible. Id.
If a claim recites a judicial exception but fails to integrate it into a practical application, we move to the second step of Alice (i.e., Office Step 2B). to evaluate the additional limitations of the claim, both individually and as an ordered combination, to determine whether they provide an inventive concept. Id. at 56 (Section III.B.). In particular, we look to whether the claim:
• Adds a specific limitation or combination of limitations that are not well-understood, routine, conventional in the field, which is indicative that an inventive concept may be present; or
• simply appends well-understood, routine, conventional activities previously known to the industry, specified at a high level of generality, to the judicial exception, which is indicative that an inventive concept may not be present.
The analysis in line with current 101 guidelines. Even if the abstract idea is deemed to be novel, the abstract idea is no less abstract (see Flook- new mathematical formula was an abstract idea).
“ In accordance with judicial precedent and in an effort to improve consistency and predictability, the 2019 Revised Patent Subject Matter Eligibility Guidance extracts and synthesizes key concepts identified by the courts as abstract ideas to explain that the abstract idea exception includes the following groupings of subject matter, when recited as such in a claim limitation(s) (that is, when recited on their own or per se):
(b) Certain methods of organizing human activity—fundamental economic principles or practices (including hedging, insurance, mitigating risk); commercial or legal interactions (including agreements in the form of contracts; legal obligations; advertising, marketing or sales activities or behaviors; business relations); managing personal behavior or relationships or interactions between people (including social activities, teaching, and following rules or instructions)1 – See Federal Register / Vol. 84, No. 4 / Monday, January 7, 2019 / p.52.
Step 1: The claims are directed to one or more of the following statutory categories: a process, a machine, a manufacture, and a composition of matter.
Claim 11 which is illustrative of independent claims 1and 12 recites:
11. A receipt data examination method executed by a computer in communication with a database and a terminal device, the method comprising:
receiving an examination request including receipt data from the terminal device, the receipt data indicating a detailed statement of
medical fees and including a medical care information item;
receiving a plurality of examination failure conditions from the database;
generating, based on the receipt data, receipt data conversion information indicating whether the medical care information item that corresponds to the plurality of examination failure conditions is present or not, the generating comprising converting at least a primary disease name, a medication name, and a medication administration period into numerical values indicating whether each of the plurality of examination failure conditions is satisfied;
performing learning by machine learning, on relationships between receipt data conversion information generated from a plurality of past receipts, examination failure results of the receipts, and medical care information items that are failure factors in the examination failure results, and generating and updating an examination failure risk predictor that calculates a failure risk level according to a relationship between the primary disease name and a medical care method or a medication administration method ;
for receipt data to be examined, calculating a failure risk level based on the medical care information item included in the receipt data, by inputting the receipt data conversion information andthe examination failure risk predictor;
calculating, using correlation analysis, a degree of contribution of each medical care information item to the failure risk level, and
specifying a medical care information item with a degree of contribution to the failure risk level calculation that is greater than or equal to a prescribed threshold value for the degree of contribution;
transmitting
in a case where the failure risk level is greater than or equal to a prescribed threshold value for risk level.
outputting, to the terminal device, as a risk factor for an examination failure, only the specified medical care information item with the degree of contribution that is greater than or equal to a prescribed threshold value:
outputting, to the terminal device, a revision screen for the specified medical care information item that is the risk factor;
automatically changing a display order of the specified medical care information item that is the risk factor on the terminal device based on the degree of contribution; and
in response to a user revision of at least one specified medical care information item on the revision screen of the terminal device, acquiring revised receipt data in which the specified medical care information item has been revised, regenerating the receipt data conversion information for the revised receipt data, and repeatedly calculating the failure risk level based on the revised receipt data until the failure risk level becomes less than the prescribed threshold value for risk level.
2A, Prong One, The invention is directed to a method of organizing human activity that is a fundamental economic practice of evaluating transaction data for accurate medical billing purposes, wherein the data is evaluated based on pre-defined instructions. This suggests reviewing data and evaluating the information against predefined criteria to determine the examination error risk predictor (see App. Spec. Figs. 4-5; see also paras. 0034, 0047-0050).
