Frederick E Howe

US Patent:

8069059, Nov 29, 2011

Filed:

Mar 12, 2009

Appl. No.:

12/403139

Inventors:

Frederick Howe - Rancho Santa Fe CA, US
William J. Barre - Escondido CA, US
Michael W. Lyon - Olivenhain CA, US

Assignee:

Medimpact Healthcare Systems, Inc. - San Diego CA

International Classification:

G06Q 50/00
G06Q 30/00

US Classification:

705 2, 705 3

Abstract:

A method is disclosed by which pharmacies and physicians are encouraged to select appropriate and effective medications but dissuaded from selecting higher priced medications where more economical versions are available as alternatives, but where physicians and patients can also select such higher priced medications if they so choose and are prepared to pay that higher price. Under this system a single representative price (capitation rate) is calculated by a prescription payment plan manager for a group of related medications, usually including both branded and generic, and that price is paid to a pharmacy for all prescriptions of that group of medications fulfilled under the plan. The representative prices for different groups, including their minimum levels, are periodically reviewed and updated as appropriate.

US Patent:

8265950, Sep 11, 2012

Filed:

Dec 18, 2008

Appl. No.:

12/338993

Inventors:

Frederick Howe - Rancho Santa Fe CA, US
Paul M. Momita - San Diego CA, US

Assignee:

MedImpact Healthcare Systems, Inc. - San Diego CA

International Classification:

G06Q 10/00
G06Q 50/00

US Classification:

705 2

Abstract:

A method of processing drug claims, by: (a) receiving a claim; (b) sorting the claim for processing by determining which processed drug list the claim belongs with; and then (c) processing the claim according to the particular processed drug list to which the claim belongs. A hierarchy of drug lists are used in a preferred order. If the drug is found on the first drug list, the system then moves directly to the processing stage. However, if the drug is not found on the first list, the system checks whether the drug is on the second drug list. If the drug is found on the second drug list, the system then moves directly to the processing stage, etc. Preferably, the drug list hierarchy is as follows: (i) home infusion drug list; (ii) drug only listed as a Medicare Part B drug list; (iii) drug listed as either Medicare Part B or D drug list; (iv) required special class drug list; (v) nebulized drug list; (vi) over the counter drug list; (vii) Medicare statutorily excluded non-Part D drug list; (viii) enhanced benefit system drug list; (ix) Medicare Part D or Medicare Part D covered under an enhanced benefit drug list, and (x) a vaccine drug list.

US Patent:

20070233516, Oct 4, 2007

Filed:

Apr 4, 2006

Appl. No.:

11/397928

Inventors:

Frederick Howe - La Jolla CA, US
William Barre - Escondido CA, US
Michael Lyon - Olivenhain CA, US

International Classification:

G06Q 10/00
G07G 1/00
G07G 1/14
G06F 17/00

US Classification:

705002000, 705014000, 705010000, 705400000

Abstract:

A method is disclosed by which pharmacies and physicians are encouraged to select appropriate and effective medications but dissuaded from selecting higher priced medications where more economical versions are available as alternatives, but where physicians and patients can also select such higher priced medications if they so choose and are prepared to pay that higher price. Under this system a single representative price (capitation rate) is calculated by a prescription payment plan manager for a group of related medications, usually including both branded and generic, and that price is paid to a pharmacy for all prescriptions of that group of medications fulfilled under the plan. The representative prices for different groups, including their minimum levels, are periodically reviewed and updated as appropriate.

US Patent:

20070250341, Oct 25, 2007

Filed:

Apr 20, 2006

Appl. No.:

11/408823

Inventors:

Frederick Howe - La Jolla CA, US
Dale Brown - Poway CA, US
John Tauber - San Diego CA, US

International Classification:

G06Q 10/00
A61B 5/00

US Classification:

705002000, 600300000

Abstract:

A method is disclosed whereby consumers enrolled in subscribing prescription benefit plans can easily obtain information over the Internet regarding costs and availability of their prescription medications at local and mail-order participating pharmacies of their choice, based on the prescription benefit plans of which they are members. Data on medication dosages, quantities and net costs at a plurality of pharmacies are compiled by the method and presented on-line so that each member of a plan can select the combination of cost and convenience for prescription fulfillment that he or she prefers. The method then allows the user to select prescription fulfillment directly from the selected pharmacy on-line. Other information,.such as general medical, medication and health information can also be made available. Patients, pharmacies, PBMs and plan payers all benefit.

