Facilitating Transactions for Health Applications Designed for Mobile Devices

• US 20150100328A1
• Filed: 10/04/2013
• Published: 04/09/2015
• Est. Priority Date: 10/04/2013
• Status: Active Grant

• Current Assignee: IQVIA, Inc. (IQVIA Holdings, Inc.)
• Original Assignee: IMS Health Incorporated (IQVIA Holdings, Inc.)
• Inventors: Tindall, Matthew, MacCarthy, John, Sadek, Hossam, Kress, Andrew
• Granted Patent: US 10,152,761 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/0631 Item recommendations

Abstract

Methods, systems, and apparatus, including computer programs encoded on computer storage media, for facilitating transactions for health-related computing products (e.g., mobile health applications or health-related devices). One method includes storing a plurality of lists, each list including health-related computing products approved for compensation by a payer entity. A claim for a health-related computing product is received from a user. The list with which the user is associated is determined. A determination is made whether the health-related computing product included in the claim is listed in the list with which the user is determined to be associated. When the health-related computing product is determined to be listed in the list with which the user is determined to be associated, compensation by the payer is authorized. However, when the health-related computing product is not determined to be listed in the list with which the user is determined to be associated, compensation by the payer is declined.

Claims

1. A method comprising:

storing, by one or more computer processors, a plurality of lists, each list including health-related computing products approved for compensation by a payer entity;

receiving, at the one or more computer processors, a claim for a health-related computing product, the claim including information associated with a recommendation of the health-related computing product to at least one user;

determining, by the one or more computer processors, with which of the plurality of lists the at least one user is associated;

determining, by the one or more computer processors, whether the health-related computing product recommended to the at least one user is listed in the list with which the user is determined to be associated;

when the health-related computing product is determined to be listed in the list with which the at least one user is determined to be associated, authorizing, by the one or more computer processors, compensation by the payer for the health-related computing product; and

when the health-related computing product is not determined to be listed in the list with which the at least one user is determined to be associated, declining, by the one or more computer processors, compensation by the payer for the health-related computing product.

2. A method comprising:

storing, by one or more computer processors, a plurality of formulary data structures, each formulary data structure being associated with one of a plurality of health plans and including a list of mobile applications approved for compensation by the associated health plan;

receiving, at the one or more computer processors, a claim for a mobile application, the claim including information associated with a recommendation of the mobile application to a user, and the mobile application being configured to operate on a mobile device of the user;

determining, using the one or more computer processors, with which of the plurality of health plans the user is associated;

determining, using the one or more computer processors, whether the health plan with which the user is determined to be associated covers the prescription of the mobile application to the user by determining whether the mobile application is listed in the formulary associated with the health plan with which the patient is determined to be associated;

when the prescription of the mobile application to the patient is determined to be covered by the health plan, authorizing, using the one or more computer processors, compensation by the health plan for the mobile application; and

when the prescription of the mobile application to the patient is determined not to be covered by the health plan, declining, using the one or more computer processors, compensation by the health plan for the mobile application.

3. The method of claim 2, wherein authorizing compensation by the health plan for the mobile application comprises:

requesting, by the one or more computer processors, payment of a cost of the mobile application from the health plan with which the patient is determined to be associated;

remitting, by the one or more computer processors, payment of the cost the mobile application to a provider of the mobile application.

4. The method of claim 2, wherein authorizing compensation by the health plan for the mobile application comprises:

determining, by the one or more computer processors, that the health plan with which the patient is determined to be associated covers an entire cost of the mobile application; and

based on determining that the health plan covers the entire cost of the mobile application, providing, by the one or more computer processors, the patient with a mechanism for downloading the mobile application.

5. The method of claim 2, wherein compensation by the health plan for the mobile application comprises:

determining, by the one or more computer processors, that the health plan with which the patient is determined to be associated requires the patient to pay at least a portion of a cost of the mobile application;

causing, by the one or more computer processors, a request to be sent to the patient requesting payment of the portion of the cost of the mobile application;

receiving, at the one or more computer processors, payment information indicating acceptance by the patient of the portion of the cost of the mobile application; and

after receiving payment information indicating acceptance by the patient of the portion of the cost of the mobile application, providing, by the one or more computer processors, the patient with a mechanism for downloading the mobile application.

