Systems and methods for determining and communicating a prescription benefit coverage denial to a prescriber
US10417380B1 · kind B1 · utility
Assignee
Inventors
Key dates
| Filing date | Apr 25, 2016 |
| Grant date | Sep 17, 2019 |
| Priority date | — |
| Expiry date | Jun 14, 2037 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG16H70/40
- WIPO fieldMedical technology
- WIPO sectorInstruments
Abstract
Systems and methods are provided for determining and communicating prescription benefit coverage information to a prescriber of the product, service, or medication. A prescription benefit check request may be received by the service provider computer from a healthcare provider computer for the prescriber of the product, service, or medication. The service provider computer may format a prescription request for the prescribed product, service, or medication and transmit the prescription request to a pharmacy claims processor computer for processing. The service provider computer may receive a prescription response that includes a determination of the prescription request from the pharmacy claims processor computer. The service provider computer may determine that the prescription request was denied and the basis for the denial from the prescription response and can transmit a prescription benefit check response that includes at least a portion of the data in the prescription response to the healthcare provider computer.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.