Mckesson Corporation

Stacy Hopkins

Elizabeth S Kaye

Beth Kaye

Roger George Pinsonneault

Mark Beers

Jeremiah Rothschild

Keith Crozier

Stewart Aragon

Scott Genone

Vickie Andros

Ashley Proctor

James Donald Stillman

A computing device, method and computer program product are provided to construct a consolidated message. In the context of a computing device, the computing device includes a communication interface configured to receive first information regarding a product from a request processor in response to an inquiry from a source. The computing device also includes processing circuitry configured to determine whether the product is supported by one or more operational services. In an instance in which the product is supported by one or more operational services, the processing circuitry is configured to obtain second information regarding the one or more operational services to construct the consolidated message having a predefined message format and containing both the first information and the second information. The communication interface is also configured to cause the consolidated message containing both the first information and the second information to be provided to the source of the inquiry.

Computing device, method and computer program product for constructing a consolidated message

A method, apparatus and computer program product are provided for generating a first evaluation message and an alternative evaluation messages in response to an electronic message from a requesting computer. Multiple responses, including a first evaluation message response and at least one alternative evaluation message response are returned to the requesting computer. A user can select one of the multiple responses for further forwarding to a verification system via a service provider computer. The service provider computer further facilitates verification of the selected response, such as an alternative evaluation system, via the verification system. The system enables generation of multiple pricing inquiries for alternative therapy and/or via different pricing schemas, to be imitated by a pharmacy computer upon a patient requesting a prescription refill.

Method, apparatus, and computer program product for generating alternative evaluation messages

An improved alternative therapy identification system increases the efficiency for obtaining information for alternative therapies. The alternative therapy identification system automates alternative therapy identification information from both a product level and a drug cost level. The improved alternative therapy identification system may also increase the efficiency by improving alternative therapy selection to occur at the prescriber level.

Alternative therapy identification system

A method, apparatus and computer program product construct an updated order and verify compliance with predefined rule(s) prior to submission to a supplier. In a method, first information from a request processor responsive to an inquiry is provided to a source. The method receives an order in a first format that includes second information, different than the first information, from the source. The method analyzes the order relative to predefined rule(s) to identify whether the order satisfies the predefined rule(s). The method converts the order to a second format, different than the first format, and combines the converted order with at least some first information to form an updated order. If the predefined rule(s) are satisfied, the method transmits the updated order to the supplier. However, if a first category of the predefined rule(s) is unsatisfied, the method notifies the source of the predefined rule(s) that were unsatisfied.

Method, apparatus and computer program product for constructing an updated order and verifying compliance with predefined rule(s)

An improved adherence monitoring and notification system notifies a healthcare provider of vaccination eligibility during a patient encounter, and improves the network of a healthcare provider and service provider by providing automated adherence monitoring. The improved adherence monitoring and notification system reduces network traffic with regards to the communication of patient adherence information. The improved adherence monitoring and notification system can increase patient adherence by notifying prescribers. The improved adherence monitoring and notification system may also increase the efficiency by which notification regarding vaccination eligibility, and patient adherence information is disbursed.

Adherence monitoring and notification system

A method, apparatus and computer program product efficiently verify a transaction, such as an order, in accordance with a multi-stage verification process. In a method, data is extracted from an order submitted pursuant to a program having a plurality of verification qualifications. The method performs a first set of verification checks and, in an instance in which the first set of verification checks is satisfied, the method modifies the order to include a first indication of satisfaction of the first set of verification checks. The method also extracts data from a claim that is based upon the order. The claim includes the first indication that the first set of verification checks was satisfied. The method also performs a second set of verification checks based upon the data extracted from the claim and, in an instance in which the second set of verification checks is satisfied, the method submits the claim via an adjudication network for adjudication.

Method, apparatus and computer program product for conducting a multi-stage verification

A method, apparatus and computer program product provide for monitoring an adjudication network. In relation to a method, first information is caused to be provided by a request processor in response to an inquiry to be provided to a source. The method also receives an order including second information, different than the first information, from the source. The method further combines at least some of the second information with at least some of the first information to form an updated order and transmits the updated order to a supplier. Additionally, the method monitors the adjudication network, such as for a predefined period of time, to determine a status of the updated order and provides a notification to the source in response to the updated order having a predefined status.

