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 .
Status of Claims
This action is in reply to the application filed on July 29, 2024 and amendments filed on December 16, 2024.
Claim(s) 1 has been amended and are hereby entered.
Claim(s) 21-23 have been added.
Claim(s) 18-20 have been canceled.
Claim(s) 1-17 and 21-23 are currently pending and have been examined.
This action is made Non-Final.
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.
Claim(s) 1-17 and 21-23 is/are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea without significantly more.
Claim(s) 1-17 and 21-23 are directed to a system, method, or product, which are/is one of the statutory categories of invention. (Step 1: YES).
The Examiner has identified independent system claim 21 as the claim that represents the claimed invention for analysis and is similar to independent system Claim 1 and system Claim 11. Claim 21 recites the following limitations:
[A computerized enrollment system for facilitating telemedicine practitioner onboarding with on-demand per-encounter malpractice liability coverage, the system comprising: a processor;]
[a memory coupled to the processor; and]
[a non-transitory computer-readable medium having stored thereon instructions that, when executed by the processor, cause the system to:]
[render, for display on an electronic interface, an enrollment graphical user interface generated by an enrollment module stored in the memory, wherein the enrollment graphical user interface] prompts a healthcare practitioner to enroll in a telemedicine platform that facilitates telemedicine encounters;
receive, [via the enrollment graphical user interface,] practitioner input including licensure credentials and existing malpractice insurance information, wherein the licensure credentials are received [by a licensure module configured] to validate the practitioner’s authority to practice by electronically querying [at least one external licensure database], and wherein the existing malpractice insurance information is received [by an existing malpractice module configured] to verify coverage applicability to in-person patient encounters [through communication with a remote insurance validation system over a secure network interface;]
upon verifying that the practitioner possesses valid licensure credentials, generate a set of telemedicine encounter service options [via a service management module stored in the memory, wherein the service management module is configured] to dynamically present selectable telemedicine encounter types to the practitioner based on previously stored telemedicine platform parameters, thereby enabling customization of services that the practitioner will offer [through the telemedicine platform];
in response to practitioner selections of one or more telemedicine encounter types, execute [an on-demand malpractice enrollment module stored in the memory] to determine a per-encounter liability coverage offering, [wherein the on-demand malpractice enrollment module:]
(i) retrieves practitioner-specific data including validated licensure information and existing malpractice insurance parameters,
(ii) determines coverage terms for telemedicine encounters that differ from in-person encounters based on at least one characteristic of the practitioner’s practice setting obtained from stored practitioner profile data, and
(iii) calculates a fee structure for the per-encounter coverage using a pricing algorithm [implemented by the on-demand malpractice enrollment module], such fee structure being derived from factors including the selected telemedicine encounter types, practitioner’s licensure jurisdiction, and patient demographic data [provided by the telemedicine platform];
render, [for display on the electronic interface, a coverage graphical user interface produced by the on-demand malpractice enrollment module] that presents the per-encounter liability coverage offering and prompts the practitioner to accept the calculated fee structure, wherein acceptance of the coverage offering is recorded and stored [in a secure data structure in the memory];
upon acceptance, [execute a coverage module stored in the memory to] initiate activation of the per-encounter liability coverage by electronically transmitting, [via the secure network interface,] coverage activation data [to a telemedicine platform registry or a third-party insurer’s underwriting system,] wherein the coverage applies exclusively to telemedicine encounters conducted through the telemedicine platform and is verified in real-time prior to commencement of each telemedicine encounter; and
periodically execute [a billing module stored in the memory] to determine the number and type of telemedicine encounters performed by the practitioner over a defined time period and to generate billing data reflecting fees for the on-demand per-encounter malpractice coverage, wherein the billing data is securely transmitted [to a payment processing subsystem configured] to invoice the practitioner based on actual telemedicine encounters conducted.
