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 application dated January 28, 2025. Claims 1-20 are pending. All pending claims are examined.
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 1, which is illustrative of independent claim 19, recites:
1. A method for automating collection of premiums by a financial institution owed to a healthcare services payer from subscribers to the healthcare services payer, wherein the healthcare services payer manages a payer database, the method comprising:
receiving, by a computer system of the financial institution, via an electronic data network, subscriber account data for subscribers to the healthcare services payer, wherein the subscriber account data comprise sensitive Automated Clearing House (ACH) data for each subscriber;
upon receiving subscriber account data for subscribers to the healthcare services provider, verifying, by a computerized account verification system of the computer system of the financial institution, the subscriber account data;
upon verifying the subscriber account data, identifying, by the computerized account verification system, each subscriber as one of a verified subscriber and an unverified subscriber, such that at least one subscriber is identified as a verified subscriber and at least one subscriber is identified as an unverified subscriber;
for each unverified subscriber, transmitting, via the electronic data network, by the computerized account verification system to the healthcare services payer, an electronic notification that the subscriber is unverified; and for each verified subscriber:
storing, encryptedly, by the financial institution, the sensitive ACH data in a compliant database of the computer system of the financial institution;
transmitting, by the financial institution to the healthcare services payer, via the electronic data network, clearance to remove the sensitive ACH data from the payer database; and
routinely transferring, by the financial institution to the healthcare services payer, the premium owed by the verified subscriber to the healthcare services payer by an ACH transfer.
.
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 20provide 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.
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/CHIKAODINAKA OJIAKU/Primary Examiner, Art Unit 3696