Systems and methods for identifying risk evaluation and mitigation strategies (REMS) compliance
First Claim
1. A computer-implemented method for identifying Risk Evaluation and Mitigation Strategies (REMS) compliance, the method comprising:
- routing, by a service provider system comprising one or more computers, one or more healthcare transactions submitted by a healthcare provider to one or more claims processor computers;
routing, by the service provider system to the healthcare provider, one or more respective adjudicated replies received from the one or more claims processor computers for the one or more healthcare transactions;
determining, by the service provider system based at least in part upon information included in the routed healthcare claim transactions and adjudicated replies, an amount of a product dispensed by the healthcare provider;
comparing, by the service provider system, the determined dispensed amount to a purchased amount of the product; and
determining, by the service provider system based at least in part upon the comparison, whether a REMS condition associated with the product is satisfied.
3 Assignments
0 Petitions
Accused Products
Abstract
Systems and methods for identifying REMS compliance are provided. A service provider system that includes one or more computers may route one or more healthcare transactions submitted by a healthcare provider to one or more claims processor computers. One or more respective adjudicated replies received from the one or more claims processor computers for the one or more healthcare transactions may then be routed by the service provider system to the healthcare provider. Based at least in part upon information included in the routed healthcare claim transactions and adjudicated replies, an amount of a product dispensed by the healthcare provider may be determined by the service provider system. The determined dispensed amount may be compared to a purchased amount of the product. Based at least in part upon the comparison, a determination may be made as to whether a REMS condition associated with the product is satisfied.
86 Citations
20 Claims
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1. A computer-implemented method for identifying Risk Evaluation and Mitigation Strategies (REMS) compliance, the method comprising:
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routing, by a service provider system comprising one or more computers, one or more healthcare transactions submitted by a healthcare provider to one or more claims processor computers; routing, by the service provider system to the healthcare provider, one or more respective adjudicated replies received from the one or more claims processor computers for the one or more healthcare transactions; determining, by the service provider system based at least in part upon information included in the routed healthcare claim transactions and adjudicated replies, an amount of a product dispensed by the healthcare provider; comparing, by the service provider system, the determined dispensed amount to a purchased amount of the product; and determining, by the service provider system based at least in part upon the comparison, whether a REMS condition associated with the product is satisfied. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10)
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11. A system for Risk Evaluation and Mitigation Strategies (REMS) compliance, the system comprising:
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at least one memory configured 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; direct the routing of one or more healthcare transactions submitted by a healthcare provider to one or more claims processor computers; direct the routing, to the healthcare provider, of one or more respective adjudicated replies received from the one or more claims processor computers for the one or more healthcare transactions; determine, based at least in part upon information included in the routed healthcare claim transactions and adjudicated replies, an amount of a product dispensed by the healthcare provider; compare the determined dispensed amount to a purchased amount of the product; and determine, based at least in part upon the comparison, whether a REMS condition associated with the product is satisfied. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19, 20)
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Specification