These limitations, under their broadest reasonable interpretation, cover performance of the limitation as certain methods of organizing human activity because the limitations recite commercial or legal interactions. If a claim limitation, under its broadest reasonable interpretation, covers performance of the limitation as a commercial or legal interaction, then it falls within the “Certain Methods of Organizing Human Activity” grouping of abstract ideas. Accordingly, the claim recites an abstract idea. The computerized enrollment system for facilitating telemedicine practitioner onboarding; processor; memory coupled to the processor; non-transitory computer-readable medium; electronic interface, enrollment graphical user interface generated by an enrollment module stored in the memory; licensure module; at least one external licensure database; existing malpractice module; remote insurance validation system; secure network interface; service management module stored in the memory; telemedicine platform; on-demand malpractice enrollment module stored in the memory; coverage graphical user interface produced by the on-demand malpractice enrollment module; secure data structure in the memory; coverage module stored in the memory; secure network interface; telemedicine platform registry; third-party insurer’s underwriting system; billing module stored in the memory; and payment processing subsystem in Claim 21 are just applying generic computer components to the recited abstract limitations. The recitation of generic computer components in a claim does not necessarily preclude that claim from reciting an abstract idea. Claim(s) 1 and 11 are also abstract for similar reasons. (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 a computerized enrollment system for facilitating telemedicine practitioner onboarding; processor; memory coupled to the processor; non-transitory computer-readable medium; electronic interface, enrollment graphical user interface generated by an enrollment module stored in the memory; licensure module; at least one external licensure database; existing malpractice module; remote insurance validation system; secure network interface; service management module stored in the memory; telemedicine platform; on-demand malpractice enrollment module stored in the memory; coverage graphical user interface produced by the on-demand malpractice enrollment module; secure data structure in the memory; coverage module stored in the memory; secure network interface; telemedicine platform registry; third-party insurer’s underwriting system; billing module stored in the memory; and payment processing subsystem. The computer hardware/software is/are recited at a high-level of generality (i.e., as a generic processor performing a generic computer function) such that it amounts to 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. Therefore, claim(s) 1, 11, and 21 are 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)
The claims do not include additional elements that are sufficient to amount to significantly more than the judicial exception because, when considered separately and as an ordered combination, they do not add significantly more (also known as an “inventive concept”) to the exception. As discussed above with respect to integration of the abstract idea into a practical application, the additional element of using computer hardware amounts to no more than mere instructions to apply the exception using a generic computer component. Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept. Accordingly, these additional elements do not change the outcome of the analysis when considered separately and as an ordered combination. Thus, claim(s) 1, 11, and 21 are not patent eligible. (Step 2B: NO. The claims do not provide significantly more)
Dependent claims 2-10, 12-17, and 22-23 further define the abstract idea that is present in their respective independent claim(s) 1, 11, and 21 and thus correspond to certain methods of organizing human activity and hence are abstract for the reasons presented above. Dependent claims 2-10, 12-17, and 22-23 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, dependent claims 2-10, 12-17, and 22-23 are directed to an abstract idea. Thus, claim(s) 1-17 and 21-23 are not patent-eligible.
Claim Rejections - 35 USC § 103
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.
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 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 1-10 are rejected under 35 U.S.C. 103 as being unpatentable over Macoviak (US 2016/0055307) in view of McGarvey (US 2020/0020454) in view of Milanovich (US 8,392,221).
Regarding claim(s) 1:
Macoviak teaches:
process the request from the user with a licensure validation subsystem to electronically verify multi-jurisdictional licensure records stored in disparate databases; (Macoviak: pgh 81, “…the software module verifies a credential issued by a licensed primary healthcare provider…”)
authenticate existing malpractice insurance policies of the user; (Macoviak: pgh 81, “…a screening process includes verification of, by way of non-limiting examples…malpractice insurance coverage…”)
wherein the per-encounter liability coverage offering is based, at least in part, on:(i) the user’s existing malpractice insurance policies, (Macoviak: pgh 81, “In further embodiments, a screening process includes verification of, by way of non-limiting examples, prescription license, education, training, malpractice insurance coverage…”)
render, for display on the electronic display, a coverage graphical user interface that prompts the user to enroll in the per-encounter liability coverage. (Macoviak: pgh 50, “…a computer program includes a module for identifying and/or verifying the credentials of healthcare providers.”; pgh 90, “In further embodiments, the user interfaces include graphic user interfaces (GUIs)”)
Macoviak does not teach, however, McGarvey teaches:
An enrollment system, comprising: a processor; and (McGarvey: pgh 6, “The system may include…one or more processors…”)
a non-transitory computer-readable medium with instructions stored thereon that, when executed by the processor, cause the enrollment system to: render, for display on an electronic display, an enrollment graphical user interface that prompts a user to enroll in a telemedicine platform, (McGarvey: pgh 6, “The system may include…a graphical user interface (GUI) module…”; pgh 54, “Adoption of or enrollment in the care network platform may be driven by several means of pushing or pulling a new user (e.g., a patient, a provider, an advocate, etc.) into the ever-expanding care network platform.)
