This invention relates to managed healthcare systems and more particularly to managed healthcare systems which address health enhancement life styles, illness prevention, claims management, illness treatment and post treatment monitoring and/or review; and which integrate physicians, medical care facilities, patients, insurance companies and/or other health care payers, employers and banks and/or other financial institutions.
A comprehensive healthcare management system comprising:
(a) Input means for entering data identifying each of a predetermined plurality of persons and for entering data symbolic of patient symptoms.
(b) A first data bank memory interconnected with said input means, said first data bank memory containing predetermined items of medical history for said predetermined plurality of persons.
(c) Another data bank memory interconnected with said first data bank memory, said another data bank memory including an identification of predetermined procedures requiring utilization review.
(d) Payment means.
(e) Means interconnected with said payment means responsive to input to said system of said data symbolic of patient symptoms for tentatively identifying a proposed mode of treatment and, when said proposed mode of treatment includes one of said predetermined procedures requiring utilization review, for producing indicia indicative thereof and for preventing payment therefor by said payment means until said utilization review has been obtained and data indicative thereof has been entered in said system.