Methods and systems for claim adjudication
US10438693B1 · kind B1 · utility
Assignee
Inventors
Key dates
| Filing date | Dec 28, 2011 |
| Grant date | Oct 8, 2019 |
| Priority date | — |
| Expiry date | Oct 2, 2034 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG16H40/20
- WIPO fieldMedical technology
- WIPO sectorInstruments
Abstract
Methods and systems for claim adjudication are described. In one embodiment, a status of a drug benefit plan associated with a member is determined. Claims data associated with the member is accessed. A current-filled prescription is identified based on the claims data. At least one adjudication operation for the current-filled prescription is performed prior to receiving a new request for the current-filled prescription. The new request is determined as fillable based on the performance of the at least one adjudication operation. A notification is generated to the member based on the determination. Additional methods and systems are disclosed.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.