wherein the telemedicine platform facilitates telemedicine encounters between the user and patients; (McGarvey: pgh 52, “The tele-health care network platform is created by securely linking the patient with one or more healthcare providers…”)
receive, via an enrollment module, a request from the user to enroll in the telemedicine platform; (McGarvey: 59, “If the referred provider is not already enrolled, the referred provider may be directed to a sign-up or enrollment landing page…”, pgh 100, “By making provider signup easy, without significant cost and via trusted peer referrals, a quality care network of providers may exist…”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak to include the teachings of McGarvey to improve access to tele-health technologies (McGarvey: pgh 4). Macoviak/McGarvey does not teach the remaining limitations. However, Milanovich teaches:
implement a rule-based algorithm to dynamically generate a customized per-encounter liability coverage offering for the user to cover the telemedicine encounters, (Milanovich: col 13, lines 55-65, “Then a risk rating is calculated, and a menu of malpractice coverage is provided to the patient and the doctor. Note that this is additional coverage for the specific procedure, and is in addition to the coverage mentioned above.”)
(ii) a residence location of the practitioner, and (Milanovich: col 10, lines 1-10, “The sixth preferred embodiment is a method of rating hospitals for their risk of medical malpractice liability…”; col 8, lines 25-45, “The hospital’s risk is rated. Factors used in determining the hospital’s risk may include it size, location…The ratings in (a) through (d) are added together to give a total risk rating. As above, the patient is then provided with a menu of malpractice coverage, with premiums determined by the total risk rating and the policy limits chosen by the patient.”)
(iii) an identified type of telemedicine encounter, and (Milanovich: col 7, lines 35-45, “The office procedure is given a risk rating.”; col 8, lines 1-10, “The higher the total risk rating, the more costly the patient’s malpractice insurance coverage will be.”)
(iv) at least one additional characteristic of the user; and (Milanovich: col 12, lines 10-15, “The eighth preferred embodiment is a method of rating a service provider for risk of malpractice.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/McGarvey to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55).
Regarding claim(s) 2:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 1. Macoviak further teaches:
wherein the instructions, when executed by the processor, further cause the enrollment system to: render, for display on the electronic display, a validation graphical user interface that prompts a user to enter credentials of an existing liability coverage plan applicable to in-person encounters between the user and patients; (Macoviak: pgh 90, “In further embodiments, the user interfaces include graphic user interfaces (GUIs)”; pgh 80, “The systems, devices, software, and methods described herein include, in various embodiments, a software module for verifying the identity and/or credentials of a healthcare provider.”; pgh 67, “In further embodiments, a subject enters identifying information via an input device.”)
receive the credentials of the existing liability coverage plan; and validate the credentials of the existing liability coverage plan. (Macoviak: pgh 50, “…a computer program includes a module for identifying and/or verifying the credentials of healthcare providers.”)
Regarding claim(s) 3:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 1. Milanovich further teaches:
wherein the enrollment graphical user interface further prompts a user to select between at least two different service tiers of the telemedicine platform. (Milanovich: col 15, lines 30-40, A menu of health care insurance coverages for the first office visit and their costs to the individual consumer is outputted by printing the menu or displaying it on the device. The menu of health care insurance coverages for the first office visit may include: a range of co-payment percentages, a health savings account, a continuation of existing coverage, one or more government health care programs, and one or more private insurance policies“)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/McGarvey to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55).
