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11. 发明授权

US08639523B1 Systems and methods for managing a prescription rewards program 有权
标题翻译：用于管理处方奖励计划的系统和方法
公开(公告)号：US08639523B1
公开(公告)日：2014-01-28
申请号：US12420288
申请日：2009-04-08
申请人： Roger Pinsonneault
发明人： Roger Pinsonneault
IPC分类号： G06Q10/00 , G06Q50/00 , G06Q30/00 , G06Q40/00
CPC分类号： G06Q30/02 , G06F19/00 , G06F19/328 , G06F19/3456 , G06Q10/10 , G06Q50/22
摘要： Systems and methods for managing a prescription rewards program include receiving, at a switch, an adjudicated prescription claim transaction, where the adjudicated prescription claim transaction includes an indication that the prescription claim transaction has been approved by a claim processor. The systems and methods further include identifying, from the adjudicated prescription claim transaction, a patient associated with the adjudicated prescription claim transaction, retrieving, from a database associated with the switch, a reward accumulator value associated with the patient, and updating the reward accumulator value associated with the patient based at least in part on the adjudicated prescription claim transaction. The systems and methods may further include determining that a threshold value has been satisfied by the reward accumulator value, and issuing a reward message based at least in part on the reward accumulator satisfying the threshold value.
摘要翻译：用于管理处方奖励计划的系统和方法包括在开关处接收所述裁定的处方索赔交易，其中所述裁定的处方申请交易包括处方要求交易已被索赔处理者批准的指示。所述系统和方法还包括从所述裁定的处方要求交易中识别与所述裁定的处方申请交易相关联的患者，从与所述交换机相关联的数据库检索与所述患者相关联的奖励累计值，以及更新所述奖励累计值至少部分地基于被判定的处方索赔交易与患者相关联。系统和方法还可以包括：通过奖励累加器值确定阈值已被满足，以及至少部分地基于满足阈值的积分累加器发出奖励消息。

12. 发明授权

US08392219B1 Systems and methods for streamlined patient enrollment for one or more healthcare programs 有权
标题翻译：为一个或多个医疗保健计划简化患者登记的系统和方法
公开(公告)号：US08392219B1
公开(公告)日：2013-03-05
申请号：US12776974
申请日：2010-05-10
申请人： Roger Pinsonneault , Patrick Harris, Sr.
发明人： Roger Pinsonneault , Patrick Harris, Sr.
IPC分类号： A61B5/00
CPC分类号： G06Q50/22 , G06F19/00 , G06Q50/24
摘要： Systems and methods are provided for supporting and validating patient enrollment in one or more healthcare programs. The systems and methods may include receiving a prescription claim request from a pharmacy computer, where the prescription claim request includes at least (i) a first product identifier identifying with a prescribed product for a patient, and (ii) patient information associated with the patient; determining, based at least in part upon the first identifier, that patient is subject to a requirement to enroll in one or more required healthcare programs prior to the prescription product being released to the patient; extracting enrollment information from the prescription claim request, the extracted enrollment information including at least a portion of the patient information from the prescription claim request; and automatically utilizing the extracted enrollment information to complete at least a portion of an enrollment process for the one or more required healthcare programs.
摘要翻译：提供系统和方法来支持和验证一个或多个保健计划中的患者登记。系统和方法可以包括从药房计算机接收处方要求请求，其中处方申请请求至少包括（i）用患者的规定产品识别的第一产品标识符，和（ii）与患者相关联的患者信息 ; 至少部分地基于第一标识符确定该患者在处方产品被释放到患者之前需要注册一个或多个所需的保健程序; 从所述处方要求请求中提取注册信息，所述提取的注册信息包括来自所述处方要求请求的所述患者信息的至少一部分; 以及自动利用所提取的注册信息来完成所述一个或多个所需保健程序的注册过程的至少一部分。

