Optum, Inc. v. Optum Wellness PLLC, txedc:4:2020cv00583

Hospital admission counseling services; patient healthcare support services in the nature of health care decision support counseling and health care planning for individuals at risk of needing intensive treatment; medical case management and disease management services, namely, disease-specific information and medical care resources to assist patients in managing their own health care and to reinforce the treatment plan; providing information in the field of health care;

Health care advocacy services to members of health benefit plans; individualized health care coordination services, namely, facilitating an array of services, namely, medical care services, behavior health services, and health care management;

[printed materials, namely, pamphlets, magazines, brochures regarding physical and mental health, substance abuse, legal and financial issues, and daily living problems];

employee assistance services, namely, providing online, telephonic, and in-person consultation, information, assessment, and referral services for physical, and mental health, and substance abuse; and referral services for legal and financial issues and work and family problems;

Nurse information services, namely, nurse triage and nurse call centers providing information regarding the identification of specific health related concerns and general health issues;

employee assistance services; namely, telephonic assessment and referral services for mental health, substance abuse and daily living problems;

Providing continuing medical education courses; Education services, namely, conducting seminars, courses, conferences, audio conferences, and online seminars in the fields of continuing medical education and health care and well-being, and distribution of course materials in connection therewith; Training clinical trial site personnel in the use of tests and rating systems for drug protocol requirements; training clinical trial site personnel in the use of medical and research equipment required by drug protocols; educational services, namely, providing clinical education training to physicians and hospital managed care personnel in the fields of utilization review, case management, medical cost management, and quality assurance;

Downloadable electronic newsletters in the fields of health care, medical diagnosis coding, health care billing and reimbursement, health data and health management; downloadable electronic newsletters delivered by e-mail in the field of health care, medical diagnosis coding, health care billing and reimbursement, health data and health management; Computer software for use in health care database management; Electronic databases in the field of health care claims review, managed care utilization rates, and health care coding and reimbursement, recorded on computer media; Computer software, namely, an application for collecting and analyzing information in the process of underwriting health care insurance; Computer software used for the secured transmission of health care data and health insurance data via a global computer network; Computer software for case management in the field of health care; Computer software for data processing in the field of health care; Computer software for providing data analysis of member-provider relationships; Computer software for use in analyzing and generating reports on health care data; Coding and compliance software programs used in the health care industry; Downloadable databases for coding evaluation in the healthcare industry; Database management software provided to health care providers in the health care and insurance industries for health information and physician credentialing management and tracking; Downloadable electronic publications in the nature of books and newsletters in the fields of health data, health management, insurance, and medical diagnosis coding. [Computer software for use in developing other computer software for conducting health related transactions in the healthcare and insurance industries and accompanying user manuals sold as a unit therewith;] Computer software for use in accessing health information and conducting health-related transactions via computer and communication networks. Computer software that allows the maintenance of reimbursement terms, formulas, and rates associated with managed care contracts and that calculates expected reimbursement for both the inpatient and outpatient settings using a variety of reimbursement strategies including case-based, per diem, tiered per diem, discounted charges, and case rates; [Computer software featuring a window environment for creating healthcare provider directories;] Computer software used for comparing and analyzing facility and medical device utilization data, financial data, and clinical data in the health care industry; Computer software for analyzing and communicating the accessibility of managed care networks; Computer software providing database analysis and management for use in the healthcare industry for bill auditing, treatment management, treatment guidelines and parameters, provider analysis, fraud management and control, coding verification, and pricing and payment; Computer software databases containing payor and provider data of medical, dental, anesthesia, and workers compensation prices, billing, and payment rules, and containing treatment guidelines and parameters, for use in the healthcare industry; customized downloadable computer databases featuring business data and information regarding drug prescriptions; Computer software for use by health care providers to control and manage patient information; computer software for integrating patient data taken from medical devices, laboratories and information systems; computer software for automating caregiver workflow; computer software for accessing and analyzing medical information databases; computer software for scheduling and tracking patients, personnel and the use of medical facilities; Computer software for tracking and reporting patient and health care provider information and instruction manuals sold therewith. Computer software for capturing, storing, organizing, exchanging and reporting data from medical equipment, for automated patient charting and data storage, to assist health care providers in their review and assessment of patients' conditions; medical documentation system comprising computer software for recording clinical documentation in an electronic medical record and pattern encoded paper; software for tracking, analyzing, and reporting hospital resource location and information for movement within a healthcare facility or system; computer software for automated patient management and clinical documentation for use by healthcare providers; computer software for managing the transmission of data between two different computer software systems; Computer software for tracking, reporting, and communicating information related to patient care, hospital administration, hospital operation, hospital department management, patient billing, and patient charging and coding; Computer software for tracking and reporting medical and health care information in the fields of patient, medication reconciliation, documentation creation, and health care provider information; [computer software and manuals sold as a unit for monitoring and reporting the status and locations of patients and resources in a health care facility;] software for managing data for use by health care facilities; revenue management software that captures and calculates charges for services provided to patients by health care institutions, infusion centers, and chemotherapy/oncology organizations. Computer software for providing communication between health care providers concerning patient, clinical and insurance information, storing and managing patient information, generating prescriptions and storing and managing prescription information, locating price information and ordering medical and office supplies and services, scheduling and tracking patient appointments, generating and filing insurance claims, generating, storing and managing referral information and creating, storing and managing administrative information; Computer software for use in the communication of personal and medical information for patients;