Regarding claim(s) 4:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 1. Macoviak further teaches:
wherein the telemedicine platform facilitates telemedicine encounters between the user and other healthcare practitioners. (Macoviak: pgh 258, “…said software for prediction of a health or economic outcome suggests a prescription, a therapy, an evaluation, or a referral to a specialist.”)
Regarding claim(s) 5:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 1. Milanovich further teaches:
wherein the per-encounter liability coverage offering includes a first pricing model for telemedicine encounters between the user and patients and a second pricing model for telemedicine encounters between the user and other healthcare practitioners. (Milanovich: col 15, lines 20-30, “The cost of a range of health care insurance coverages for a first office visit based on the initial information is determined…”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/McGarvey to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55).
Regarding claim(s) 6:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 1. Macoviak further teaches:
wherein the per-encounter liability coverage offering comprises an on-demand per-encounter medical malpractice insurance coverage offering. (Macoviak: pgh 5, “…the first device, the second device, or the computer program comprises a module for providing instantaneous encounter-specific financial insurance coverage…”)
Regarding claim(s) 7:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 1. Milanovich further teaches:
wherein the characteristic of the user on which the per-encounter malpractice coverage offering is, at least in part based, comprises one or more of: a residence of the user, residences of the patients, and the licensure credentials of the user. (Milanovich: col 7, lines 55-65, “A national data base containing information on doctors is checked and the doctor is given a risk rating. The data base includes information on each doctor’s field of expertise…and/or other objective or subjective criteria.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/McGarvey to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55).
Regarding claim(s) 8:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 1. Milanovich further teaches:
wherein the characteristic of the user on which the per-encounter malpractice coverage offering is, at least in part based, comprises a ratio of in-person encounters conducted by the user to telemedicine encounters conducted by the user. (Milanovich: col 12, lines 55-65, “Negative (or positive) point values may be given to criteria that include, but are not limited to, the following: work by a specialist within his or her specialty (the percentage of time that a specialist works within his or her specialty time FF)…”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/McGarvey to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55).
Regarding claim(s) 9:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 1. Macoviak further teaches:
receive a selection by the user of one or more of the available encounter types, wherein the per-encounter liability coverage offering is further based, at least in part, on the encounter types selected by the user. (Macoviak: pgh 282, “In some embodiments, a telemedical, outpatient, managed care health program is part of a health insurance program and/or plan…the insurance coverage is encounter-specific financial insurance coverage.”)
Macoviak/Milanovich do not teach the remaining limitation. However, McGarvey teaches:
wherein the instructions, when executed by the processor, further cause the enrollment system to: render, for display on the electronic display, a selection graphical user interface that prompts a user to select one or more encounter types from a set of encounter types available via the telemedicine platform; and (McGarvey: Fig. 3A. Figure 3A shows a selection graphical user interface that prompts a user to select one or more encounter types from a set of encounter types available via the telemedicine platform.)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/Milanovich to include the teachings of McGarvey to improve access to tele-health technologies (McGarvey: pgh 4).
Regarding claim(s) 10:
The combination of Macoviak/McGarvey/Milanovich, as shown in the rejection above, discloses the limitations of claim 9. McGarvey further teaches:
wherein the set of encounter types includes at least some of: telephone visits, store-and-forward photo visits, and video conferencing visits. (McGarvey: pgh 36, “Such tele-health tools may include, for example, secure chat and messaging tools, video conferencing tools…”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/Milanovich to include the teachings of McGarvey to improve access to tele-health technologies (McGarvey: pgh 4).
Claims 11 and 12 are rejected under 35 U.S.C. 103 as being unpatentable over McGarvey (US 2020/0020454) in view of Milanovich (US 8,392,221) in view of Ress (US 2008/0154647).
