Patents by Inventor Heather D. Sundar

Heather D. Sundar has filed for patents to protect the following inventions. This listing includes patent applications that are pending as well as patents that have already been granted by the United States Patent and Trademark Office (USPTO).

  • Methods and systems for claim adjudication
    Patent number: 11127493
    Abstract: Methods and systems for claim adjudication are described. In one embodiment, a status of a drug benefit plan associated with a member is determined. Claims data associated with the member is accessed. A current-filled prescription is identified based on the claims data. At least one adjudication operation for the current-filled prescription is performed prior to receiving a new request for the current-filled prescription. The new request is determined as fillable based on the performance of the at least one adjudication operation. A notification is generated to the member based on the determination. Additional methods and systems are disclosed.
    Type: Grant
    Filed: August 30, 2019
    Date of Patent: September 21, 2021
    Assignee: Express Scripts Strategic Development, Inc.
    Inventors: John William Vandervoort, Heather D. Sundar, Michael Z. Chen, Adam W. Kautzner, Randy L. Canis
  • METHODS AND SYSTEMS FOR CLAIM ADJUDICATION
    Publication number: 20200013496
    Abstract: Methods and systems for claim adjudication are described. In one embodiment, a status of a drug benefit plan associated with a member is determined. Claims data associated with the member is accessed. A current-filled prescription is identified based on the claims data. At least one adjudication operation for the current-filled prescription is performed prior to receiving a new request for the current-filled prescription. The new request is determined as fillable based on the performance of the at least one adjudication operation. A notification is generated to the member based on the determination. Additional methods and systems are disclosed.
    Type: Application
    Filed: August 30, 2019
    Publication date: January 9, 2020
    Inventors: John William Vandervoort, Heather D. Sundar, Michael Z. Chen, Adam W. Kautzner, Randy L. Canis
  • Methods and systems for claim adjudication
    Patent number: 10438693
    Abstract: Methods and systems for claim adjudication are described. In one embodiment, a status of a drug benefit plan associated with a member is determined. Claims data associated with the member is accessed. A current-filled prescription is identified based on the claims data. At least one adjudication operation for the current-filled prescription is performed prior to receiving a new request for the current-filled prescription. The new request is determined as fillable based on the performance of the at least one adjudication operation. A notification is generated to the member based on the determination. Additional methods and systems are disclosed.
    Type: Grant
    Filed: December 28, 2011
    Date of Patent: October 8, 2019
    Assignee: Express Scripts Strategic Development, Inc.
    Inventors: John William Vandervoort, Heather D. Sundar, Michael Z. Chen, Adam W. Kautzner, Randy L. Canis
  • METHODS AND SYSTEMS FOR MEMBER MESSAGING
    Publication number: 20150032465
    Abstract: Methods and systems for improving therapy adherence are described. In an embodiment, a disease state associated with a member is identified. A member classification of the member is determined. The member classification may be based on past therapy the member received to treat a condition associated with the disease state. A diagnostic loop is selected based on the disease state associated with the member and the member classification. The diagnostic loop may include a plurality of operations. At least one of the plurality of operations of the diagnostic loop is performed. Other methods and systems are described.
    Type: Application
    Filed: July 1, 2014
    Publication date: January 29, 2015
    Inventors: Heather D. Sundar, David A. Tomala, Tina Lynn Bauman Butcher, Krista Lynn Theby, Robert F. Nease, JR., Katherine Harini Sundararaman
  • Methods and systems for member messaging
    Patent number: 8799204
    Abstract: Methods and systems for improving therapy adherence are described. In an embodiment, a disease state associated with a member is identified. A member classification of the member is determined. The member classification may be based on past therapy the member received to treat a condition associated with the disease state. A diagnostic loop is selected based on the disease state associated with the member and the member classification. The diagnostic loop may include a plurality of operations. At least one of the plurality of operations of the diagnostic loop is performed. Other methods and systems are described.
    Type: Grant
    Filed: December 20, 2011
    Date of Patent: August 5, 2014
    Assignee: Express Scripts, Inc.
    Inventors: Robert F. Nease, Jr., Katherine Harini Sundararaman, Heather D. Sundar, Krista Lynn Theby, Tina Lynn Bauman Butcher