The patent badge is an abbreviated version of the USPTO patent document. The patent badge does contain a link to the full patent document.

The patent badge is an abbreviated version of the USPTO patent document. The patent badge covers the following: Patent number, Date patent was issued, Date patent was filed, Title of the patent, Applicant, Inventor, Assignee, Attorney firm, Primary examiner, Assistant examiner, CPCs, and Abstract. The patent badge does contain a link to the full patent document (in Adobe Acrobat format, aka pdf). To download or print any patent click here.

Date of Patent:
Sep. 21, 2021

Filed:

Aug. 30, 2019
Applicant:

Express Scripts Strategic Development, Inc., St. Louis, MO (US);

Inventors:

John William Vandervoort, O'Fallon, IL (US);

Heather D. Sundar, Edwardsville, IL (US);

Michael Z. Chen, St. Louis, MO (US);

Adam W. Kautzner, Festus, MO (US);

Randy L. Canis, Chesterfield, MO (US);

Assignee:
Attorney:
Primary Examiner:
Int. Cl.
CPC ...
G16H 10/60 (2018.01); G16H 20/60 (2018.01); G06Q 40/08 (2012.01); G16H 40/20 (2018.01);
U.S. Cl.
CPC ...
G16H 20/60 (2018.01); G06Q 40/08 (2013.01); G16H 10/60 (2018.01);
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.


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