Systems and methods for conversions of denied transactions...

Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management

Reexamination Certificate

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C705S002000, C705S004000

Reexamination Certificate

active

08036918

ABSTRACT:
Systems and methods may be provided for claim denial conversion. The systems and methods may include receiving a prescription claim from a pharmacy, where the prescription claim is associated with a drug or other product requested by a customer, routing the prescription claim to a claims processor for adjudication, and receiving, from the claims processor, a denied claim response for the claim request. The systems and methods may further include determining that funding is available to cover at least a portion of a price of the requested drug or other product, converting the denied claim response to an approved claim response upon determination of the available funding, and transmitting the approved claim response to the pharmacy.

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