Regarding claim(s) 11:
McGarvey teaches:
A per-encounter risk management system, comprising: an enrollment module to receive practitioner credentials for enrollment in a telemedicine platform, (McGarvey: 59, “If the referred provider is not already enrolled, the referred provider may be directed to a sign-up or enrollment landing page…”)
wherein the telemedicine platform facilitates telemedicine encounters; (McGarvey: pgh 52, “The tele-health care network platform is created by securely linking the patient with one or more healthcare providers…”)
wherein pricing of the per-encounter malpractice coverage is based, at least in part, on a characteristic of the user; and (McGarvey: pgh 64, “Providers may then bill for tele-health services in many clinical scenarios…”; pgh 103, “The system may also integrate automatic billing of insurance plans and analysis of a providers’ network status with insurance, credentials, licensure and medical malpractice status.”)
McGarvey does not teach, however, Milanovich teaches:
a billing module to bill the user a fee for the per-encounter malpractice coverage based on the number of telemedicine encounters conducted by the user via the telemedicine platform. (Milanovich: col 13, lines 25-30, “The patient and/or the doctor pay the initial premium for malpractice insurance coverage. (The doctor may include the premium in his (or her) billing statement, but the premium should be pre-paid at this time)…the initial premium payment is electronically transferred to Hygiea’s account.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified McGarvey to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55). McGarvey/Milanovich does not teach the remaining limitation. However, Ress teaches:
an on-demand malpractice enrollment module to obtain per-encounter malpractice coverage for the practitioner to cover the telemedicine encounters, (Ress: pgh 26, “The physician will then apply to participate in the network…”; pgh 29, “Insurance provider provides the elective insurance coverage to physician…”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified McGarvey/Milanovich to include the teachings of Ress because there is a need for a method to provide elective malpractice liability insurance (Ress: pgh 5).
Regarding claim(s) 12:
The combination of McGarvey/Milanovich/Ress, as shown in the rejection above, discloses the limitations of claim 11. Milanovich further teaches:
further comprising a service management module to: determine quantity and type information for telemedicine encounters conducted by the user during a time period, wherein the billing module is configured to bill the user at the end of each time period based on: (i) the quantity of telemedicine encounters conducted during the time period, and (ii) the type of information of each of the telemedicine encounters conducted during the time period. (Milanovich: col 13, lines 25-30, “The patient and/or the doctor pay the initial premium for malpractice insurance coverage. (The doctor may include the premium in his (or her) billing statement, but the premium should be pre-paid at this time)…the initial premium payment is electronically transferred to Hygiea’s account.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified McGarvey/Ress to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55).
Claims 13-17 are rejected under 35 U.S.C. 103 as being unpatentable over McGarvey (US 2020/0020454) in view of Milanovich (US 8,392,221) in view of Ress (US 2008/0154647) in view of Macoviak (2016/0055307).
Regarding claim(s) 13:
The combination of McGarvey/Milanovich/Ress, as shown in the rejection above, discloses the limitations of claim 11. Macoviak further teaches:
13.(Original) The system of claim 11, an existing coverage module to: receive credentials from the user relating to an existing malpractice coverage plan applicable to in-person encounters between the user and patients; and validate the credentials relating to the existing malpractice coverage plan. (Macoviak: pgh 50, “…a computer program includes a module for identifying and/or verifying the credentials of healthcare providers.”; pgh 90, “In further embodiments, the user interfaces include graphic user interfaces (GUIs)”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified McGarvey/Milanovich/Ress to include the teachings of Macoviak to improve access to healthcare in underserved or remote areas (Macoviak: pghs 2-3).
Regarding claim(s) 14:
The combination of McGarvey/Milanovich/Ress, as shown in the rejection above, discloses the limitations of claim 11. Macoviak further teaches:
14.(Original) The system of claim 11, further comprising a licensure module to: receive licensure credentials from the user relating to licenses granted to the user authorizing the practice of the user; and validate the licensure credentials. (Macoviak: pgh 81, “…a screening process includes verification of…legal license to practice their profession…”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified McGarvey/Milanovich/Ress to include the teachings of Macoviak to improve access to healthcare in underserved or remote areas (Macoviak: pghs 2-3).
