Abstract: In accordance with some embodiments, an alternative system for processing a data packet received via a secure pharmacy prescription claim network is provided, in which data included in the data packet as received from a pharmacy system is modified prior to being routed to a PBM. The data packet may be modified such that a first BIN/PCN is replaced by a second BIN/PCN and a Consumer Price is added. The alternative system allows for a third party to act as a switchboard for prescription claims such that requests for prescription claims received from pharmacy systems are pre-adjudicated and data packets included in the requests are modified prior to being routed to a PBM selected by the third party.

Abstract: In accordance with some embodiments, an alternative system for processing a data packet received via a secure pharmacy prescription claim network is provided, in which data included in the data packet as received from a pharmacy system is modified prior to being routed to a PBM. The data packet may be modified such that a first BIN/PCN is replaced by a second BIN/PCN and a Consumer Price is added. The alternative system allows for a third party to act as a switchboard for prescription claims such that requests for prescription claims received from pharmacy systems are pre-adjudicated and data packets included in the requests are modified prior to being routed to a PBM selected by the third party.

Abstract: In accordance with some embodiments, an alternative system for processing a data packet received via a secure pharmacy prescription claim network is provided, in which data included in the data packet as received from a pharmacy system is modified prior to being routed to a PBM. The data packet may be modified such that a first BIN/PCN is replaced by a second BIN/PCN and a Consumer Price is added. The alternative system allows for a third party to act as a switchboard for prescription claims such that requests for prescription claims received from pharmacy systems are pre-adjudicated and data packets included in the requests are modified prior to being routed to a PBM selected by the third party.

Abstract: In accordance with some embodiments, an alternative system for processing a data packet received via a secure pharmacy prescription claim network is provided, in which data included in the data packet as received from a pharmacy system is modified prior to being routed to a PBM. The data packet may be modified such that a first BIN/PCN is replaced by a second BIN/PCN and a Consumer Price is added. The alternative system allows for a third party to act as a switchboard for prescription claims such that requests for prescription claims received from pharmacy systems are pre-adjudicated and data packets included in the requests are modified prior to being routed to a PBM selected by the third party.

Abstract: Methods and systems may be associated with an enhanced Health Saving Account (“HSA”) offered by an employer to a plurality of employees. An advance limit calculation platform may access information in a member data store that contains information associated with the plurality of employees. The member data store may include, for each employee, an employee identifier, a communication address, and employment characteristics that were received from an employer human resources system. The advance limit calculation platform may then calculate, for each employee, an advance limit based on the employment characteristics (e.g., salary information, a date of hire, payroll deduction availability, a number of dependents, etc.). The system may then arrange to transmit, to each employee via the communication address and a distributed communication network, enhanced HSA information including the calculated advance limit. Moreover, embodiments may provide a scoring model and/or purse amount for the enhanced HSA.

Abstract: In accordance with some embodiments, an alternative system for processing a request for a healthcare service is described. In accordance with some embodiments, the system obtains a diagnostic code and identifies one or more healthcare services, healthcare service providers and/or healthcare service facilities based on the diagnostic code and one or more additional data (e.g., a geographic location of a consumer and one or more terms of the consumer's healthcare benefit policy). The system may then output one or more offers to the consumer, at least one of the offers defining a reward to be provided to the consumer for selecting a healthcare service provider defined by the offer.

Abstract: In accordance with some embodiments, an alternative system for facilitating the purchase of prescription drugs by consumers allows for savings that may be realized by having the consumer pay a consumer price for a prescription drug that is based on a pharmacy reimbursement amount. In accordance with some embodiments, a plurality of prescription fulfillment offers are output to a consumer for different pharmacy locations and defining different consumer prices. In accordance with some embodiments, at least one of the offers defines a reward to be provided to the consumer (in exchange for going to a lower cost pharmacy location). Electronic prescription data is dynamically generated upon a consumer accepting one of the offers, the prescription data indicating a price list that was utilized to calculate the consumer price and allowing a claim processor to process the claim based on the consumer price defined by the accepted offer.