Systems and Methods for Real-Time Monitoring and Analysis of Prescription Claim Rejections
First Claim
1. A transaction performance monitoring system for facilitating real-time monitoring of the rejection of claims, the transaction performance monitoring system comprising:
- a transaction performance monitoring application operable to;
receive a plurality of claims associated with at least one dispenser, wherein each of the claims relates to at least one prescription and at least one payor;
in real-time, identify rejected claims and associated causes of the rejected claims; and
a network operable to;
communicate the plurality of claims between the at least one dispenser and the at least one payor.
4 Assignments
0 Petitions
Accused Products
Abstract
Embodiments of the invention can provide systems and methods for real-time monitoring and analysis of prescription claim rejections. In one embodiment, a transaction performance monitoring system for facilitating real-time monitoring of the rejection of claims can be provided. The transaction performance monitoring system can include a transaction performance monitoring application operable to receive a plurality of claims associated with at least one dispenser, wherein each of the claims relates to at least one prescription and at least one payor. In addition, a transaction performance monitoring application operable to, in real-time, identify rejected claims and associated causes of the rejected claims. Furthermore, a transaction performance monitoring system can include a network operable to communicate the plurality of claims between the at least one dispenser and the at least one payor.
109 Citations
20 Claims
-
1. A transaction performance monitoring system for facilitating real-time monitoring of the rejection of claims, the transaction performance monitoring system comprising:
-
a transaction performance monitoring application operable to; receive a plurality of claims associated with at least one dispenser, wherein each of the claims relates to at least one prescription and at least one payor; in real-time, identify rejected claims and associated causes of the rejected claims; and a network operable to; communicate the plurality of claims between the at least one dispenser and the at least one payor. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8)
-
-
9. A method for facilitating real-time monitoring of the rejection of claims communicated between at least one dispenser and at least one payor, the method comprising:
-
receiving a plurality of claims associated with at least one dispenser, wherein each of the claims relates to at least one prescription and at least one payor; in real-time, identifying rejected claims and associated causes of the rejected claims; and outputting a real-time display of aggregated rejected claims and associated causes of the rejected claims. - View Dependent Claims (10, 11, 12, 13, 14)
-
-
15. A transaction performance monitoring application for facilitating real-time monitoring of the rejections of claims communicated between at least one dispenser and at least one payor via a network, the transaction performance monitoring application comprising computer-readable instructions operable to:
-
receive a plurality of claims associated with at least one dispenser, wherein each of the plurality of claims relates to at least one prescription and at least one payor; in real-time, identify rejected claims and associated causes of the rejected claims; determining at least one NCPDP (National Council for Prescription Drug Programs) reject code associated with each rejected claim; provide a user interface for monitoring, in real-time, rejected claims and the associated causes of the rejected claims; and communicate at least a portion of the plurality of claims between the at least one dispenser and the at least one payor. - View Dependent Claims (16, 17, 18, 19, 20)
-
Specification