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 . This action is in response to an Amendment dated May 6, 2026. Claim 19 is amended. Claims 1-20 are pending.
All pending claims are examined.
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: Claim 19 which is illustrative of the independent claim 1 recites:
As to claim 19.
19. (Currently Amended) A computer system for automating collection of premiums by a financial institution owed to a healthcare services payer from subscribers to the healthcare services payer, the healthcare services payer comprising a payer database, and the computer system comprising:
a subscriber repository platform;
an account verification platform comprising a machine learning model comprising a neural network;
a subscriber management platform comprising a compliant database; an integrated payables platform; one or more processors; and
a memory storing instructions such that the computer system, through software stored in the memory, is configured to:
receive subscriber account data for subscribers, via an electronic data network, at the subscriber repository platform, wherein the subscriber account data comprise sensitive Automated Clearing House (ACH) data for each subscriber;
verify, by the machine learning model of the account verification platform, the subscriber account data for each subscriber such that at least one subscriber is classified as a verified subscriber and at least one subscriber is classified as an unverified subscriber;
store the sensitive ACH data for each verified subscriber in an electronic format in the compliant database of the subscriber management platform, wherein the electronic format comprises an encrypted format, and wherein the compliant database stores the sensitive ACH data in a format that is non-human-readable at rest;
transmit, via an electronic data network, electronic instructions from the integrated payables platform to the healthcare services payer to remove the sensitive ACH data from the payer database; and
transmit, via an electronic data network, an ACH file from the integrated payables platform to an ACH operator to initiate a transfer of the premium owed by the verified subscriber to the healthcare services payer”
2A, Prong One, Taking the broadest reasonable interpretation, the invention is directed to a method of organizing human activity that is 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) of providing payment collection wherein premiums due a service provider are collected from the customer based on pre-defined rules. (see App. Spec. Figs. 1. 3).
2A, Prong Two
Beyond the abstract idea, the additional elements recite hardware components such as computing device 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.
According to the Applicant’s specification (see App. Spec paras. 0035-0039; see also paras. 0018-0023);
[0019] The system 100 in FIG. 2 is for automating collection of premiums owed to the healthcare services payer 150 from subscribers 106 to the healthcare services payer 150 by the RDFI 110. The system 100 comprises a computer network with multiple inter-networked computer systems, e.g., computers systems for the subscriber repository system 120, the RDFI 110, the payer 150, and the various subscribers 106. Each of the computer systems may comprise one or more processors and associated computer memory storing instructions such that the various computer systems, through software stored in the memory, are configured to receive and store subscriber account data and initiate ACH transfers of the premium owned by the subscribers 106 to the healthcare services payer 150. For example, the RDFI 110 can include at least one computer system with a processor and a memory, along with a compliant database (e.g. database 114), and the healthcare services payer 150 can include at least one computer system, with a processor and a memory, along with a database 154 that stores different information than the database 154 as described herein. The various computer systems may be interconnected via an electronic data network(s), such as the Internet, a LAN(s), a WAN(s), etc., with wired and/or wireless communication links.
[0020] The RDFI 110 includes the subscriber management system 112, an account verification system 130, and an integrated payables system 140. The subscriber management system 112 is communicatively coupled to the account verification system 130 via a communication protocol 131 and to the integrated payables system 140 via the communications pathway 113.
[0021] In certain instances, the RDFI 110 can further include a subscriber repository system 120, which is configured to receive the subscriber account data. The subscriber repository system 120 can be an in-house computer system of the RDFI 110, e.g., within the network firewalls/perimeter of the RDFI 110. The reader will appreciate that various components of an in-house computer system can be remote to the physical location or address of the RDFI 110, such as remote servers, for example.
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 the transfer based on a evaluation of certain criteria is executed and not one of a technology or technological field.
Although the claims recite:
verify, by the machine learning model of the account verification platform, the subscriber account data for each subscriber such that at least one subscriber is classified as a verified subscriber and at least one subscriber is classified as an unverified subscriber;
store the sensitive ACH data for each verified subscriber in an electronic format in the compliant database of the subscriber management platform, wherein the electronic format comprises an encrypted format, and wherein the compliant database stores the sensitive ACH data in a format that is non-human-readable at rest;
It suggests additional description of the format in which the ACH data is presented (App. Spec. paras. 0039, 0050). Absent is any support for the claims as recited for how it is an improvement to the computer or technical field beyond automating the transfer of premiums in the insurance coverage context.
