Systems and methods for prescription price comparison across processors
AssigneeOptum, Inc.
InventorsHolly Calahan, Jason Grantham
Life of this patent
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AssigneeOptum, Inc.
InventorsHolly Calahan, Jason Grantham
Estimating the term…
A pharmacy claims switch is provided that allows pharmacy claims processors to determine the lowest cost for a prescription. A pharmacy submits a claim to the switch. The claim may be for a prescription for a patient and may identify a processor associated with the patient. The switch submits the claim to a third-party intermediary who submits the claim to the identified processor. The identified processor provides a response with a price for the patient. The third-party intermediary instructs the switch to submit follower claims to alternative processors. The switch receives responses from each alternative processor that includes a price the pharmacy should charge. Based on the prices in each response, the third-party intermediary selects the processor with the lowest price, and sends a response to the switch that identifies the selected processor. The pharmacy claims switch updates the pharmacy, which may present the best price to the patient.
A method comprising:
A pharmacy claims switch comprising:
A non-transitory computer-readable medium storing instructions that when executed by the at least one processor cause the at least one processor to:
Dependencies are inferred from the claim text.