Kenneth J. Brown - Yorktown Heights NY, US William D. Tobin - Franklin Lakes NJ, US Glen D. Stettin - Upper Saddle River NJ, US Roselin Daniel - Randolph NJ, US
Assignee:
Medco Health Solutions, Inc. - Franklin Lakes NJ
International Classification:
G06Q 50/00 G06Q 40/00
US Classification:
705 2, 705 4
Abstract:
A system for constructing formularies is disclosed. The system includes a central computer system and at least one additional computer. The central computer system compiles a list of various pharmaceutical products and sorts them into different categories based on predetermined relational characteristics. The relational characteristics are based on therapeutic classifications of the pharmaceutical products, which in turn share these relational characteristics. Formularies are then created by selecting individual products and/or categories of products that the formularies would support. When prescription claims are received, coverage is either accepted or denied based on whether the products in die prescription claims are covered by the formulary.
Kenneth J. Brown - Yorktown Heights NY, US William D. Tobin - Franklin Lakes NJ, US Glen D. Stettin - Upper Saddle River NJ, US Roselin Daniel - Randolph NJ, US
Assignee:
Medco Health Solutions, Inc. - Franklin Lakes NJ
International Classification:
G06Q 50/00 G06Q 40/00
US Classification:
705 2, 705 4
Abstract:
An system for constructing formularies is disclosed. The system includes a central computer system and at least one additional computer. The central computer system compiles a list of various pharmaceutical products and sort them into different categories. Formularies are then created by selecting individual products or categories of products that will be covered. When prescription claims are received, coverage is either accepted or denied based on whether the products in the prescription claims are covered by the formulary.
Kenneth J. Brown - Yorktown Heights NY, US William D. Tobin - Franklin Lakes NJ, US Glen D. Stettin - Upper Saddle River NJ, US Roselin Daniel - Randolph NJ, US
Assignee:
Medco Health Solutions, Inc. - Franklin Lakes NJ
International Classification:
G06Q 50/00 G06Q 10/00
US Classification:
705 2, 705 3
Abstract:
An system for constructing formularies is disclosed. The system includes a central computer system and at least one additional computer. The central computer system compiles a list of various pharmaceutical products and sort them into different categories. Formularies are then created by selecting individual products or categories of products that will be covered. When prescription claims are received, coverage is either accepted or denied based on whether the products in the prescription claims are covered by the formulary.
Kenneth J. Brown - Yorktown Heights NY, US William D. Tobin - Franklin Lakes NJ, US Glen D. Stettin - Upper Saddle River NJ, US Roselin Daniel - Randolph NJ, US
Assignee:
Medco Health Solutions, Inc. - Franklin Lakes NJ
International Classification:
G06Q 50/00 G06Q 10/00
US Classification:
705 2, 705 3
Abstract:
An system for constructing formularies is disclosed. The system includes a central computer system and at least one additional computer. The central computer system compiles a list of various pharmaceutical products and sort them into different categories. Formularies are then created by selecting individual products or categories of products that will be covered. When prescription claims are received, coverage is either accepted or denied based on whether the products in the prescription claims are covered by the formulary.
Apparatus And Method For Constructing And Managing Clinical Rules
Kenneth Brown - Yorktown Heights NY, US William Tobin - Franklin Lakes NJ, US Glen Stettin - Upper Saddle River NJ, US Paul Brisson - Pelham Manor NY, US
Assignee:
Medco Health Solutions, Inc. - Franklin Lakes NJ
International Classification:
G06F017/60 A61B005/00
US Classification:
705/002000, 600/300000, 705/003000
Abstract:
An apparatus and method are disclosed for defining and managing clinical rules. A computer system provides access to administrators for defining and entering the details of clinical rules for various clients. The administrator selects the prescription products, or medication, for which the clinical rule will apply. The administrator also specifies the coverage criteria to be used for approving coverage of the prescription products. When a prescription claim is submitted to the computer system, the appropriate clinical rule is selected and applied to determine if the cost of the prescription product should be covered.
Mayo ClinicMayo Clinic Rochester Gonda 200 1 St SW, Rochester, MN 55905 5072842511 (phone), 5072841803 (fax)
Languages:
English
Description:
Dr. Tobin works in Rochester, MN and specializes in Neurology. Dr. Tobin is affiliated with Mayo Clinic Hospital-Rochester Methodist Campus and Saint Marys Hospital.
Jeffrey Albert, James Zimmermann, William Dearth, David Hyatt, Manuel Santaella, Leopoldo Aguilera, Charles Kirk, E Mccarthy, John Mcghee, Michael Weinberg, Fred Lawrence