Regarding claim(s) 15:
The combination of McGarvey/Milanovich/Ress, as shown in the rejection above, discloses the limitations of claim 11. Macoviak further teaches:
further comprising a coverage module to: connect the user to an insurer providing the per-encounter malpractice coverage. (Macoviak: pgh 282, “In further embodiments, the insurance coverage is encounter-specific financial insurance coverage. In still further embodiments, encounter-specific insurance coves any loss, financial loss, loss of life, related to a specific remote provider-patient encounter. In further embodiments, the insurance coverage is instantaneous, wherein risk is assessed at the moment a request is made and the coverage issued on the spot.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified McGarvey/Milanovich/Ress to include the teachings of Macoviak to improve access to healthcare in underserved or remote areas (Macoviak: pghs 2-3).
Regarding claim(s) 16:
The combination of McGarvey/Milanovich/Ress, as shown in the rejection above, discloses the limitations of claim 11. Macoviak further teaches:
wherein the pricing of the per-encounter malpractice coverage is the same for each type of telemedicine encounter available via the telemedicine platform. (Macoviak: pgh 4, “…the device further comprises a software module for providing instantaneous encounter-specific financial insurance coverage, wherein said insurance includes a level of guarantee and an associated premium.”; pgh 133, “In various further embodiments, communication links enable communication via, by way of non-limiting examples, telephone, push-to-talk, audio conference, video conference, SMS, MMS, instant message, Internet bulletin board, blog, microblog, fax, Internet fax, electronic mail, VoIP, or combinations thereof.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified McGarvey/Milanovich/Ress to include the teachings of Macoviak to improve access to healthcare in underserved or remote areas (Macoviak: pghs 2-3).
Regarding claim(s) 17:
The combination of McGarvey/Milanovich/Ress, as shown in the rejection above, discloses the limitations of claim 11. Macoviak further teaches:
wherein the telemedicine platform facilitates telemedicine encounters between the user and patients and between the user and other healthcare practitioners, and (Macoviak: pgh 135, “…the communications link enables a live, remote healthcare provider to communicate with one or more other parties and vice versa…the communications link is between a live, remote healthcare provider and a subject or a group of subjects…in some embodiments, the communications link is between a live remote healthcare provider and an onsite caregiver or group of caregivers.”)
wherein the per-encounter malpractice coverage covers each type of telemedicine encounter available via the telemedicine platform. (Machoviak: pgh 4, “In one aspect, disclosed herein are computer-based devices…for providing remote medical diagnosis and therapy to a subject…In some embodiments, the device further comprises a software module for providing instantaneous encounter-specific financial insurance coverage, wherein said insurance includes a level of guarantee and an associated premium.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified McGarvey/Milanovich/Ress to include the teachings of Macoviak to improve access to healthcare in underserved or remote areas (Macoviak: pghs 2-3).
Claims 21-23 are rejected under 35 U.S.C. 103 as being unpatentable over Macoviak (2016/0055307) in view of McGarvey (US 2020/0020454) in view of Milanovich (US 8,392,221) in view of Ress (US 2008/0154647).
Regarding claim(s) 21:
Macoviak teaches:
receive, via the enrollment graphical user interface, practitioner input including licensure credentials and existing malpractice insurance information, (Macoviak: pgh 67, “…a subject enters identifying information via an input device…”; pgh 81, “…the software module verifies a credential issued by a licensed primary healthcare provider…”; pgh 90, “…the user interfaces include graphic user interfaces (GUIs).”)
wherein the licensure credentials are received by a licensure module configured to validate the practitioner’s authority to practice by electronically querying at least one external licensure database, and (Macoviak: Fig. 22, item 119. Figure 22 shows a credentialing module for validating credentials that queries an external database; pgh 261, “…a live, remote adjunct provider’s identity and credential status are verified as suitable by consulting a credential database.”).
wherein the existing malpractice insurance information is received by an existing malpractice module configured to verify coverage applicability to in-person patient encounters through communication with a remote insurance validation system over a secure network interface; (Macoviak: pgh 77, “In some embodiments, a live healthcare provider is insured for professional malpractice.”; pgh 81, “…a screening process includes verification of…malpractice insurance coverage, malpractice insurance state, malpractice insurance coverage limits…”)
wherein the on-demand malpractice enrollment module: (i) retrieves practitioner-specific data including validated licensure information and existing malpractice insurance parameters, (Macoviak: pgh 30, “…the software module verifies a credential issued by a licensed primary healthcare provider facility…that indicates the remote adjunct healthcare provider successfully completed a medical and legal screening process.”)
