Mckesson Corporation

James Adair

Elizabeth S Kaye

Mark Beers

Ramond McBeth

Jamie Lau

Anika Khare

Roy Toney

Elke Helga Katharina Timmerman

A method, apparatus and computer program product are provided to facilitate the efficient generation and submission of medical eligibility and medical claim data. In a method, a modified pharmacy benefits transaction associated with a patient is received that is formatted in a first predefined format. The modified pharmacy benefits transaction is parsed to determine an indicator and data is extracted from the modified pharmacy benefits transaction based on the indicator. A database is accessed to retrieve additional data that is at least partly based on a pharmacy with which the source is associated, a potential payor of the medical transaction or a medication that is a subject of the medical transaction. A medical transaction is generated that includes the extracted data and the additional data and formatted in a second predefined format. A response to the medical transaction is then transmitted to a source for display to a user.

Method, apparatus, and computer program product for submission of medical eligibility and claim data

Systems and methods are provided for generating an individual's longitudinal medication history. Consent to generate an individual's longitudinal medication history across a pharmacy(s) and a claims processor(s) is received. A first collection of medication history data corresponding to the individual is selectively identified from medication history data files associated with the claims processor(s) and a first plurality of individuals. The selective identification is based on a claims processor patient identifier(s) associated with the individual and the claims processor(s). A second collection of medication history data corresponding to the individual is selectively identified from medication history data files associated with the pharmacy(s) and a second plurality of individuals. The selective identification is based on a linking index(s) associated with the claims processor patient identifier(s). An individual's longitudinal medication history is generated, based on the first collection of medication history data and the second collection of medication history data.

Systems and methods for establishing an individual's longitudinal medication history

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Alpharetta, GA, United States of America

James Adair