US 12,229,833 B1
Method, apparatus, and computer program product for reformatting an electronic prescription transaction
Phillip Draa, Atlanta, GA (US); and Jared Burdine, Dunwoody, GA (US)
Assigned to MCKESSON CORPORATION, Irving, TX (US)
Filed by McKesson Corporation, Irving, TX (US)
Filed on Feb. 18, 2022, as Appl. No. 17/675,616.
Application 17/675,616 is a continuation in part of application No. 16/792,413, filed on Feb. 17, 2020, granted, now 11,610,240.
Int. Cl. G06Q 40/08 (2012.01); G06Q 30/00 (2023.01); G06Q 30/0283 (2023.01)
CPC G06Q 40/08 (2013.01) [G06Q 30/0283 (2013.01)] 8 Claims
OG exemplary drawing
 
4. A method comprising:
receiving an indication of a prescription transaction comprising a patient identifier identifying a patient, a prescription identifier identifying a drug, and benefit information associated with a first adjudication computer to which the prescription transaction is directed;
in real-time or near real-time relative to receiving the indication of the prescription transaction:
determining the prescription transaction is denied or predicted to likely be denied based on a requirement for prior authorization;
in response to determining the prescription transaction is denied or predicted to likely be denied based on the requirement for the prior authorization, determining a cash price of the drug;
further in response to determining the prescription transaction is denied or predicted to likely be denied based on the requirement for the prior authorization, determining a credit amount to be applied to the cash price;
reformatting the prescription transaction to a format that indicates a cash transaction and the credit amount; and
redirecting the prescription transaction and causing transmission of the reformatted prescription transaction including the indication of the cash transaction and the credit amount to a second adjudication computer, different than the first adjudication computer.