SYSTEMS AND METHODS FOR COMMUNICATING FINANCIAL BENEFIT INFORMATION TO PATIENTS AND PRESCRIBERS FOR A MEDICATION PRESCRIBED DURING A PRESCRIPTION PROCESS

• US 20150278472A1
• Filed: 03/26/2014
• Published: 10/01/2015
• Est. Priority Date: 03/26/2014
• Status: Abandoned Application

• Current Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Original Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Inventors: King, Brian, Kaye, Elizabeth S., Marks, Allan
• Application Number:
  US14/226,689
• Publication Number:
  US 20150278472A1
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 70/40 relating to drugs, e.g. their side effects or intended usage

Abstract

Systems, methods are provided for communicating financial benefit information associated with an electronic prescription transaction submitted by a healthcare provider as part of the healthcare provider'"'"'s medication selection process for a patient. The transaction may be received at a service provider computer from a healthcare provider computer and may include patient identification information and one or more identifiers for a product being prescribed to the patient. The service provider computer may identify a financial benefit provided for the product and may transmit the transaction, including the identified financial benefit for the product, to a pharmacy computer. The identified financial benefit for the product may alternatively and/or additionally be transmitted to a healthcare provider computer or a patient communication device.

Claims

1. A computer-implemented method, comprising:

receiving, from a healthcare provider computer associated with a healthcare provider, an electronic prescription transaction, wherein the electronic prescription transaction comprises patient information identifying a patient and a product identifier identifying a product being prescribed;

identifying, based at least in part on the product identifier, whether at least one financial benefit is provided for the product;

determining, based at least in part on the patient identifier, whether patient contact information associated with the patient identifier is available;

transmitting the identified available benefits message to a patient communication device associated with the available patient contact information, the identified available benefits message including the identified financial benefit for the product, the patient information identifying the patient, and the product identifier identifying the product,

wherein the above operations are performed by one or more computers associated with a service provider.

2. The computer-implemented method of claim 1 further comprising:

transmitting the identified available benefits message to the healthcare provider computer associated with the healthcare provider.

3. The computer-implemented method of claim 1 further comprising:

identifying a pharmacy computer identifier included in the electronic prescription transaction; and

transmitting the electronic prescription transaction and the identified available benefits message to the identified pharmacy computer.

4. The computer-implemented method of claim 3, wherein the pharmacy computer identifier is at least one of a National Provider ID (NPI), a National Council for Prescription Drug Programs (NCPDP) Provider ID, ePrescribing identifier or other unique pharmacy computer identifier.

5. The method of claim 1, wherein identifying whether a financial benefit is provided for a prescription comprises:

comparing the product identifier associated with the product with a plurality of stored product identifiers to identify at least one match; and

for each matching stored product identifier, identifying a financial benefit associated with the stored product identifier.

6. The method of claim 1 further comprising the step of facilitating the storage of financial benefit information associated with one or more products in one or more financial benefit files, the financial benefit information comprising at least one of a drug identifier, a product name, an electronic voucher, a coupon, or a discount.

7. The method of claim 1 further comprising the step of facilitating the storage of patient contact information associated with one or more patients in one or more patient communication files, the patient contact information comprising at least one of a patient home phone number, a patient cellular phone number, a patient fax number, and/or a patient email address.

8. The method of claim 1, wherein the patient contact information is identified by comparing the patient information identifying the patient in the electronic prescription transaction with one or more patient identifiers stored in a patient communication file, wherein each patient identifier stored in the patient communication file is associated with at least one means of patient contact information.

9. The method of claim 1, wherein the financial benefit is identified by comparing a product identifier identifying the product with one or more product identifiers stored in a financial benefit file, wherein each product identifier stored in the financial benefit file is associated with at least one financial benefit.

10. The method of claim 1, wherein the product identifier is a National Drug Code (NDC), and the NDC code is compared with one or more NDC codes stored in one or more drug code tables stored in a financial benefit file.

11. The method of claim 1, wherein the financial benefit includes at least one of a co-pay savings, a standard co-pay savings card, a discount associated with a first fill of a prescription product free, a voucher, an e-voucher, or a discount for purchasing an extended prescription product supply.

12. The method of claim 1 further comprising the steps of:

accessing a financial benefit file associated with the product;

determining, based upon information included in the financial benefit file, one or more patient eligibility requirements that must be satisfied by the patient identified in the prescription to receive the financial benefit for the product;

accessing one or more patient history files for the patient identified in the prescription request; and

determining, based at least in part on information included in the one or more patient history files, that the patient satisfies the one or more eligibility requirements to receive the financial benefit for the product.

20. The system of claim 11, wherein the at least one processor is further configured to access the at least one memory and execute the computer-executable instructions to:

access a financial benefit file associated with the product;

determine, based upon based upon information included in the financial benefit file, one or more patient eligibility requirements that must be satisfied by the patient identified in the prescription to receive the financial benefit;

access one or more patient history files for the patient identified in the prescription; and

determine, based at least in part on information included in the one or more patient history files, that the patient satisfies the one or more eligibility requirements to receive the financial benefit.

13. A system comprising:

at least one memory operable to store computer-executable instructions; and

at least one processor configured to access the at least one memory and execute the computer-executable instructions to;

receive, from a healthcare provider computer associated with a healthcare provider, an electronic prescription transaction, wherein the electronic prescription transaction comprises patient information identifying a patient and a product identifier identifying a product;

identify, based at least in part on the product identifier, if at least one financial benefit is provided for the product;

determine, based at least in part on the patient identifier, whether patient contact information associated with the patient identifier is available;

direct communication of an available benefits message to a patient communication device associated with the available patient contact information, the available benefits message including the identified financial benefit for the product, the patient information identifying the patient, and the product identifier identifying the product.

14. The system of claim 13, wherein the at least one processor is further configured to access the at least one memory and execute the computer-executable instructions to:

direct communication of the identified available benefits message to the healthcare provider computer associated with the healthcare provider.

15. The system of claim 14, wherein the at least one processor is further configured to access the at least one memory and execute the computer-executable instructions to:

identify a pharmacy computer identifier included in the electronic prescription transaction; and

direct communication of the electronic prescription transaction and the identified available benefits message to the identified pharmacy computer.

16. The system of claim 15, wherein the pharmacy computer identifier is at least one of a National Provider ID (NPI), a National Council for Prescription Drug Programs (NCPDP) Provider ID, ePrescribing identifier or other unique pharmacy computer identifier.

17. The system of claim 13, wherein the at least one processor is further configured to access the at least one memory and execute the computer-executable instructions to identify if a financial benefit is provided for a product comprises:

comparing the product identifier associated with the product with a plurality of stored product identifiers to identify at least one match; and

for each matching stored product identifier, identifying a financial benefit associated with the stored product identifier.

18. The system of claim 13, wherein the patient contact information is identified by comparing the patient information identifying the patient in the electronic prescription transaction with one or more patient identifiers stored in a patient communication file, wherein each patient identifier stored in the patient communication file is associated with at least one means of patient contact information.

19. The system of claim 13, wherein the financial benefit is identified by comparing a product identifier identifying the product with one or more product identifiers stored in a financial benefit file, wherein each product identifier stored in the financial benefit file is associated with at least one financial benefit.