13. 发明授权

US08386274B1 Systems and methods for a prescription safety network utilizing eligibility verification transactions 有权
标题翻译：使用资格认证交易的处方安全网络的系统和方法
公开(公告)号：US08386274B1
公开(公告)日：2013-02-26
申请号：US12212129
申请日：2008-09-17
申请人： Roger Pinsonneault
发明人： Roger Pinsonneault
IPC分类号： G06Q50/00
CPC分类号： G06F19/3456 , G06F19/00 , G06Q50/24
摘要： Systems and methods may be provided for a prescription safety network program. The systems and methods may include receiving an eligibility verification request for a prescribed drug or product, where the eligibility verification request may include a pharmacy identifier, a patient identifier, and physician identifier; determining, based upon the received pharmacy identifier, that a pharmacy associated with the pharmacy identifier has enrolled in the prescription safety network program for filling the prescribed drug or product; determining, based upon the received patient identifier, that a patient associated with the patient identifier has enrolled in the prescription safety network program for utilizing the prescribed drug or product; and determining, based upon the received physician identifier, that a physician associated with the physician identifier has enrolled in the prescription safety network program for prescribing the prescribed drug or product; and generating an approval authorization by the validation engine in response to the eligibility verification request.
摘要翻译：可以为处方安全网络程序提供系统和方法。系统和方法可以包括接收针对规定药物或产品的资格验证请求，其中资格验证请求可以包括药房标识符，患者标识符和医师标识符; 基于所接收的药剂标识符确定与药房标识符相关联的药房已经登记在处方安全网络程序中，用于填充规定的药物或产品; 基于所接收的患者标识确定与所述患者标识符相关联的患者已经登记在所述处方安全网络程序中以利用所述规定的药物或产品; 以及基于所接收的医师识别符，确定与所述医师标识符相关联的医师已经登记在用于规定所述规定药物或产品的处方安全网络程序中; 以及响应于资格验证请求，由验证引擎产生批准授权。

14. 发明授权

US08321243B1 Systems and methods for the intelligent coordination of benefits in healthcare transactions 有权
标题翻译：智能协调医疗保健交易福利的系统和方法
公开(公告)号：US08321243B1
公开(公告)日：2012-11-27
申请号：US12705921
申请日：2010-02-15
申请人： Patrick Harris, Sr. , Roger Pinsonneault
发明人： Patrick Harris, Sr. , Roger Pinsonneault
IPC分类号： G06F19/00
CPC分类号： G06Q10/10 , G06F19/00 , G06F19/328 , G06Q50/22
摘要： Systems and methods are provided for the coordination of benefits. The systems and methods may include receiving a healthcare claim request from a healthcare provider computer; determining, based at least in part from patient information in the healthcare transaction claim request, that the patient is associated with at least a first payer and a second payer; generating a primary claim request based upon the identified product and the patient associated with the healthcare claim request, the primary claim associated with the first payer; and generating a coordination of benefits (COB) claim request based at least in part on the received first adjudicated reply associated with the primary claim request, the COB claim request, the COB claim request associated with a second payer.
摘要翻译：提供系统和方法来协调利益。所述系统和方法可以包括从医疗保健提供者计算机接收医疗保健要求请求; 至少部分地基于医疗保健交易申请请求中的患者信息来确定患者与至少第一付款者和第二付款者相关联; 基于所述识别的产品和与所述医疗保健要求请求相关联的患者生成与所述第一付款人相关联的所述主要请求的主要请求请求; 以及至少部分地基于与所述主要请求请求相关联的所接收到的第一裁决回复，所述COB请求请求，与第二付款者相关联的所述COB请求请求，生成所述利益协调（COB）请求。