render, for display on the electronic interface, a coverage graphical user interface produced by the on-demand malpractice enrollment module that presents the per-encounter liability coverage offering and prompts the practitioner to accept the calculated fee structure, (Macoviak: pgh 50, “…a computer program includes a module for identifying and/or verifying the credentials of healthcare providers.”; pgh 90, “In further embodiments, the user interfaces include graphic user interfaces (GUIs)”)
wherein acceptance of the coverage offering is recorded and stored in a secure data structure in the memory; (Macoviak: pgh 38, “Each of the patient, provider, matching, and interactions databases…may be communicatively coupled with the operations server running the operations processors…and may store any appropriate data and/or information required to implement the care network subsystem…”)
Macoviak does not teach, however, McGarvey teaches:
a processor; a (McGarvey: pgh 6, “The system may include…one or more processors…”)
memory coupled to the processor; and (McGarvey: pgh 35, “Each of the terminals may be any appropriate network-enabled mobile or desktop user device such as, for example, a desktop computer, laptop computer, tablet computer, smartphone, or the like.”)
a non-transitory computer-readable medium having stored thereon instructions that, when executed by the processor, cause the system to: render, for display on an electronic interface, an enrollment graphical user interface generated by an enrollment module stored in the memory, (McGarvey: pgh 5, “The system may include…a graphical user interface (GUI) module…”; pgh 54, “Adoption of or enrollment in the care network platform may be driven by several means of pushing or pulling a new user (e.g., a patient, a provider, an advocate, etc.) into the ever-expanding care network platform.)
wherein the enrollment graphical user interface prompts a healthcare practitioner to enroll in a telemedicine platform that facilitates telemedicine encounters; (McGarvey: pgh 54, “Adoption of or enrollment in the care network platform may be driven by several means of pushing or pulling a new user (e.g., a patient, a provider, an advocate, etc.) into the ever-expanding care network platform.)
(iii) calculates a fee structure for the per-encounter coverage using a pricing algorithm implemented by the on-demand malpractice enrollment module, such fee structure being derived from factors including the selected telemedicine encounter types, practitioner’s licensure jurisdiction, and patient demographic data provided by the telemedicine platform; (McGarvey: pgh 64, “Providers may then bill for tele-health services in many clinical scenarios…”; pgh 103, “The system may also integrate automatic billing of insurance plans and analysis of a providers’ network status with insurance, credentials, licensure and medical malpractice status.”)
wherein the billing data is securely transmitted to a payment processing subsystem configured to invoice the practitioner based on actual telemedicine encounters conducted. (McGarvey: pgh 35, “…the healthcare advocates may operate a network-enabled terminal configured to securely compile and transmit information to and from other system components.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak to include the teachings of McGarvey to improve access to tele-health technologies (McGarvey: pgh 4). Macoviak/McGarvey does not teach the remaining limitations. However, Milanovich teaches:
upon verifying that the practitioner possesses valid licensure credentials, generate a set of telemedicine encounter service options via a service management module stored in the memory, (Milanovich: col 15, lines 35-40, “A menu of health care insurance coverages for the first office visit and their costs to the individual consumer is outputted by printing the menu or displaying it on the device.”)
wherein the service management module is configured to dynamically present selectable telemedicine encounter types to the practitioner based on previously stored telemedicine platform parameters, thereby enabling customization of services that the practitioner will offer through the telemedicine platform; (Milanovich: col 13, line 60 – col 14, line 5, “The patient’s medical history and other information is updated and entered into the system…The system prints out (or displays on a terminal) for the patient and doctor a menu of malpractice options and coverage.”)