US Patent:

20100057489, Mar 4, 2010

Filed:

Sep 3, 2008

Appl. No.:

12/203785

Inventors:

Frederick Howe - Rancho Santa Fe CA, US
Gregory G. Watanabe - Poway CA, US

International Classification:

G06Q 50/00
G06Q 40/00

US Classification:

705 2, 705 40

Abstract:

A method of operating a health care needs fulfillment system, by: (a) a PBM contracting with a plurality of health care suppliers to fulfill a plurality of health care needs requests; (b) end users sending individual health care needs requests to the PBM; (c) the PBM selecting the health care suppliers to supply each of the end users' individual health care needs requests; and (d) the PBM alerting the selected health care suppliers to fulfill the end users' individual health care needs requests.

US Patent:

20100217622, Aug 26, 2010

Filed:

Feb 23, 2009

Appl. No.:

12/390790

Inventors:

Dale R. Brown - Poway CA, US
William J. Barre - Escondido CA, US
Frederick Howe - Rancho Santa Fe CA, US

International Classification:

G06Q 50/00
G06Q 10/00
G06Q 40/00
G06F 17/30
G06F 15/16
G06F 3/048
G06Q 20/00
G06F 17/40

US Classification:

705 3, 705 2, 705 4, 709206, 715760, 707E17044

Abstract:

A method for electronically determining patient medical treatment eligibility, coverage, copayment amount and insurer billing, by: (a) a patient requesting medical treatment at a retail clinic; (b) the patient presenting a health insurance card at the retail clinic; (c) the retail clinic transmitting patient health insurance card information to a centralized adjudication facility; (d) the retail clinic transmitting medical treatment information to the centralized adjudication facility; (e) the centralized adjudication facility determining patient medical treatment coverage, eligibility and copayment amount (f) transmitting the patient medical treatment coverage, eligibility and copayment amount from the centralized adjudication facility to the retail clinic; (g) the patient purchasing the medical treatment by paying the retail clinic the copayment amount, (h) transmitting a bill to the health care insurance provider; and (i) thereby informing the retail clinic clinician to sell the medical treatment to the patient. By simultaneously billing the patient and the insurer, the present invention provides a system that processes the sale of the medical treatment as a sales transaction.

US Patent:

20220391858, Dec 8, 2022

Filed:

Aug 16, 2022

Appl. No.:

17/888880

Inventors:

- San Diego CA, US
William J. Barre - Escondido CA, US
Frederick Howe - Rancho Santa Fe CA, US

International Classification:

G06Q 20/04
G06Q 10/08
G06Q 20/14
G06Q 40/08
G06Q 10/10
G06Q 50/22
G16H 40/20
G16H 10/60

Abstract:

A method for electronically determining patient medical treatment eligibility, coverage, copayment amount and insurer billing simultaneously, by: (a) a patient requesting medical treatment at a retail clinic; (b) the patient presenting a health insurance card at the retail clinic; (c) the retail clinic transmitting patient health insurance card information to a centralized adjudication facility; (d) the retail clinic transmitting medical treatment information to the centralized adjudication facility; (e) the centralized adjudication facility determining patient medical treatment coverage, eligibility and copayment amount (f) transmitting the patient medical treatment coverage, eligibility and copayment amount from the centralized adjudication facility to the retail clinic; (g) the patient purchasing the medical treatment by paying the retail clinic the copayment amount, (h) transmitting a bill to the health care insurance provider; and (i) thereby informing the retail clinic clinician to sell the medical treatment to the patient.

US Patent:

20220344021, Oct 27, 2022

Filed:

Mar 18, 2022

Appl. No.:

17/698945

Inventors:

- San Diego CA, US
Dale R. Brown - Poway CA, US
Frederick Howe - Rancho Santa Fe CA, US

International Classification:

G16H 20/10

Abstract:

Systems, devices, non-transitory computer storage mediums, and methods are described herein for pharmaceutical benefits management including routing pharmaceutical claims over a computer network. The system includes a computer network and a client device communicatively coupled to the computer network. The client device is configured to receive order information representative of a prescription drug prescribed for a consumer. The system includes a communications switch configured to derive a processor control number associated with the order information and route the order information based on the processor control number. The system includes a pharmaceutical benefits manager configured to authorize the prescription drug with the reimbursement based on the processor control number and configured to transmit the authorization with the reimbursement to the client device.