METHODS AND SYSTEMS FOR PROMOTING MOBILE AWARENESS

• US 20140244307A1
• Filed: 05/06/2014
• Published: 08/28/2014
• Est. Priority Date: 12/09/2011
• Status: Active Grant

• Current Assignee: Express Scripts Strategic Development, Inc. (The Cigna Group)
• Original Assignee: Express Scripts Incorporated (The Cigna Group)
• Inventors: Shutko, Alan T., Bini, Mark G.
• Granted Patent: US 10,541,049 B2
• Time in Patent Office: Days
• US Class Current: 705/3
• CPC Class Codes: G06Q 10/083 Shipping
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/0629 for generating comparisons
• CPC Class Codes: G06Q 30/0639 Item locations
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 20/00 ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients

Abstract

Methods and systems for promoting mobile awareness are described. In an embodiment, a location associated with a member of a drug benefit plan is accessed. A drug benefit plan action is determined based on the location associated with the member. The drug benefit plan action is an action at least partially at the direction of a pharmacy benefit manager that administers the drug benefit plan. A drug benefit notification is generated based on the drug benefit plan action. The pharmacy notification benefit is associated with the drug benefit plan. Additional methods and systems are disclosed.

Claims

1. A method comprising:

determining, on a computer processor, a location of a mobile electronic device associated with a member of a drug benefit plan, the location being a current geographic location of the mobile device;

accessing, on the computer processor, member filtered pharmacy data, the member filtered pharmacy data being pharmacy location data filtered for the member based on adjudicated claims data of the member, the member filtered pharmacy data including filtered pharmacy location data of a plurality of member-utilized pharmacies where the member previously obtained prescription drug fills as reflected within a plurality of claims of the adjudicated claims data of the member;

automatically comparing, on the computer processor, the location of the mobile device with the filtered pharmacy location data of a retail pharmacy to determine whether a pharmacy location criterion is satisfied, the pharmacy location criterion including that the mobile electronic device is at least within a range of the retail pharmacy;

selecting, on the computer processor, a drug benefit plan action based on a determination that the location associated with the member satisfies the pharmacy location criterion, the drug benefit plan action being an action for the member to take relative to the retail pharmacy at least partially at the direction of a pharmacy benefit manager that administers the drug benefit plan; and

generating, on the computer processor, a drug benefit notification based on the drug benefit plan action, the drug benefit notification benefit being associated with the drug benefit plan.

2. The method of claim 1, wherein accessing the member filtered pharmacy data comprises:

accessing prescription drug history data of the member; and

filtering the pharmacy data based on the prescription drug history data of the member to obtain the member filtered pharmacy data.

3. The method of claim 1, wherein the pharmacy location criterion includes that the member is at a retail pharmacy location.

4. The method of claim 1, wherein selecting the drug benefit plan action comprises:

determining a lower cost alternative prescription drug fill is available at an additional location, the additional location being a different location than the location associated with the member,

wherein the drug benefit drug benefit notification includes a lower cost alternative drug fill indication.

5. The method of claim 1, wherein the drug benefit notification includes information notifying the member that a member notification that a lower cost alternative is available at an additional location different than the location associated with the mobile electronic device.

6. The method of claim 1, wherein the location of the mobile device includes a retail pharmacy at least within proximity of the member.

7. The method of claim 1, wherein the drug benefit notification includes information notifying that an active decision regarding mail order delivery or retail pickup of a prescription drug is needed, the method further comprising:

receiving an active decision response from the member; and

transmitting an active decision notification to a computing device, the active decision notification based on the active decision response, the computing device associated with a provider of the drug benefit plan.

8. The method of claim 7, further comprising:

receiving an enrollment initiation response from the computing device in response to the active decision notification; and

generating an enrollment display based on, at least in part, the enrollment initiation response.

9. The method of claim 1, further comprising:

transmitting the drug benefit notification.

10. The method of claim 1, further comprising:

rendering a display based on generation of the drug benefit notification.

11. The method of claim 1, wherein the location of the mobile device includes a pharmacy location at least within proximity of the mobile device.

12. The method of claim 11, further comprising:

receiving the member filtered pharmacy data prior to determining the location of the mobile device,

wherein accessing the filtered data is based on a determination that the pharmacy location is at least within proximity of the mobile device.

13. The method of claim 1, wherein the member filtered pharmacy data is further filtered based on inclusion and exclusion in a pharmacy network.

14. The method of claim 1, wherein the pharmacy location data is filtered based on the plurality of member-utilized pharmacies where the member previously obtained the prescription drug fills as reflected within the plurality of claims of adjudicated claims.

15. The method of claim 1, wherein the drug benefit notification is a location-appropriate drug benefit notification.

16. The method of claim 1, wherein generating the drug benefit notification comprises:

generating a member-targeted drug benefit notification based on the drug benefit plan action and the member, the member-targeted drug benefit notification benefit being associated with the drug benefit plan and targeting the member with member-specific messaging.

17. The method of claim 1, wherein retail pharmacy location is designated as an unpreferred pharmacy pursuant to the drug benefit plan.

18. A non-transitory machine-readable medium comprising instructions, which when executed by one or more processors, cause the one or more processors to perform the following operations:

determine a location of a mobile device associated with a member of a drug benefit plan, the location being a current geographic location of the mobile device;

access member filtered pharmacy data, the member filtered pharmacy data being pharmacy location data filtered for the member based on adjudicated claims data of the member, the member filtered pharmacy data including filtered pharmacy location data of a plurality of member-utilized pharmacies where the member previously obtained prescription drug fills as reflected within a plurality of claims of the adjudicated claims data of the member;

automatically compare the location of the mobile device with the filtered pharmacy location data of a retail pharmacy to determine whether the pharmacy location criterion is satisfied, the pharmacy location criterion including that the mobile electronic device is at least within a range of the retail pharmacy;

select a drug benefit plan action based on a determination that the location associated with the member satisfies the pharmacy location criterion, the drug benefit plan action being an action for the member to take relative to the retail pharmacy at least partially at the direction of a pharmacy benefit manager that administers the drug benefit plan; and

generate a drug benefit notification based on the drug benefit plan action, the drug benefit notification benefit being associated with the drug benefit plan.

19. A system comprising:

a processor and a memory coupled to the processor;

a location module deployed in the memory and executed by the processor to determine a location of a mobile device associated with a member of a drug benefit plan, the location being a current geographic location of the mobile device;

a plan action determination module deployed in the memory and executed by the processor to access member filtered pharmacy data, the member filtered pharmacy data being pharmacy location data filtered for the member based on adjudicated claims data of the member, the member filtered pharmacy data including filtered pharmacy location data of a plurality of member-utilized pharmacies where the member previously obtained prescription drug fills as reflected within a plurality of claims of the adjudicated claims data of the member, automatically compare the location of the mobile device with the filtered pharmacy location data of a retail pharmacy to determine whether a pharmacy location criterion is satisfied, the pharmacy location criterion including that the mobile electronic device is at least within a range of the retail pharmacy and select a drug benefit plan action based on a determination that the location associated with the member satisfies the pharmacy location criterion, the drug benefit plan action being an action for the member to take relative to the retail pharmacy at least partially at the direction of a pharmacy benefit manager that administers the drug benefit plan, the pharmacy location criterion including that the mobile device is at least within a range of the retail pharmacy; and

a notification generation module to generate a drug benefit notification based on the drug benefit plan action determined by the plan action determination module, the drug benefit notification benefit being associated with the drug benefit plan.