Methods and systems for maintaining pharmacy provider networks
US12039608B2 · kind B2 · utility
Assignee
Inventor
Key dates
| Filing date | Aug 18, 2021 |
| Grant date | Jul 16, 2024 |
| Priority date | — |
| Expiry date | Jul 26, 2042 |
Classification
- Technology area (CPC G)Physics
- CPC primaryG16H40/67
- WIPO fieldIT methods for management
- WIPO sectorElectrical engineering
Abstract
Methods and systems for maintaining pharmacy provider networks are described. In one embodiment, claims adjudication data associated with a member and a prescribed drug is accessed. The prescribed drug associated with the member is classified as one of an acute medication and a maintenance medication. A pharmacy provider network is associated with the prescribed drug based on, at least in part, classifying the prescribed drug. It is determined if a pharmacy associated with the claims adjudication data is included within the pharmacy provider network associated with the prescribed drug. A pharmacy claim may be adjudicated for the prescribed drug based on the claim and the pharmacy provider network. Additional methods and systems are disclosed.
Source: USPTO / EPO open patent data. Objective bibliographic and citation counts.