Systems and methods for managing and/or administering prescription benefits
First Claim
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1. A method comprising:
- storing, on an electronic processor, account information in a computer database.,receiving, on the electronic processor, an access request to access a benefit management account, the benefit management account associated with an entity that administers prescription drug benefits for a plurality of members, the benefit management account associated with a plurality of benefit contracts, a contract of the plurality of benefit contracts being associated with a client;
in response to receiving the access request, transmitting, on the electronic processor, the account information associated with at least a portion of the plurality of benefit contracts;
receiving, on the electronic processor, a new contract request to add a new contract associated with the client to the benefit management account;
receiving, on the electronic processor, information relating to the new contract associated with the client including prescription benefits and coverage data, broker data, and billing data;
processing, on the electronic processor, the prescription benefits and coverage data, the broker data, and the billing data;
generating, on the electronic processor, the new contract based on the prescription benefits and coverage data, the broker data, and the billing data;
associating, on the electronic processor, the new contract with the client;
receiving, on the electronic processor, an add member request to add a new member to the new contract;
receiving, on the electronic processor, information relating to the new member associated with the new contract including a type of prescription program, a pharmacy network, pricing options, co-payments, prescription overrides, deductibles, drug plan, and prescription benefits and coverage;
generating, on the electronic processor, a group including the new member; and
generating, on the electronic processor, a group summary display.
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Accused Products
Abstract
Systems and methods for allowing a user (e.g., a benefits administrator) to maintain and modify a contract or a group for a prescription drug plan may be provided. In response to receiving a request to modify a contract or a group, a prescription benefits management application may retrieve data relating to the contract or group and allow the user to input information relating to the contract or group, input broker information, input billing information, select a pharmacy network, select pricing options for the prescription plan, create a customized prescription plan, input brand/generic difference overrides, etc. In some embodiments, the modifications and/or additions made to a contract or group may be transmitted to a pharmacist, thereby allowing the pharmacist to fill one or more prescriptions in real-time or upon updating the system (e.g., within 48 to 72 hours).
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Citations
13 Claims
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1. A method comprising:
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storing, on an electronic processor, account information in a computer database., receiving, on the electronic processor, an access request to access a benefit management account, the benefit management account associated with an entity that administers prescription drug benefits for a plurality of members, the benefit management account associated with a plurality of benefit contracts, a contract of the plurality of benefit contracts being associated with a client; in response to receiving the access request, transmitting, on the electronic processor, the account information associated with at least a portion of the plurality of benefit contracts; receiving, on the electronic processor, a new contract request to add a new contract associated with the client to the benefit management account; receiving, on the electronic processor, information relating to the new contract associated with the client including prescription benefits and coverage data, broker data, and billing data; processing, on the electronic processor, the prescription benefits and coverage data, the broker data, and the billing data; generating, on the electronic processor, the new contract based on the prescription benefits and coverage data, the broker data, and the billing data; associating, on the electronic processor, the new contract with the client; receiving, on the electronic processor, an add member request to add a new member to the new contract; receiving, on the electronic processor, information relating to the new member associated with the new contract including a type of prescription program, a pharmacy network, pricing options, co-payments, prescription overrides, deductibles, drug plan, and prescription benefits and coverage; generating, on the electronic processor, a group including the new member; and generating, on the electronic processor, a group summary display. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. 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:
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store account information in a computer database; receive an access request to access a benefit management account, the benefit management account associated with an entity that administers prescription drug benefits for a plurality of members, the benefit management account associated with a plurality of benefit contracts, a contract of the plurality of benefit contracts being associated with a client; in response to receipt of the access request, transmit the account information associated with at least a portion of the plurality of benefit contracts; receive a new contract request to add a new contract associated with the client to the benefit management account; receive information relating to the new contract associated with the client including prescription benefits and coverage data, broker data, and billing data; process the prescription benefits and coverage data, the broker data, and the billing data; generate the new contract based on the prescription benefits and coverage data, the broker data, and the billing data; associate the new contract with the client; receive an add member request to add a new member to the new contract; receive information relating to the new member associated with the new contract including a type of prescription program, a pharmacy network, pricing options, co-payments, prescription overrides, deductibles, drug plan, and prescription benefits and coverage; generate a group including the new member; and generate a group summary display.
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Specification
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Current AssigneeExpress Scripts Strategic Development, Inc. (The Cigna Group)
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Original AssigneeMedco Health Solutions Incorporated (The Cigna Group)
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InventorsJackson, William J., Eckstein, Yehuda
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Primary Examiner(s)NGUYEN, HIEP VAN
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Application NumberUS13/567,941Publication NumberTime in Patent Office393 DaysField of Search705/2US Class Current705/3CPC Class CodesG06Q 10/10 Office automation; Time man...G06Q 40/08 InsuranceG16H 20/10 relating to drugs or medica...