In particular, there is a lack of improvement to a computer or technical field of evaluating the customer’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. There is no integration of the judicial exception.
Step 2B; The next step is to identify any additional limitations beyond the judicial exception. The additional elements are computing device (see App Spec. paras. 0018-0024, Figs. 1-3) 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 2-18 and 20 are rejected under 35 U.S.C. § 101. For example, claims 2-5 describe with additional specificity details about the additional databases, what the transfer of premiums entails and what the ACH data comprises that are factored into the transfer of healthcare premiums process, however the recited abstract idea is not integrated into a practical application. In particular, the claims only recite generic computer components (e.g., computing device that is a general-purpose components) to evaluate the submitted data based on predefined conditions.
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 and 19 are rejected under 35 U.S.C. § 101 including dependent claims 2-18 and 20 which fall with claims 1 and 19.
Therefore, claims 1-20 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 1-20 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 19, which is illustrative of independent claim 1, recites:
119. (Currently Amended) A computer system for automating collection of premiums by a financial institution owed to a healthcare services payer from subscribers to the healthcare services payer, the healthcare services payer comprising a payer database, and the computer system comprising:
a subscriber repository platform;
an account verification platform comprising a machine learning model comprising a neural network;
a subscriber management platform comprising a compliant database; an integrated payables platform; one or more processors; and
a memory storing instructions such that the computer system, through software stored in the memory, is configured to:
receive subscriber account data for subscribers, via an electronic data network, at the subscriber repository platform, wherein the subscriber account data comprise sensitive Automated Clearing House (ACH) data for each subscriber;
verify, by the machine learning model of the account verification platform, the subscriber account data for each subscriber such that at least one subscriber is classified as a verified subscriber and at least one subscriber is classified as an unverified subscriber;
store the sensitive ACH data for each verified subscriber in an electronic format in the compliant database of the subscriber management platform, wherein the electronic format comprises an encrypted format, and wherein the compliant database stores the sensitive ACH data in a format that is non-human-readable at rest;
transmit, via an electronic data network, electronic instructions from the integrated payables platform to the healthcare services payer to remove the sensitive ACH data from the payer database; and
transmit, via an electronic data network, an ACH file from the integrated payables platform to an ACH operator to initiate a transfer of the premium owed by the verified subscriber to the healthcare services payer”
The invention as claimed recites an abstract idea of payment collection which is a method of organizing human activity wherein premiums due a service provider are collected from the customer based on pre-defined rules, which is a process of commercial or legal interactions (including agreements in the form of contracts; legal obligations; advertising, marketing or sales activities or behaviors.
Besides reciting the abstract idea, the remaining claim limitations recite generic computer components (e.g. computer system, network – See App. Spec. paras. 0019-0026; Fig. 1). This recited abstract idea is not integrated into a practical application. In particular, the claim only recites generic computer components (e.g. computer system) to receiving/verifying/identifying/transmitting/transferring based on the activity associated with the user. The additional elements are recited at a high-level of generality 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 system) amount to no more than mere instructions to apply the abstract idea using generic computer components.
Dependent claims 2-18 and 20 provide additonal details about the types of data elements collected or output generated. For example, claims 2-6 provide additional descriptions of the type of data inputs and other predefined rules applied to make an assessment on the premiums due the provider based on transactional activity, and 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, the claims 1-20 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:
Manzo, USP Pub. No. 20220076811, Healthcare Claims Submission Method
Raymond, USP Pub. No. 20130282608, Engine, System And Method Of Providing A Multi-Platform Payment And Information Exchange
Hummer, USP Pub. No. 20110295614, Healthcare Point Of Service Adjudication And Payment System
Beisner, USP Pub. No. 20140032414, Account-To-Account Transfers
Kumar, USP Pub. No. 20230306454, Account Management With Real-Time Incentive.Reed, USP. Pub. No. US 20210081244, System For Intelligent Routing Of Resources Associated With Resource Entities.
Conclusion
THIS ACTION IS MADE FINAL. 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 nonprovisional extension fee (37 CFR 1.17(a)) 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 mailing date of this final action.
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
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