Express Scripts Strategic Development, Inc.

Glen D Stettin

Mark G Bini

Sara A Raj

Christina Marie Vallery

Sarah E Ham

Jamie R Williams

Daniel C Casper

Zachary A Goodman

Snezana Mahon

William S Patterson

Damian Ng

Ashley M Jenne

Sarah Micheletti

Steven B Miller

Harry S Gangaikondan-Iyer

Sharon Glave Frazee

Shahnawaz A Khan

Juliana Dierks

Selva Prabhu

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.

Computerized aggregation and transaction processing architecture for digital health infrastructure

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.

Computerized aggregation and distribution architecture for digital health infrastructure

Systems and methods for prescription drug packaging are described. In some embodiments, a determination that a member of a pharmacy benefit plan has had a plurality of prescription drugs previously filled is made. An adjudication request for a prescription drug prescribed for the member is received. The adjudication request is based on a fulfillment request to fill the prescription drug. A determination that a blister packaging criterion has been met may be made based on a drug type of the prescription drug and a determination that the member has had the plurality of prescription drugs that have previously been filled. A blister fill instruction is transmitted based on receipt of the adjudication request and a determination that the blister packaging criterion has been met, wherein the blister fill instruction reflects that a pharmacy is to fill the prescription drug utilizing blister packaging. Additional methods and systems are disclosed.

Systems and methods for prescription drug packaging

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.

Methods and systems for database management based on code-marker discrepancies

Growing community of inventors

St. Louis, MO, United States of America

Glen D Stettin