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:
Jan. 03, 2023

Filed:

Jul. 02, 2021
Applicant:

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

Inventors:

Balakrishnan Nambirajan, Parsippany, NJ (US);

Garret L. Anderson, Arden Hills, MN (US);

Heather L. Durosko, New Castle, PA (US);

Angela Gorbett, Alpharetta, GA (US);

Assignee:
Attorney:
Primary Examiner:
Assistant Examiner:
Int. Cl.
CPC ...
G16H 20/10 (2018.01); G06F 16/901 (2019.01); G06F 17/18 (2006.01); G06N 20/00 (2019.01);
U.S. Cl.
CPC ...
G16H 20/10 (2018.01); G06F 16/9027 (2019.01); G06F 17/18 (2013.01); G06N 20/00 (2019.01);
Abstract

A machine learning system for training a data model to predict data states in medical orders is described. The machine learning system is configured to train a data model to predict whether a medical order requires prior authorization ('PA') for medical orders within a medical order data set so that related systems may process incoming medical orders with PA determinations predicted by the data model. The machine learning system includes a first data warehouse system. The first prescription processing system generates a data model of historical orders and payer responses, apply a predictive machine learning model to the data model to generate a trained predictor of whether a medical order requires PA, associated with order data, apply the trained predictor to a plurality of production orders to determine PA for each of the plurality of production orders, and process the plurality of production orders with each associated PA determination.


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