Abstract: Medical benefit management systems and methods are disclosed herein. The system, in an embodiment, includes one or more data storage devices storing a plurality of instructions configured to be executed to perform a plurality of steps. The steps include receiving a provisioning request comprising a benefit specification from a first processor controlled by a product related entity; configuring a benefit processing business logic of the benefit processing system with the provisioning request; receiving a benefit submission from a second processor controlled by a dispensary entity or medical merchant; processing the benefit submission using the benefit processing business logic based on the benefit specification; generating a benefit transaction record related to the benefit submission; and displaying a first access interface to the product related entity and a second access interface to the dispensing entity, having different views to different portions of the benefit transaction record.

Abstract: Medical benefit fraud protection system and method are disclosed herein. The method, in an embodiment, performs the following steps: receiving a provisioning request from a first processor controlled by a product related entity, wherein the provisioning request comprises a benefit specification from the product related entity, including limitations of use; configuring a benefit processing business logic of the benefit processing system with the provisioning request; receiving a benefit submission from a second processor controlled by a dispensary entity; determining an approval decision or a denial decision of the benefit submission based on the limitations of use in the benefit specification; and processing or denying the benefit submission based on such determination.

Abstract: Medical benefit management systems and methods are disclosed herein. The system, in an embodiment, includes one or more data storage devices storing a plurality of instructions configured to be executed to perform a plurality of steps. The steps include receiving a provisioning request comprising a benefit specification from a first processor controlled by a product related entity; configuring a benefit processing business logic of the benefit processing system with the provisioning request; receiving a benefit submission from a second processor controlled by a dispensary entity or medical merchant; processing the benefit submission using the benefit processing business logic based on the benefit specification; generating a benefit transaction record related to the benefit submission; and displaying a first access interface to the product related entity and a second access interface to the dispensing entity, having different views to different portions of the benefit transaction record.