-
公开(公告)号：US11127493B2
公开(公告)日：2021-09-21
申请号：US16556407
申请日：2019-08-30
Applicant: Express Scripts Strategic Development, Inc.
Inventor： John William Vandervoort , Heather D. Sundar , Michael Z. Chen , Adam W. Kautzner , Randy L. Canis
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.
-
公开(公告)号：US20200013496A1
公开(公告)日：2020-01-09
申请号：US16556407
申请日：2019-08-30
Applicant: Express Scripts Strategic Development, Inc.
Inventor： John William Vandervoort , Heather D. Sundar , Michael Z. Chen , Adam W. Kautzner , Randy L. Canis
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.
-
Search Results
2
records
(took 0.022 seconds)
