Method and system for calculating an alignment date for prescriptions

• US 8,560,347 B1
• Filed: 01/27/2010
• Issued: 10/15/2013
• Est. Priority Date: 11/21/2008
• Status: Active Grant

• Current Assignee: Walgreen Co. (Walgreens Boots Alliance Incorporated)
• Original Assignee: Walgreen Co. (Walgreens Boots Alliance Incorporated)
• Inventors: Ali, Syed Y., Biesenthal, Amy C., Pankow, Greg, McGonagle, Sean, Gounder, Deivasigamani K.
• Primary Examiner(s): Hunter, Sean K
• Application Number:
  US12/694,968
• Time in Patent Office: 1,357 Days
• Field of Search: 705/2, 705/3
• US Class Current: 705/3
• CPC Class Codes: G06Q 10/00 Administration; Management

Abstract

A system and method facilitate alignment of refill dates associated with a plurality of prescriptions, such that each of the plurality of prescriptions requires a refill on the same date, thus limiting the number of occasions on which a customer must visit the pharmacy to retrieve refills of the aligned prescriptions, and increasing the likelihood that the customer will comply with the prescribed medication regimen. The system and method facilitate the alignment of the refill dates while complying with one or more rules governing the adjudication of the prescriptions.

Claims

1. A computer readable storage medium storing instructions executable by a processor to perform a method for aligning to a single alignment date refill dates associated with a plurality of prescriptions for a customer, each prescription for a medication, the method comprising:

receiving a selection of a plurality of prescriptions to align;

determining with the processor, for each of the plurality of selected prescriptions, a remaining day supply, the remaining day supply indicative of how many days of the medication the customer has remaining;

determining with the processor a latest adjudication date;

calculating with the processor a final alignment date;

determining with the processor, for each of the plurality of selected prescriptions, whether an intermediate fill is required so that the customer does not exhaust the remaining day supply of the medication before the final alignment date;

calculating with the processor one or both of an intermediate-fill day supply and an intermediate-fill quantity for any prescription requiring an intermediate fill;

determining with the processor a type for any required intermediate fill;

causing any required intermediate fill to be filled and provided to the customer, based on either the intermediate-fill quantity or the intermediate-fill day supply for the prescription; and

causing each of the selected prescriptions to be filled.

2. The computer readable medium of claim 1, wherein calculating a final alignment date further comprises complying with at least one adjudication rule set by a third-party payor.

3. The computer readable medium of claim 2, wherein complying with at least one rule set by the third-party payor further comprises:

calculating, for each of the plurality of selected prescriptions, a next adjudication date;

selecting as a latest adjudication date, from the plurality of next adjudication dates, the next adjudication date occurring on the latest date;

calculating an alignment adjudication date; and

selecting the final alignment date using the alignment adjudication date.

4. The computer readable medium of claim 3, wherein selecting the final alignment date using the alignment adjudication date further comprises adding one or more days to the alignment adjudication date for processing the prescriptions and providing the medications to the customer.

5. The computer readable medium of claim 3, wherein selecting the final alignment date using the alignment adjudication date further comprises adding one or more days to the alignment adjudication date as a patient start buffer.

6. The computer readable medium of claim 3, wherein calculating, for each of the plurality of selected prescriptions, a next adjudication date, further comprises determining a number of days corresponding to a percentage of a prescribed day supply for the medication.

7. The computer readable medium of claim 1, further comprising:

determining, for any prescription requiring an intermediate fill, a date by which the customer will receive the intermediate fill; and

wherein the date by which the customer will receive an intermediate fill for a particular prescription is used to calculate one or both of the intermediate-fill quantity and the intermediate-fill day supply of medication corresponding to the particular prescription if the customer will receive the intermediate fill for the particular prescription before exhausting the remaining day supply of the medication.

8. The computer readable medium of claim 7, wherein determining, for any prescription requiring an intermediate fill, a date by which the customer will receive the intermediate fill, further comprises adding one or more days to the next adjudication date for the prescription for processing the prescription and providing the medication to the customer.

9. A system for aligning to a single alignment date refill dates associated with a plurality of prescriptions for a customer, each prescription for a medication, the system comprising:

a network;

a computer coupled to the network;

a database coupled to the computer; and

an alignment engine for determining parameters associated with the alignment of the plurality of prescriptions, the alignment engine configured to;

receive a selection of a plurality of prescriptions to align;

determine a latest adjudication date;

calculate a final alignment date; and

calculate an intermediate-fill parameter.

10. The system of claim 9, wherein the alignment engine is further configured to determine a latest adjudication date, from a plurality of calculated next adjudication dates, in compliance with a rule determined by a third-party payor or a regulatory agency.

11. The system of claim 10, wherein the alignment engine is further configured to:

retrieve information from the database; and

calculate a parameter required to determine compliance with the rule determined by the third-party payor or the regulatory agency.

12. The system of claim 11, wherein the rule comprises an adjudication rule and wherein calculating a parameter required to determine compliance with the rule comprises calculating a percent-consumption period.

13. The system of claim 11, wherein calculating an intermediate-fill parameter comprises one of the group consisting of:

calculating an intermediate-fill day supply;

calculating an intermediate-fill quantity; and

calculating an intermediate-fill delivery date.

14. A computer readable storage medium storing instructions executable by a processor to perform a method for aligning to a single alignment date refill dates associated with a plurality of prescriptions for a customer, each prescription for a medication, the method comprising:

receiving a selection of a plurality of prescriptions to align;

determining with the processor, for each of the plurality of selected prescriptions, a remaining day supply, the remaining day supply indicative of how many days of medication the customer has remaining;

determining with the processor a latest adjudication date;

receiving a selection of a final alignment date;

determining with the processor, for each of the plurality of selected prescriptions, whether an intermediate fill is required so that the customer does not exhaust the remaining day supply of the medication before the final alignment date;

calculating with the processor one or both of an intermediate-fill day supply and an intermediate-fill quantity for any prescription requiring an intermediate fill;

causing any required intermediate fill to be filled and provided to the customer, based on either the intermediate-fill quantity or the intermediate-fill day supply for any prescription; and

causing each of the selected prescriptions to be filled.

15. The computer readable medium of claim 14, wherein receiving a selection of a final alignment date further comprises limiting the selection to dates on or after an earliest final alignment date.

16. The computer readable medium of claim 15, wherein the earliest final alignment date complies with at least one adjudication rule set by a third-party payor.

17. The computer readable medium of claim 16, wherein complying with at least one rule set by the third-party payor further comprises:

calculating, for each of the plurality of selected prescriptions, a next adjudication date;

selecting as a latest adjudication date, from the plurality of next adjudication dates, the next adjudication date occurring on the latest date; and

calculating the earliest final alignment date using the latest adjudication date.

18. The computer readable medium of claim 17, wherein calculating the earliest final alignment date using the latest adjudication date further comprises adding one or more days to the latest adjudication date for processing the prescriptions and providing the medications to the customer.

19. The computer readable medium of claim 17, wherein calculating, for each of the plurality of selected prescriptions, a next adjudication date, further comprises determining a number of days corresponding to a percentage of a prescribed day supply for the medication.

20. The computer readable medium of claim 14, further comprising:

determining, for any prescription requiring an intermediate fill, a date by which the customer will receive the intermediate fill; and

wherein the date by which the customer will receive an intermediate fill for a particular prescription is used to calculate the intermediate-fill quantity of medication corresponding to the particular prescription if the customer will receive the intermediate fill for the particular prescription before exhausting the remaining day supply of the medication.