Pharmaceutical information tracking system
First Claim
1. A pharmaceutical information tracking system comprising:
- a payor;
a computer system accessible by said payor including;
a pharmaceutical subsystem, comprising a pharmaceutical representation;
a prescription subsystem, comprising a prescription representation for said pharmaceutical representation; and
a reimbursement subsystem, comprising a reimbursement representation for said prescription representation.
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Abstract
A system that facilitates direct, efficient, non-linear, integrated and proactive communications between a payor, a PBM, a pharmacy, and health care provider such as a physician. The system increases efficiency and reducing costs by reducing the number of processes needed to prescribe pharmaceuticals in accordance with the policies of a payor or PBM. The system can pre-certify prescriptions, check of for unfavorable pharmaceutical interactions and allergic reactions, prevent misuse of a prescription, monitor the filling and re-filling of a prescription, as well as cancel a prescription after it has been issued by a provider. Instead of merely allowing different entities to communicate with each other through interfaces and other indirect means, one embodiment of the system actually centralizes the information storage into a one or more locations that are accessible to all the appropriate entities.
101 Citations
34 Claims
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1. A pharmaceutical information tracking system comprising:
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a payor;
a computer system accessible by said payor including;
a pharmaceutical subsystem, comprising a pharmaceutical representation;
a prescription subsystem, comprising a prescription representation for said pharmaceutical representation; and
a reimbursement subsystem, comprising a reimbursement representation for said prescription representation. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27)
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28. A pharmaceutical information tracking system comprising:
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a payor;
a computer system accessible by said payor including;
a pharmaceutical subsystem comprising a plurality of pharmaceutical representations, a representation of an unfavorable pharmaceutical interaction, a representation of an unfavorable allergy interaction, and a subset of eligible pharmaceutical representations;
a prescription subsystem comprising a plurality of prescription representations, a patient attribute representation, and a representation of filling a prescription;
a reimbursement subsystem comprising a reimbursement representation, a reimbursement rule, a pre-certified status, a cost analysis, a cost criteria, and a treatment protocol; and
an eligibility subsystem comprising an eligibility criteria and an eligibility decision; and
wherein said pharmaceutical subsystem, said prescription subsystem, said reimbursement subsystem, and said eligibility subsystem share information in a substantially simultaneous manner.
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29. A method of tracking pharmaceutical information comprising the steps of:
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using a single computer system to track pharmaceutical, prescription, eligibility and reimbursement information; and
pre-certifying a prescription before generating an electronic representation of the prescription. - View Dependent Claims (30, 31, 32, 33, 34)
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Specification