Beyond the abstract idea, the additional elements recite hardware components such as a computer (see App. Spec. para. 0248 – “…Those computer program instructions can be provided to a general computer, a dedicated computer, an embedded processor or a processor of other programmable data processing device to produce a machine, so that the instructions executed by the processor of the computer or other programmable data processing device produce device for realizing specified functions in one or more flows in the flow diagram and/or one or more blocks in the block diagram.,”) there does not appear to be any technology being improved.
They are described at a high level of generality where each step does no more than require a generic computer to perform generic computer functions. Absent is any support in the specification that the claims as recited require specialized computer hardware or other inventive computer components.
Unlike, McRO, the present claims contain improvements to the context in which transactions are executed and not one of a technology or technological field.
Although the claims recite:
performing learning by machine learning, on relationships between receipt data conversion information generated from a plurality of past receipts, examination failure results of the receipts, and medical care information items that are failure factors in the examination failure results, and generating and updating an examination failure risk predictor that calculates a failure risk level according to a relationship between the primary disease name and a medical care method or a medication administration method ;
for receipt data to be examined, calculating a failure risk level based on the medical care information item included in the receipt data, by inputting the receipt data conversion information andthe examination failure risk predictor;
calculating, using correlation analysis, a degree of contribution of each medical care information item to the failure risk level, and
specifying a medical care information item with a degree of contribution to the failure risk level calculation that is greater than or equal to a prescribed threshold value for the degree of contribution;
transmitting
and a bare assertion of an improvement is made, the necessary detail on how the machine learning is executed has to be apparent to a person of ordinary skill in the art. However, absent is support (explanation) for how the identified improvement to machine learning technology is executed. As recited it suggests a process similar to a feedback loop in which feedback is used to update the data fed the model.
These suggest outlining the additional description of the conditions for the output and displayed, absent is any support for the claims as recited for how it is an improvement to the computer or technical field beyond automating the evaluation process. In particular, there is a lack of improvement to a computer or technical field of accessing the user’s data because the data processing performed merely uses a system as a tool to perform an abstract idea- see MPEP 2106.05(f). Therefore, the claims are directed to an abstract idea. The invention as claimed recites a generic computer component and the claim does not pass step 2A, Prong Two.
Step 2B; The next step is to identify any additional limitations beyond the judicial exception. The additional elements is computer which is disclosed in the specification at a high degree of generality. Absent is any genuine issue of material fact that this component requires any specialized hardware or inventive computer component.
Likewise, the dependent claims 4, 6-8, 13 and 16-18 are rejected under 35 U.S.C. § 101. For example, claims 4, 6-8 provide descriptive details of what is used in processing the data describes conditions for executing the request. These claim limitations recite steps at a high level of generality and performed in a traditional manner and therefore do not integrate the abstract idea into a practical application or provide an inventive concept.
Independent claims 1, 11 and 12 are rejected under 35 U.S.C. § 101 including dependent claims 4, 6-8, 13 and 16-18 which fall with claims 1, 11 and 12. Therefore, claims 1, 4, 6-8, 11-3 and 16-18 are not patent eligible under 35 USC 101.
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, 4, 6-8, 11-3 and 16-18 are rejected under 35 U.S.C. 101 because the claimed invention is directed to a judicial exception (abstract idea) without significantly more.
The claim recites abstract idea of organizing human activities. This judicial exception is not integrated into a practical application and the claim(s) does/do not include additional elements that are sufficient to amount to significantly more than the judicial exception.
Analysis
The claims are directed to one or more of the following statutory categories: a process, a machine, a manufacture, and a composition of matter.
