Managed distribution solution and methods thereof

• US 20090319294A1
• Filed: 06/18/2008
• Published: 12/24/2009
• Est. Priority Date: 06/18/2008
• Status: Abandoned Application

• Current Assignee: CuraScript, Inc. (The Cigna Group)
• Original Assignee: CuraScript, Inc. (The Cigna Group)
• Inventors: Pool, Tricia, Phillips, Perry, Seymour, Thaddeus
• Application Number:
  US12/214,360
• Publication Number:
  US 20090319294A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/08 Logistics, e.g. warehousing, loading or distribution; Inventory or stock management
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 20/102 Bill distribution or payments
• CPC Class Codes: G06Q 30/04 Billing or invoicing
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

The managed distribution solution (“MDS”) of the present invention includes systems and methods for giving the point-of-service provider (“POS”) (i.e., physicians, home infusion, clinics, long term care, etc.) an alternative to the traditional buy and bill model. In one exemplary embodiment in accordance with the present invention, a processing site is configured for communicating with a distributor, a Client and a POS to facilitate delivery of a Product from a distributor to the POS. In another exemplary embodiment of the present invention, a billing system is associated with the processing site for facilitating billing for Products delivered to POS to a Client, when a patient of the Client receives the Product from the POS.

Claims

1. A managed distribution system for distribution and billing a product, the system comprising:

a processing site configured for communicating with a distributor, a client and a point-of-service provider (“

POS”

), wherein the processing site facilitates delivery of a product from the distributor to the POS;

a billing system associated with the processing site, wherein the billing system is configured to bill the client for the Product delivered to the POS when the product is used to treat a patient who is a member/insured of the client.

2. The system of claim 1, wherein the processing site is configured with one or more databases to store information of at least one of a distributor, a client and a POS.

3. The system of claim 1, wherein the processing site is configured to receive registration information from at least one of a distributor, a client and a POS.

4. The system of claim 1, wherein the processing site is configured receive inventory information of the POS and communicate this information to the distributor.

5. The system of claim 1, wherein the product comprises at least one of a medical, health care, and pharmaceutical product.

6. The system of claim 1, wherein the POS comprises at least one of a physician, home infusion provider, physician clinic, group practice, pharmacist, medical practitioner, nurse, veterinarian, and long term care facility.

7. A method for distributing a product, the method comprising:

registering a client and a point-of-service (“

POS”

) with a distributor processing system;

receiving a product order from the POS at the processing system;

coordinating delivery of the product from the distributor to the POS;

verifying a patient of the client using the processing system;

approving the administration of the product to the patient by the POS; and

facilitating payment by the client to the distributor for the product.

8. The method for distributing a product of claim 7, further comprising reconciling billing between the client and the POS for the product.

9. The method for distributing a product of claim 7, further comprising deducting the product from an inventory of the POS.

10. The method for distributing a product of claim 7, the step of receiving a product order comprises receiving an order for at least one of a medical, health care, and pharmaceutical product.

11. The method for distributing a product of claim 7, wherein the step of registering a client and a point-of-service comprises registering a client and at least one of a physician, home infusion provider, physician clinic, group practice, pharmacist, medical practitioner, nurse, veterinarian, and long term care facility.

12. A method for adjudicating a claim for a product, the method comprising:

receiving a claim for a product from a clearinghouse, wherein product is ordered by a point-of-service provider (POS) from a distributor;

receiving a remittance from a client;

reconciling the claim with the remittance to form an approved amount;

crediting an account of the POS for the approved amount;

paying the distributor for the product; and

billing the client for the product.

13. The method of claim 12, wherein the step of receiving a claim for a product comprises receiving a claim for at least one of a medical, health care, and pharmaceutical product.

14. The method of claim 12, wherein the step of crediting an account of the POS comprises crediting the account of at least one of a physician, home infusion provider, physician clinic, group practice, pharmacist, medical practitioner, nurse, veterinarian, and long term care facility.