发明名称 Systems & methods for pharmacy reimbursement claim resubmission
摘要 Systems, and methods for reimbursing prescription fulfillment that includes identifying a drug associated with a claim submitted by a pharmacy for reimbursement by a payer (e.g., insurance carrier) and identifying a change in a manufacturer set price associated with the drug. The invention includes monitoring reimbursed claims received from at least one payer, where one of the reimbursed claims received from the payer is associated with the drug and determining if the payer has updated its internal pricing value associated with the drug. The invention further includes generating a report that includes the payer's updated internal pricing value associated with the drug, and/or creating and submitting a reversal transaction to the at least one payer followed by a resubmission of the original claim, where the resubmitted claim value is based on the payer's updated internal pricing value associated with the drug.
申请公布号 US2006212318(A1) 申请公布日期 2006.09.21
申请号 US20060364987 申请日期 2006.02.28
申请人 DOOLEY CHERIE M;RUSSELL RITA S 发明人 DOOLEY CHERIE M.;RUSSELL RITA S.
分类号 G06Q40/00 主分类号 G06Q40/00
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