SYSTEMS AND METHODS FOR DETERMINING AND COMMUNICATING PATIENT ELIGIBILITY FOR AN INTERVENTION SERVICE

摘要

Systems and methods are provided for determining an intervention service to provide to a patient and communicating the determined intervention service opportunities to a healthcare provider as part of the processing of a healthcare transaction. A service provider computer may evaluate historical healthcare transaction data for a patient to determine if the patient should receive an intervention service and can store an indication to notify a healthcare provider about the intervention service. A healthcare transaction, such as a prescription billing transaction, may be received by the service provider computer from a healthcare provider computer. The service provider computer may determine if an intervention service has been identified for the patient. The service provider computer may generate a notification of the intervention service, append the notification to an adjudicated response to the healthcare transaction, and transmit the notification and adjudicated response to the healthcare provider computer.