(ii) determines coverage terms for telemedicine encounters that differ from in-person encounters based on at least one characteristic of the practitioner’s practice setting obtained from stored practitioner profile data, and (Milanovich: col 10, lines 1-20, “The sixth preferred embodiment is a method of rating hospitals for their risk of medical malpractice liability…the status of various objective criteria related to the hospital’s risk is determined. The criteria can include, but are not limited to…the types of infectious diseases treated at the hospital, and the number of patients having each type…”)
upon acceptance, execute a coverage module stored in the memory to initiate activation of the per-encounter liability coverage by electronically transmitting, via the secure network interface, coverage activation data to a telemedicine platform registry or a third-party insurer’s underwriting system, (Milanovich: col 13, lines 25-35, “The signed agreement is then electronically transferred into Hygiea’s data base. The initial premium payment is electronically transferred to Hygiea’s account. And information about the agreement and the premium payment is simultaneously entered into the doctor’s data base.”)
wherein the coverage applies exclusively to telemedicine encounters conducted through the telemedicine platform and is verified in real-time prior to commencement of each telemedicine encounter; and (Milanovich: col 14, lines 5-15, “The system prints out…a menu of lifetime earning coverage options for the patient and doctor to review. The patient and/or doctor select coverage. A policy is then printed, signed and paid for. A smart wrist band is printed out and placed on the patient. Treatment is then rendered.”)
periodically execute a billing module stored in the memory to determine the number and type of telemedicine encounters performed by the practitioner over a defined time period and to generate billing data reflecting fees for the on-demand per-encounter malpractice coverage, (Milanovich: col 13, lines 25-30, “The patient and/or the doctor pay the initial premium for malpractice insurance coverage. (The doctor may include the premium in his (or her) billing statement, but the premium should be pre-paid at this time)…the initial premium payment is electronically transferred to Hygiea’s account.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/McGarvey to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55). Macoviak/McGarvey/Milanovich does not teach the remaining limitation. However, Ress teaches:
in response to practitioner selections of one or more telemedicine encounter types, execute an on-demand malpractice enrollment module stored in the memory to determine a per-encounter liability coverage offering, (Ress: pgh 26, “The physician will then apply to participate in the network…”; pgh 29, “Insurance provider provides the elective insurance coverage to physician…”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/McGarvey/Milanovich to include the teachings of Ress because there is a need for a method to provide elective malpractice liability insurance (Ress: pgh 5).
Regarding claim(s) 22:
The combination of Macoviak/McGarvey/Milanovich/Ress, as shown in the rejection above, discloses the limitations of claim 21. McGarvey further teaches:
wherein the on-demand malpractice enrollment module further employs an encrypted communication protocol to query multiple remote licensure and insurance databases concurrently, wherein the encrypted communication protocol reduces latency and enhances data integrity, thereby improving real-time verification of licensure credentials and existing malpractice insurance information. (McGarvey: pgh 43, “…the communication interface may be configured to transmit and/or receive information using secure socket layer (SSL) encryption.”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/Milanovich/Ress to include the teachings of McGarvey to improve access to tele-health technologies (McGarvey: pgh 4).
Regarding claim(s) 23:
The combination of Macoviak/McGarvey/Milanovich/Ress, as shown in the rejection above, discloses the limitations of claim 21. Milanovich further teaches:
wherein the billing module is further configured to adjust the billing data by applying one or more pre-defined maximum fee caps per patient, per day, or per billing cycle, such that the total charges to the healthcare practitioner for the on-demand per-encounter liability coverage are limited based on usage thresholds stored within the memory. (Milanovich: col 4, lines 1-10, “A policy limit is chosen by a patient…”)
It would have been obvious to one of ordinary skill in the art before the effective filing date of the invention to have modified Macoviak/McGarvey/Ress to include the teachings of Milanovich to improve the risk rating of insurance coverage (Milanovich: col 3, lines 50-55).
Conclusion
Pertinent Art
The prior art made of record and not relied upon is considered pertinent to Applicant’s disclosure. Ortgiese (US 2010/0049553) discloses on-demand flight accident insurance.
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/JOHN O PRESTON/Examiner, Art Unit 3698
December 2, 2025
/Mike Anderson/Supervisory Patent Examiner, Art Unit 3693