公开(公告)号：US20230317281A1

公开(公告)日：2023-10-05

申请号：US17712346

申请日：2022-04-04

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Kristin A. Biedinger ,  Randy L. Canis

IPC: G16H50/20 ,  G16H10/60 ,  G16H40/67

CPC classification number: G16H50/20 ,  G16H10/60 ,  G16H40/67

Abstract: Targeted medical intervention system comprises a processor that performs operations comprising selecting target user and generating targeted subset from population of users. To generate the targeted subset, the processor, compares each of the medical claim histories of the population of users to the target medical claim history based on similarity, frequency, and recency; generates a similarity score, a frequency score, and a recency score for each of the plurality of users; and selects the users to be included in the targeted subset based on the similarity score, the frequency score, and the recency score. The processor then monitors, for a period of time, the target medical claim history in comparison with medical claim histories to detect an anomaly in the target medical claim history; and causes an electronic communication to be displayed by a client device that comprises initiation of an intervention to be performed. Other embodiments are disclosed herein.

公开(公告)号：US11747821B1

公开(公告)日：2023-09-05

申请号：US16729864

申请日：2019-12-30

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Timothy B. Clise ,  Randy L. Canis

IPC: G05D1/02 ,  G05B15/02 ,  G06Q50/28 ,  G06Q10/0631 ,  H04L12/28 ,  G06Q10/0832

CPC classification number: G05D1/0246 ,  G05B15/02 ,  G06Q10/06314 ,  G06Q10/0832 ,  G06Q50/28 ,  H04L12/2803

Abstract: Methods and systems for prescription drug shipping selection are provided. The methods and systems include operations comprising: obtaining, by a server, activity data from a plurality of devices associated with a location, the activity data representing different types of activities that take place at the location over a threshold period of time; aggregating, by the server, the activity data to generate a location-based presence model for the location, the location-based presence model indicating likelihoods that a person is present at the location at a plurality of different time windows; and identifying, by the server, based on the location-based presence model, a time window for delivery of a perishable item to the location.

公开(公告)号：US20230350419A1

公开(公告)日：2023-11-02

申请号：US18212303

申请日：2023-06-21

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Timothy B. Clise ,  Randy L. Canis

IPC: G05D1/02 ,  G06Q50/28 ,  G06Q10/0832 ,  G06Q10/0631 ,  H04L12/28 ,  G05B15/02

CPC classification number: G05D1/0246 ,  G06Q50/28 ,  G06Q10/0832 ,  G06Q10/06314 ,  H04L12/2803 ,  G05B15/02

Abstract: Methods and systems for prescription drug shipping selection are provided. The methods and systems include operations comprising: obtaining, by a server, activity data from a plurality of devices associated with a location, the activity data representing different types of activities that take place at the location over a threshold period of time; aggregating, by the server, the activity data to generate a location-based presence model for the location, the location-based presence model indicating likelihoods that a person is present at the location at a plurality of different time windows; and identifying, by the server, based on the location-based presence model, a time window for delivery of a perishable item to the location.

公开(公告)号：US20230367327A1

公开(公告)日：2023-11-16

申请号：US18227422

申请日：2023-07-28

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Timothy B. Clise ,  Randy L. Canis

IPC: G05D1/02 ,  G06Q50/28 ,  G06Q10/0832 ,  G06Q10/0631 ,  H04L12/28 ,  G05B15/02

CPC classification number: G05D1/0246 ,  G06Q50/28 ,  G06Q10/0832 ,  G06Q10/06314 ,  H04L12/2803 ,  G05B15/02

Abstract: Methods and systems for prescription drug shipping selection are provided. The methods and systems include operations comprising: obtaining, by a server, activity data from a plurality of devices associated with a location, the activity data representing different types of activities that take place at the location over a threshold period of time; aggregating, by the server, the activity data to generate a location-based presence model for the location, the location-based presence model indicating likelihoods that a person is present at the location at a plurality of different time windows; and identifying, by the server, based on the location-based presence model, a time window for delivery of a perishable item to the location.

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

IPC: G16H10/60 ,  G16H20/60 ,  G06Q40/08 ,  G16H40/20

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

IPC: G16H20/60 ,  G16H10/60 ,  G06Q40/08

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.