Claim 11 which is illustrative of the independent claims including 1 and 12, recite:
11. A receipt data examination method executed by a computer in communication with a database and a terminal device, the method comprising:
receiving an examination request including receipt data from the terminal device, the receipt data indicating a detailed statement of
medical fees and including a medical care information item;
receiving a plurality of examination failure conditions from the database;
generating, based on the receipt data, receipt data conversion information indicating whether the medical care information item that corresponds to the plurality of examination failure conditions is present or not, the generating comprising converting at least a primary disease name, a medication name, and a medication administration period into numerical values indicating whether each of the plurality of examination failure conditions is satisfied;
performing learning by machine learning, on relationships between receipt data conversion information generated from a plurality of past receipts, examination failure results of the receipts, and medical care information items that are failure factors in the examination failure results, and generating and updating an examination failure risk predictor that calculates a failure risk level according to a relationship between the primary disease name and a medical care method or a medication administration method ;
for receipt data to be examined, calculating a failure risk level based on the medical care information item included in the receipt data, by inputting the receipt data conversion information andthe examination failure risk predictor;
calculating, using correlation analysis, a degree of contribution of each medical care information item to the failure risk level, and
specifying a medical care information item with a degree of contribution to the failure risk level calculation that is greater than or equal to a prescribed threshold value for the degree of contribution;
transmitting
in a case where the failure risk level is greater than or equal to a prescribed threshold value for risk level.
outputting, to the terminal device, as a risk factor for an examination failure, only the specified medical care information item with the degree of contribution that is greater than or equal to a prescribed threshold value:
outputting, to the terminal device, a revision screen for the specified medical care information item that is the risk factor;
automatically changing a display order of the specified medical care information item that is the risk factor on the terminal device based on the degree of contribution; and
in response to a user revision of at least one specified medical care information item on the revision screen of the terminal device, acquiring revised receipt data in which the specified medical care information item has been revised, regenerating the receipt data conversion information for the revised receipt data, and repeatedly calculating the failure risk level based on the revised receipt data until the failure risk level becomes less than the prescribed threshold value for risk level.
Taking the broadest reasonable interpretation, the invention (as recited in claims 1, 4, 6-8, 11-3 and 16-18) is directed towards that is a fundamental economic practice of evaluating transaction data for accurate medical billing purposes, wherein the data is evaluated based on pre-defined instructions. This suggests reviewing data and evaluating the information against predefined criteria to determine the examination error risk predictor (see App. Spec. Figs. 4-5; see also paras. 0034, 0047-0050).
It can also be considered a mental process practically with the human mind since it entails making comparisons of data albeit with the help of a computer. Besides reciting the abstract idea, the remaining claim limitations recite generic computer components (e.g. computer (see App. Spec. para. 0248 – “…Those computer program instructions can be provided to a general computer, a dedicated computer, an embedded processor or a processor of other programmable data processing device to produce a machine, so that the instructions executed by the processor of the computer or other programmable data processing device produce device for realizing specified functions in one or more flows in the flow diagram and/or one or more blocks in the block diagram.,”).
This recited abstract idea is not integrated into a practical application. In particular, the claim only recites generic computer components to execute the receiving, receiving, generating/performing,calculating,specifying,transmitting,outputting,outputting, acquiring and calculating steps.
The additional elements are recited at a high-level of generality (e.g computer) such that they amount to no more than mere instructions to apply the exception using generic computer components. Accordingly, these additional elements do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea. Therefore, the claim is directed to an abstract idea.
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 elements - (e.g. computer) amount to no more than mere instructions to apply the abstract idea using generic computer components.
The dependent claims 4, 6-8, 13 and 16-18 are rejected under 35 U.S.C. § 101. For example, claims 4, 6-8 provide descriptive details of what is used in processing the data describes conditions for executing the request. These claim limitations recite steps at a high level of generality and performed in a traditional manner and therefore do not integrate the abstract idea into a practical application or provide an inventive concept.
They do not address the issues raised in the independent claims and therefore do not amount to a technical improvement or an integration of a practical application. In conclusion, merely “applying” the exception using generic computer components cannot provide an inventive concept. Therefore, claims 1, 4, 6-8, 11-3 and 16-18 are not patent eligible under 35 USC 101.