6. The method of claim 2, wherein determining whether the health plan with which the patient is determined to be associated covers the prescription of the mobile application to the patient further comprises determining whether a physician that provided the prescription is authorized to prescribe the mobile application.

7. The method of claim 2, further comprising:

identifying a plurality of mobile applications that are related to health care;

categorizing the identified plurality of mobile applications into one or more groups based on one or more functions of each mobile application in relation to health care;

storing a list of the identified plurality of mobile applications, the categorizations for each of the identified plurality of mobile applications, and a real cost associated with each of the identified plurality of mobile applications, wherein the real cost comprises a cost to initially download the mobile application and any continuing costs necessary for continued use of the mobile application;

providing an interface to a payer that enables the payer to search the stored list of the identified plurality of mobile applications based on the categorizations for each of the identified plurality of mobile applications;

receiving, through the interface, input from the payer to add a mobile application to a formulary data structure associated with the payer, the input including an indication of an amount and type of compensation the payer will provide for the mobile health application; and

adding the mobile application to the formulary data structure associated with the payer including the indication of the amount and type of compensation the payer will provide for the mobile health application.

8. A non-transitory computer storage medium encoded with a computer program, the program comprising instructions that when executed by one or more computers cause the one or more computers to perform operations comprising:

storing, by one or more computer processors, a plurality of formulary data structures, each formulary data structure being associated with one of a plurality of health plans and including a list of mobile applications approved for compensation by the associated health plan;

receiving, at the one or more computer processors, a claim for a mobile application, the claim including information associated with a recommendation of the mobile application to a user, and the mobile application being configured to operate on a mobile device of the user;

determining, using the one or more computer processors, with which of the plurality of health plans the user is associated;

determining, using the one or more computer processors, whether the health plan with which the user is determined to be associated covers the prescription of the mobile application to the user by determining whether the mobile application is listed in the formulary associated with the health plan with which the patient is determined to be associated;

when the prescription of the mobile application to the patient is determined to be covered by the health plan, authorizing, using the one or more computer processors, compensation by the health plan for the mobile application; and

when the prescription of the mobile application to the patient is determined not to be covered by the health plan, declining, using the one or more computer processors, compensation by the health plan for the mobile application.

9. The non-transitory computer storage medium of claim 8, wherein authorizing compensation by the health plan for the mobile application comprises:

requesting, by the one or more computer processors, payment of a cost of the mobile application from the health plan with which the patient is determined to be associated;

remitting, by the one or more computer processors, payment of the cost the mobile application to a provider of the mobile application.

10. The non-transitory computer storage medium of claim 8, wherein authorizing compensation by the health plan for the mobile application comprises:

determining, by the one or more computer processors, that the health plan with which the patient is determined to be associated covers an entire cost of the mobile application; and

based on determining that the health plan covers the entire cost of the mobile application, providing, by the one or more computer processors, the patient with a mechanism for downloading the mobile application.

11. The non-transitory computer storage medium of claim 8, wherein compensation by the health plan for the mobile application comprises:

determining, by the one or more computer processors, that the health plan with which the patient is determined to be associated requires the patient to pay at least a portion of a cost of the mobile application;

causing, by the one or more computer processors, a request to be sent to the patient requesting payment of the portion of the cost of the mobile application;

receiving, at the one or more computer processors, payment information indicating acceptance by the patient of the portion of the cost of the mobile application; and

after receiving payment information indicating acceptance by the patient of the portion of the cost of the mobile application, providing, by the one or more computer processors, the patient with a mechanism for downloading the mobile application.

12. The non-transitory computer storage medium of claim 8, wherein determining whether the health plan with which the patient is determined to be associated covers the prescription of the mobile application to the patient further comprises determining whether a physician that provided the prescription is authorized to prescribe the mobile application.

