Abstract: A method, apparatus and computer program product are provided for utilizing accumulation records to reduce a number of transactions occurring in a network. Aggregated quantities are calculated from at least a first quantity from a first sub-system and a second quantity from the second sub-system. Preliminary amounts may be reduced based on cap amounts less the aggregated quantity, and transmission of messages to certain sub-systems may be precluded. Accumulation records may be maintained by a service provider computer on an ongoing basis. The service provider computer forwards responses that reflect a reduced preliminary amount to a requesting computer that initiated a response.

Abstract: A system includes a gantry having an end-of-arm tool (EOAT). The gantry can include a first linear actuator that is configured to axially move the EOAT along a first axis and second linear actuator that is configured to axially move the EOAT along a second axis that is perpendicular to the first axis. The system can further include at least one input conveyor. Each input conveyor can have a plurality of pucks that are each configured to receive a prescription container and carry the prescription container to the gantry. The system can further include at least one output conveyor that is configured to receive the prescription container from the gantry. The gantry can be configured to move the prescription containers from the plurality of pucks to the output conveyor(s).

Abstract: Provided are methods, systems, and apparatuses for improving supply chain management interfaces and functionality. The supply chain management interfaces may provide visualizations of one or more standardization constructs associated with an organization and locations thereof. A standardization construct may be generated using supply chain records associated with the organization and locations thereof. The visualizations of the one or more standardization constructs may be adjusted at a user interface. The adjusted one or more standardization constructs may be indicative of ways in which the one or more standardization constructs may be improved.

Abstract: A method, apparatus and computer program product efficiently verify a transaction, such as an order, in accordance with a multi-stage verification process. In a method, data is extracted from an order submitted pursuant to a program having a plurality of verification qualifications. The method performs a first set of verification checks and, in an instance in which the first set of verification checks is satisfied, the method modifies the order to include a first indication of satisfaction of the first set of verification checks. The method also extracts data from a claim that is based upon the order. The claim includes the first indication that the first set of verification checks was satisfied. The method also performs a second set of verification checks based upon the data extracted from the claim and, in an instance in which the second set of verification checks is satisfied, the method submits the claim via an adjudication network for adjudication.

Abstract: A method, apparatus and computer program product provide for monitoring an adjudication network. In relation to a method, first information is caused to be provided by a request processor in response to an inquiry to be provided to a source. The method also receives an order including second information, different than the first information, from the source. The method further combines at least some of the second information with at least some of the first information to form an updated order and transmits the updated order to a supplier. Additionally, the method monitors the adjudication network, such as for a predefined period of time, to determine a status of the updated order and provides a notification to the source in response to the updated order having a predefined status.

Abstract: A configuration architecture is described. The configuration architecture may be in communication with a task management application to efficiently generate customized programs.

Abstract: Embodiments of the inventive technology may relate to a robotic pill dispensing system, whether puck-based or puck-free, configured to avoid delay during the filling of orders and achieve high, perhaps even maximal, order fill rates and associated processing efficiency. Additional embodiments of the inventive technology may relate to, inter alia, a bottle placement site that is different from a bottle pick-up site, a device configured to apply lodged pill clearance forces to counted pill reserve containers; counted pill reserve containers that are large enough to contain pills required by substantially all orders to be handled by a robotic dispensary; a method of dynamically repositioning medication-dedicated pill counters to increase processing speed and a system configured to facilitate the same; a robotic dispensary configured to allow manual operation when a robot is off-line; and a robotic dispensary configured to cover open, filled vials during transport thereof to prevent pill spillage.

Abstract: A method, computing device and computer program product generate a temporary password to control access to a record created in response to an electronic message. An electronic message is parsed to separately identify a plurality of fields that provide different types of information. Record(s) are accessed from a database that are associated with the information provided by at least one field. An action to be initiated by the electronic message is determined to either be taken or to be rejected based upon information provided by the field(s) of the electronic message and also based upon information from the record(s) accessed from the database. If the action is rejected, a record of the electronic message is created for transmission along with information regarding the rejection. A temporary password is also generated to control access to the record created regarding the electronic message and its rejection. The response includes the temporary password.

Abstract: A method, apparatus and computer program product are provided for providing rebate claim validation. A drug manufacturer or associated computer may receive rebate claims from pharmacy benefit managers (PBMs). The manufacturer should not be obligated to pay the rebate if the associated prescription drug was initially sold by the manufacturer under a discount program such as 340B. However, manufacturers may not be able to discern which rebate claims are associated with a discount program. A service provider utilizes adjudicated prescription claims from a contract pharmacy, and encounter data from a covered entity to validate the rebate claims and indicate to the manufacturer whether a rebate claim is associated with a discount program such as 340B.

Abstract: Provided are methods, systems, and apparatuses for improving supply chain management interfaces and functionality. A frequency of occurrence for each unique combination of a use attribute and a product attribute for various supplies may be determined. A frequency table containing each unique combination may be generated as well as one or more association rules. A level of confidence and a level of lift may be determined for each of the one or more association rules, both of which may be used to generate a score for each unique combination that may be used to rank each unique combination. The ranked unique combinations may then be provided to a supply chain management interface and a database.