15. 发明授权

US08036913B1 Systems and methods for prescription pre-fill processing services 有权
标题翻译：处方预处理服务的系统和方法
公开(公告)号：US08036913B1
公开(公告)日：2011-10-11
申请号：US12259309
申请日：2008-10-28
申请人： Roger Pinsonneault , Scott MacKenzie
发明人： Roger Pinsonneault , Scott MacKenzie
IPC分类号： G06Q50/00
CPC分类号： G06F19/3456 , G06F19/00 , G06F19/328 , G06Q10/087 , G06Q50/22 , G06Q50/24
摘要： Systems and methods may be provided for prescription pre-fill processing services, which may include receiving a pre-fill prescription claim request from a pharmacy computer; delivering the pre-fill prescription claim request to a claims processor; and receiving a first approved response from the claims processor, where the first approved response includes first financial coverage information. The systems and methods may also include delivering the first approved response to the pharmacy computer, where a prescription order of the drug or product is prepared for pickup by a customer, where the prepared prescription order is labeled in accordance with the first financial coverage information; delivering a prescription claim reversal request to the claims processor for a second adjudication; and receiving, by switch provider in accordance with the second adjudication, a second approved response that indicates a reversal of the first claim request, where the prepared prescription order of the drug or product remains ready for pickup by the customer.
摘要翻译：可以提供用于处方预填充处理服务的系统和方法，其可以包括从药房计算机接收预填写处方请求请求; 将预填写处方要求请求提交给索赔处理器; 以及从所述权利要求处理器接收第一批准的响应，其中所述第一批准响应包括第一财务覆盖信息。所述系统和方法还可以包括向药房计算机递送第一批准的响应，其中药物或产品的处方顺序准备好由客户拾取，其中根据第一财务覆盖信息标记准备的处方顺序; 向所述索赔处理者递交处方索赔转交请求以进行第二裁决; 以及根据所述第二裁判由交换机提供者接收指示所述第一请求请求的反转的第二批准响应，其中所述药物或产品的所述准备的处方顺序仍然准备好被所述客户接收。

16. 发明申请

US20110161109A1 SYSTEMS AND METHODS FOR PROVIDING ADHERENCE-BASED MESSAGES AND BENEFITS 审中-公开
标题翻译：用于提供基于偏差的消息和优点的系统和方法
公开(公告)号：US20110161109A1
公开(公告)日：2011-06-30
申请号：US12650759
申请日：2009-12-31
申请人： Roger Pinsonneault , Brian Bertha
发明人： Roger Pinsonneault , Brian Bertha
IPC分类号： G06Q50/00 , G06Q10/00 , G06Q30/00
CPC分类号： G06Q50/22 , G06Q50/24
摘要： Systems and methods may include receiving, from a healthcare provider computer, a first healthcare transaction that identifies a product to be dispensed, and a patient for receiving the product, the first healthcare transaction associated with a first date; determining that the product is associated with an adherence monitoring program; storing an association between the patient, the product to be dispensed, and the first date associated with the first healthcare transaction; receiving, from a healthcare provider computer, a second healthcare transaction that identifies the product to be dispensed, and the patient for receiving the product, the second healthcare transaction associated with a second date; determining a level of adherence to the patient specifications of the adherence monitoring program by comparing at least the second date associated with the second healthcare transaction to the first date associated with the first healthcare transaction; and delivering or directing a delivery of an adherence message that indicates the determined level of adherence to the patient specifications of the adherence monitoring program.
摘要翻译：系统和方法可以包括从医疗保健提供者计算机接收识别要分发的产品的第一保健交易和用于接收产品的患者与第一日期相关联的第一保健交易; 确定产品与遵守监控程序相关联; 存储患者，要分配的产品与与第一保健交易相关联的第一日期之间的关联; 从医疗保健提供者计算机接收识别要分配的产品的第二保健交易，以及用于接收产品的患者与第二日期相关联的第二保健交易; 通过将至少与第二保健交易相关联的第二日期与与第一保健交易相关联的第一日期进行比较来确定遵守遵守监控程序的患者规格的水平; 以及递送或指导附着消息的递送，其指示所述确定的依从性监视程序的患者规格的依从性水平。

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