公开(公告)号：US12148014B1

公开(公告)日：2024-11-19

申请号：US16875681

申请日：2020-05-15

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Mark G. Bini ,  Zachary A. Goodman ,  Sara A. Raj ,  William S. Patterson ,  Damian Ng ,  Daniel C. Casper ,  Ashley M. Jenne ,  Sarah E. Ham ,  Jamie Williams ,  Christina M. Vallery ,  Sarah Micheletti ,  Glen D. Stettin ,  Snezana Mahon

IPC: G06Q30/0601 ,  G06Q20/12 ,  G06Q30/014 ,  G06Q30/018 ,  G06Q30/0203 ,  G06Q30/0282 ,  G06Q40/08 ,  G16H10/20 ,  G16H10/60 ,  G16H20/10 ,  G16H80/00

Abstract: A digital health solution system includes: a virtual pharmacy including one or more processors configured to operate a web portal for user devices via a network, the web portal serving as a marketplace for digital health solution applications available for download by and activation on user devices; a digital health marketplace including one or more processors configured to, in response to receipt of user input from a user device: determine activation criteria for a selected one of the digital health solution applications; and transmit the activation criteria to the virtual pharmacy, where the one or more processors of the virtual pharmacy are configured to transmit the activation criteria to the user device via the network; and where the user device is configured to, using the activation criteria, at least one of download and activate the selected one of the digital health solution applications.

公开(公告)号：US20220028513A1

公开(公告)日：2022-01-27

申请号：US17496945

申请日：2021-10-08

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Harry S. Gangaikondan-Iyer ,  Mark G. Bini ,  Zachary A. Goodman ,  Sara A. Raj ,  William S. Patterson ,  Damian Ng ,  Daniel C. Casper ,  Ashley M. Jenne ,  Sarah E. Ham ,  Jamie Williams ,  Christina M. Vallery ,  Sarah Micheletti ,  Glen D. Stettin ,  Snezana Mahon ,  Selva Prabhu ,  Shahnawaz A. Khan

IPC: G16H20/10 ,  G06Q40/08 ,  G06F9/54 ,  G06Q30/04 ,  G06Q20/40

Abstract: A digital health solution system includes: a virtual pharmacy comprising one or more processors configured to operate a web portal for user devices via a network, the web portal serving as a marketplace for products and services available from vendors for consumption by users; a transaction processing module configured to: receive, via a network, a transaction from a vendor regarding one or more of the products and services consumed by one or more users via the virtual pharmacy for payment to the vendor; adjudicate the transaction using adjudication rules stored in memory; bill an entity for the use of the one or more of the products and services associated with the one or more users when the adjudication of the transaction passes; and transmit, via a network, a response regarding the transaction to the vendor.

公开(公告)号：US10147504B1

公开(公告)日：2018-12-04

申请号：US14060513

申请日：2013-10-22

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Glen D. Stettin ,  Juliana Dierks

IPC: G16H50/30

Abstract: Methods and systems for risk assessment and adjustment are described. In one embodiment, a patient-level risk score associated with a patient is calculated. A plan-level average risk score associated with a benefit plan is calculated. The patient is a member of the benefit plan. A missing diagnosis code associated with the patient is identified based on medical claims history of the patient, historical prescription drug claims of the patient, and a drug marker. A revised patient-score associated with the patient is calculated based on identification of the missing diagnosis code. Additional methods and systems are disclosed.