13. The non-transitory computer storage medium of claim 8, further comprising:

identifying a plurality of mobile applications that are related to health care;

categorizing the identified plurality of mobile applications into one or more groups based on one or more functions of each mobile application in relation to health care;

storing a list of the identified plurality of mobile applications, the categorizations for each of the identified plurality of mobile applications, and a real cost associated with each of the identified plurality of mobile applications, wherein the real cost comprises a cost to initially download the mobile application and any continuing costs necessary for continued use of the mobile application;

providing an interface to a payer that enables the payer to search the stored list of the identified plurality of mobile applications based on the categorizations for each of the identified plurality of mobile applications;

receiving, through the interface, input from the payer to add a mobile application to a formulary data structure associated with the payer, the input including an indication of an amount and type of compensation the payer will provide for the mobile health application; and

adding the mobile application to the formulary data structure associated with the payer including the indication of the amount and type of compensation the payer will provide for the mobile health application.

14. A system comprising:

one or more processors; and

one or more storage mediums storing instructions that, when executed by the one or more processors, cause the one or more processors to perform operations comprising;

storing, by one or more computer processors, a plurality of formulary data structures, each formulary data structure being associated with one of a plurality of health plans and including a list of mobile applications approved for compensation by the associated health plan;

receiving, at the one or more computer processors, a claim for a mobile application, the claim including information associated with a recommendation of the mobile application to a user, and the mobile application being configured to operate on a mobile device of the user;

determining, using the one or more computer processors, with which of the plurality of health plans the user is associated;

determining, using the one or more computer processors, whether the health plan with which the user is determined to be associated covers the prescription of the mobile application to the user by determining whether the mobile application is listed in the formulary associated with the health plan with which the patient is determined to be associated;

when the prescription of the mobile application to the patient is determined to be covered by the health plan, authorizing, using the one or more computer processors, compensation by the health plan for the mobile application; and

when the prescription of the mobile application to the patient is determined not to be covered by the health plan, declining, using the one or more computer processors, compensation by the health plan for the mobile application.

15. The system of claim 14, wherein authorizing compensation by the health plan for the mobile application comprises:

requesting, by the one or more computer processors, payment of a cost of the mobile application from the health plan with which the patient is determined to be associated;

remitting, by the one or more computer processors, payment of the cost the mobile application to a provider of the mobile application.

16. The system of claim 14, wherein authorizing compensation by the health plan for the mobile application comprises:

determining, by the one or more computer processors, that the health plan with which the patient is determined to be associated covers an entire cost of the mobile application; and

based on determining that the health plan covers the entire cost of the mobile application, providing, by the one or more computer processors, the patient with a mechanism for downloading the mobile application.

17. The system of claim 14, wherein compensation by the health plan for the mobile application comprises:

determining, by the one or more computer processors, that the health plan with which the patient is determined to be associated requires the patient to pay at least a portion of a cost of the mobile application;

causing, by the one or more computer processors, a request to be sent to the patient requesting payment of the portion of the cost of the mobile application;

receiving, at the one or more computer processors, payment information indicating acceptance by the patient of the portion of the cost of the mobile application; and

after receiving payment information indicating acceptance by the patient of the portion of the cost of the mobile application, providing, by the one or more computer processors, the patient with a mechanism for downloading the mobile application.

18. The system of claim 14, wherein determining whether the health plan with which the patient is determined to be associated covers the prescription of the mobile application to the patient further comprises determining whether a physician that provided the prescription is authorized to prescribe the mobile application.

19. The system of claim 14, the one or more storage mediums further store instructions that, when executed by the one or more processors, cause the one or more processors to perform operations comprising:

identifying a plurality of mobile applications that are related to health care;

categorizing the identified plurality of mobile applications into one or more groups based on one or more functions of each mobile application in relation to health care;

storing a list of the identified plurality of mobile applications, the categorizations for each of the identified plurality of mobile applications, and a real cost associated with each of the identified plurality of mobile applications, wherein the real cost comprises a cost to initially download the mobile application and any continuing costs necessary for continued use of the mobile application;

providing an interface to a payer that enables the payer to search the stored list of the identified plurality of mobile applications based on the categorizations for each of the identified plurality of mobile applications;

receiving, through the interface, input from the payer to add a mobile application to a formulary data structure associated with the payer, the input including an indication of an amount and type of compensation the payer will provide for the mobile health application; and

adding the mobile application to the formulary data structure associated with the payer including the indication of the amount and type of compensation the payer will provide for the mobile health application.