公开(公告)号：US20190333158A1

公开(公告)日：2019-10-31

申请号：US16509721

申请日：2019-07-12

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Jacob Jon Cedergreen

IPC: G06Q40/08 ,  G06Q50/22

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.