Abstract: A method, apparatus and computer program product are provided for partitioning prescription transaction costs by determining offset savings amounts to be applied to prescription transactions, based on an adjudicated response from a payer computer. Prescription transactions received from a pharmacy are submitted in real time or near real-time for adjudication. Historical data associated with the patient and prescription is accessed to identify a target patient pay amount. Based on the benefit coverage and/or co-pay amount from the adjudicated response, an offset savings is determined in real-time or near real-time that will partition the prescription transaction cost such that the remaining patient pay amount is aligned with the target patient pay amount.

Abstract: A method, apparatus and computer program product are provided for providing a patient with prescribed medication cost information at a point of prescribing. A prescription benefit coverage inquiry is received and provided to a claims processor for processing. Historical data associated with prior prescription transactions is utilized to determine an estimated cost range of a prescribed medication in the event of an insufficient or absent response from a benefits manager. The estimated cost range is then provided to a prescriber to share with a patient. A targeted out-of-pocket cost according to incentives, such as vouchers and drug manufacturer rebates may also be provided.

Abstract: A method, apparatus and computer program product are provided for partitioning prescription transaction costs in an electronic prescription transaction by determining a credit amount to be applied to an adjudicated prescription claim, based on a co-pay amount provided by an adjudication computer, and a cash price obtained from a cash discount system. The remaining patient pay amount, which may be less than or equal to the cash price, may be transmitted to the pharmacy computer. The credit amount may be transmitted to the pharmacy computer or other third party computer.

Abstract: A method and apparatus for dispensing and retrieving products is provided. A system may include: a grasping head; first and second grasping members, each grasping member comprising: a top member; a post member; and first and second grasping fingers, where the first and second grasping fingers extend from the post member and are spaced apart from the top member by a predetermined distance, where the first and second grasping members are connected to the grasping head, where at least one of the first and second grasping members is movably connected to the grasping head, where the at least one of the first and second grasping members is movable relative to the other of the first and second grasping members.

Abstract: Systems and methods are provided for determining and communicating patient incentive information to a prescriber. The patient incentive information may adjust the patient copay amount for a prescribed medication. The patient incentive information may be determined by evaluating pharmacy identification information and medication identifiers in a received prescription benefit check transaction and/or adjudicated response to a healthcare transaction to determine if an incentive is available to be applied to the current transaction. The incentive amount may be retrieved and the patient copay amount in the adjudicated response may be amended prior to transmitting the adjudicated response to the prescriber of the medication.

Abstract: A method, apparatus and computer program product are provided for parsing a message received from a requesting computer to identify an indication of a transaction, an entity identifier, and an identifier of a first evaluation system. The entity identifier is evaluated based on historical data and/or eligibility data to determine an alternative evaluation procedure. The alternative evaluation procedure is preformed to obtain response information regarding the transaction, that may differ from response information otherwise obtained via the first evaluation system. A response to the message is constructed that includes the response information and is transmitted to the requesting computer.

Abstract: A method, apparatus and computer program product are provided for providing a patient with prescribed medication cost information at a point of prescribing. A prescription benefit coverage inquiry is received and provided to a claims processor for processing. Historical data associated with prior prescription transactions is utilized to determine an estimated cost range of a prescribed medication in the event of an insufficient or absent response from a benefits manager. The estimated cost range is then provided to a prescriber to share with a patient.

Abstract: An adjudicated prescription claim transaction response is received and includes a total amount paid by the claims processor, a patient pay amount, and the pharmacy's Usual and Customary Charge amount for a product/service. The adjudicated response can be evaluated to determine it was approved/paid and the total amount paid by the claims processor is zero or less. An income audit evaluation may be conducted by comparing the patient pay amount to the Usual and Customary Charge amount. Based on the Usual and Customary Charge amount being less than or less than or equal to the patient pay amount, a reversal transaction can be generated and transmitted to a claims processor computer for adjudication. Further, the adjudicated prescription claim transaction response can be converted from an approved/paid response to (or replaced by) a rejected adjudicated prescription claim transaction response and transmitted to the pharmacy computer that initiated the prescription claim transaction.

Abstract: An improved alternative therapy identification system increases the efficiency for obtaining information for alternative therapies. The alternative therapy identification system automates alternative therapy identification information from both a product level and a drug cost level. The improved alternative therapy identification system may also increase the efficiency by improving alternative therapy selection to occur at the prescriber level.

Abstract: Embodiments are disclosed for improved data modeling in a relational database management system. In the context of a method, an example embodiment includes ingesting, by data ingestion circuitry and using a set of standardized plumbing fields comprising descriptive fields including at least a stage table primary key field, a source primary key field, and a source attribute field, one or more records into one or more stage tables in a staging layer. This example embodiment further includes generating, by data modeling circuitry and using the one or more stage tables in the staging layer, a data integration layer for modeling data represented by the data ingested into the one or more stage tables in the staging layer. Corresponding apparatuses and computer program products are also provided.