Systems and methods for copay adjustments

Details Systems and methods for copay adjustments Systems and methods for copay adjustments

2011-03-22

2011-03-22

Koppikar, Vivek D (Department: 3686)

Data processing: financial, business practice, management, or co

Automated electrical financial or business practice or...

Insurance

C705S002000, C705S003000, C705S014250, C600S300000, C600S301000

Reexamination Certificate

active

07912741

ABSTRACT:
Systems and methods may provide for copay adjustment. The systems and methods may include receiving a claim request from a pharmacy computer, where the claim request may be associated with a product requested by a customer, transmitting the claim request to a claims processor for adjudication, and receiving, from the claims processor, a first claim response for the claim request, where the first claim response may include a current copay amount payable by the customer. The systems and methods may also include determining, based upon a historical claim transaction record associated with the customer, that a prior copay amount for the drug is less than the current copay amount, and transmitting a second claim response to the pharmacy computer with a new copay amount lower than the current copay amount of the first claim response.

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