Mckesson Corporation

Jared Burdine

Phillip Draa

John Giglio

A method, apparatus and computer program product are provided for partitioning prescription transaction costs in an electronic prescription transaction by determining a credit amount to be applied to an adjudicated prescription claim. The credit amount may be applied based on a co-pay amount provided by an adjudication computer and/or historical data, and may be adjusted according to an alternative cost obtained from an alternative cost data source. The alternative cost may be a cost for which a government sponsored plan can obtain the prescription. The remaining patient pay amount may be transmitted to a pharmacy computer such that a patient can purchase the prescription for a discounted cost.

Method, apparatus, and computer program product for partitioning prescription transaction costs in an electronic prescription transaction

A method, apparatus and computer program product are provided for partitioning prescription transaction costs in an electronic prescription transaction by determining a credit amount to be applied to prescription transaction, based on an alternative cash price. In circumstances which an associated prescription claim is rejected or determined to be likely rejected, such as due to a requirement for prior authorization, a patient may still be motivated to purchase a prescription via a cash transaction, particularly with the credit amount applied. The prescription transaction may be reformatted to indicate a cash transaction and include the credit amount, and may exclude benefit information. The credit amount and a reformatted prescription transaction may be transmitted to the pharmacy computer or other third party computer.

Method, apparatus, and computer program product for reformatting an electronic prescription transaction

A method, apparatus and computer program product are provided for partitioning prescription transaction costs by determining offset savings amounts to be applied to prescription transactions, based on an adjudicated response from a payer computer. Prescription transactions received from a pharmacy are submitted in real time or near real-time for adjudication. Historical data associated with the patient and prescription is accessed to identify a target patient pay amount. Based on the benefit coverage and/or co-pay amount from the adjudicated response, an offset savings is determined in real-time or near real-time that will partition the prescription transaction cost such that the remaining patient pay amount is aligned with the target patient pay amount.

A method, apparatus and computer program product are provided for partitioning prescription transaction costs in an electronic prescription transaction by determining a credit amount to be applied to an adjudicated prescription claim, based on a co-pay amount provided by an adjudication computer, and a cash price obtained from a cash discount system. The remaining patient pay amount, which may be less than or equal to the cash price, may be transmitted to the pharmacy computer. The credit amount may be transmitted to the pharmacy computer or other third party computer.

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Dunwoody, GA, United States of America

Jared Burdine