Conclusion
The prior art made of record and not relied upon is considered pertinent to applicant's disclosure:
Stover, USP Pub. No. 20060036523 (Integrated Health Savings Account Methods And Systems)
Regan, USP Pub. No. 20180108011(Method And System For A Virtual Payment Card Funded By Multiple Sources) discloses multiple funding sources used to fund a split payment transaction and the process of denial (Regan, see also paras. 0073, 0075).
Dangott, USP Pub. No. 20120233074 (Targeted Benefit Account) which discloses the order in which funds are applied to a transaction.
Any inquiry concerning this communication or earlier communications from the examiner should be directed to CHIKA OJIAKU whose telephone number is (571)270-3608. The examiner can normally be reached Monday - Friday: 8.30 AM -5:00 PM EST.
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/CHIKAODINAKA OJIAKU/Primary Examiner, Art Unit 3696
1 Interval Licensing, 896 F.3d at 1344–45 (concluding that ‘‘[s]tanding alone, the act of providing someone an additional set of information without disrupting the ongoing provision of an initial set of information is an abstract idea,’’ observing that the district court ‘‘pointed to the nontechnical human activity of passing a note to a person who is in the middle of a meeting or conversation as further illustrating the basic, longstanding practice that is the focus of the [patent ineligible] claimed invention.’’); Voter Verified, Inc. v. Election Systems & Software, LLC, 887 F.3d 1376, 1385 (Fed. Cir. 2018) (finding the concept of ‘‘voting, verifying the vote, and submitting the vote for tabulation,’’ a ‘‘fundamental activity’’ that humans have performed for hundreds of years, to be an abstract idea);
In re Smith, 815F.3d 816, 818 (Fed. Cir. 2016) (concluding that ‘‘[a]pplicants’ claims, directed to rules for conducting a wagering game’’ are abstract).
14 If a claim, under its broadest reasonable interpretation, covers performance in the mind but for the recitation of generic computer components, then it is still in the mental processes category unless the claim cannot practically be performed in the mind. See Intellectual Ventures I LLC v. Symantec Corp., 838 F.3d 1307, 1318 (Fed. Cir . 2016) (‘‘[W]ith the exception of generic computer-implemented steps, there is nothing in the claims themselves that foreclose them from being performed by a human, mentally or with pen and paper.’’); Mortg. Grader, Inc. v. First Choice Loan Servs. Inc., 811 F.3d. 1314, 1324 (Fed. Cir. 2016)(holding that computer-implemented method for ‘‘anonymous loan shopping’’ was an abstract idea because it could be ‘‘performed by humans without a computer’’); Versata Dev. Grp. v. SAP Am., Inc., 793 F.3d 1306, 1335 (Fed. Cir. 2015) (‘‘Courts have examined claims that required the use of a computer and still found that the underlying, patent-ineligible invention could be performed via pen and paper or in a person’s mind.’’); CyberSource Corp. v. Retail Decisions, Inc., 654 F.3d 1366, 1375, 1372 (Fed. Cir. 2011) (holding that the incidental use of ‘‘computer’’ or ‘‘computer readable medium’’ does not make a claim otherwise directed to process that ‘‘can be performed in the human mind, or by a human using a pen and paper’’ patent eligible); id. at 1376 (distinguishing Research Corp. Techs. v. Microsoft Corp., 627 F.3d 859 (Fed. Cir. 2010), and SiRF Tech., Inc. v. Int’l Trade Comm’n, 601 F.3d 1319 (Fed. Cir. 2010), as directed to inventions that ‘‘could not, as a practical matter, be performed entirely in a human’s mind’’). Likewise, performance of a claim limitation using generic computer components does not necessarily preclude the claim limitation from being in the mathematical concepts grouping, Benson, 409 U.S.at 67, or the certain methods of organizing human activity grouping, Alice, 573 U.S. at 219–20 - – See Federal Register / Vol. 84, No. 4 / Monday, January 7, 2019