Method, apparatus, and computer program product for constructing an updated order including information from different sources

A method, apparatus and computer program product are provided for providing a patient with prescribed medication cost information at a point of prescribing. A prescription benefit coverage inquiry is received and provided to a claims processor for processing. Historical data associated with prior prescription transactions is utilized to determine an estimated cost range of a prescribed medication in the event of an insufficient or absent response from a benefits manager. The estimated cost range is then provided to a prescriber to share with a patient. A targeted out-of-pocket cost according to incentives, such as vouchers and drug manufacturer rebates may also be provided.

Method, apparatus, and computer program product for providing estimated prescription costs

A method, apparatus and computer program product are provided for parsing a message received from a requesting computer to identify an indication of a transaction, an entity identifier, and an identifier of a first evaluation system. The entity identifier is evaluated based on historical data and/or eligibility data to determine an alternative evaluation procedure. The alternative evaluation procedure is preformed to obtain response information regarding the transaction, that may differ from response information otherwise obtained via the first evaluation system. A response to the message is constructed that includes the response information and is transmitted to the requesting computer.

Method, apparatus, and computer program product for performing an alternative evaluation procedure in response to an electronic message

A method, apparatus and computer program product are provided for providing a patient with prescribed medication cost information at a point of prescribing. A prescription benefit coverage inquiry is received and provided to a claims processor for processing. Historical data associated with prior prescription transactions is utilized to determine an estimated cost range of a prescribed medication in the event of an insufficient or absent response from a benefits manager. The estimated cost range is then provided to a prescriber to share with a patient.

Systems and methods are provided for determining and communicating prescription benefit coverage information to a prescriber of the product, service, or medication. A prescription benefit check request may be received by the service provider computer from a healthcare provider computer for the prescriber of the product, service, or medication. The service provider computer may format a prescription request for the prescribed product, service, or medication and transmit the prescription request to a pharmacy claims processor computer for processing. The service provider computer may receive a prescription response that includes a determination of the prescription request from the pharmacy claims processor computer. The service provider computer may determine that the prescription request was denied and the basis for the denial from the prescription response and can transmit a prescription benefit check response that includes at least a portion of the data in the prescription response to the healthcare provider computer.

Systems and methods for determining and communicating a prescription benefit coverage denial to a prescriber

A computing device, method and computer program product are provided to process messages received from a source and to construct messages transmitted to a recipient that include the information required to elicit the desired response. In relation to a method, an electronic message is received and analyzed relative to requirements of the related message to determine whether the electronic message includes information required by the related message. If the analysis determines that the electronic message fails to satisfy the requirements of the related message, the method searches historical data related to prior messages to identify additional information sufficient in combination with the information provided by the electronic message to satisfy the requirements of the related message, constructing the related message based upon the additional information identified from the historical data and the information provided by the electronic message, and causing the related message to be transmitted to a request processor.

Computing device and method for message construction and processing based upon historical data

An improved adherence monitoring system increases the efficiency for obtaining patient adherence information. The improved adherence monitoring system reduces network traffic with regards to the communication of patient adherence information. The improved adherence monitoring system automates an adherence notification pathway. The improved adherence monitoring system can increase patient adherence by increasing the efficiency of medication therapy. The improved adherence monitoring system may also increase the efficiency by which patient adherence information is disbursed.

Adherence monitoring system

A method, apparatus and computer program product are provided for estimating inventory based on distribution data. A requesting computer may submit an order request (e.g., benefit request) indicating a product and merchant attributes. Inventory information of the merchant may not be accessible, so inventory information may be estimated based on distribution data relating to the distribution of product to the merchant. Estimates regarding quantities, high or low inventories, and/or the like may be made based on distribution history and/or estimated subsequent distributions. A prescriber computer, such as one used by a physician, may therefore receive estimated inventory information regarding prescription medication at various pharmacies, prior to submitting the prescription to a pharmacy.

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Loganville, GA, United States of America

Stacy Hopkins