公开(公告)号：US20160055314A1

公开(公告)日：2016-02-25

申请号：US14559620

申请日：2014-12-03

Applicant: Surescripts LLC

Inventor： Todd M. Anderson ,  Bradley C. Simons ,  Keith E. Willard ,  Mark A. Gingrich ,  Ryan D. Hess

IPC: G06F19/00 ,  H04L12/24 ,  G06F3/0484 ,  G06F17/30

CPC classification number: G06F19/3456 ,  G06F19/328 ,  G16H10/20

Abstract: Methods, systems, and apparatuses are described for facilitating the delivery of an electronic prior authorization (ePA). Unique systems for facilitating the delivery of an ePA by an ePA provider system to an ePA requestor system and for modeling the state of an ePA request/response process are provided. A user interface (UI) generation component for dynamically generating a UI for presentation to a user is also provided. Methods corresponding to the functions performed by the systems and apparatuses are also provided.

Abstract translation: 描述了用于促进电子预先授权（ePA）的递送的方法，系统和装置。 提供了用于促进由ePA提供者系统向ePA请求者系统传送ePA以及用于对ePA请求/响应过程进行建模的独特系统。 还提供用于动态生成用于呈现给用户的UI的用户界面（UI）生成组件。 还提供了与由系统和装置执行的功能相对应的方法。

公开(公告)号：US11652731B2

公开(公告)日：2023-05-16

申请号：US17366569

申请日：2021-07-02

Applicant: Surescripts, LLC

Inventor： Thomas K. Skelton ,  Jeffrey B. Sponaugle ,  Andrew Mellin ,  Keith Willard

IPC: H04L45/122 ,  H04L47/52 ,  H04L45/302 ,  H04L45/42

CPC classification number: H04L45/122 ,  H04L45/306 ,  H04L45/42 ,  H04L47/522

Abstract: Methods for dynamic routing of queued network-based communications using real-time information and machine learning are performed by systems and devices. Requests associated with fulfillments are received over a network from requestor systems, and the requests are queued in a data structure of a queue. Information that includes geolocation information from a user device of a user that is associated with the fulfillment, temporal information from the user device, or related request information associated with another request is then received over the network, and a fulfiller and a fulfillment time for the fulfillment are determined from the information. The request is provided from the queue to the fulfiller at the fulfillment time over the network.

公开(公告)号：US20220006724A1

公开(公告)日：2022-01-06

申请号：US17366569

申请日：2021-07-02

Applicant: Surescripts, LLC

Inventor： Thomas K. Skelton ,  Jeffrey B. Sponaugle ,  Andrew Mellin ,  Keith Willard

IPC: H04L12/733 ,  H04L12/717 ,  H04L12/725 ,  H04L12/873

Abstract: Methods for dynamic routing of queued network-based communications using real-time information and machine learning are performed by systems and devices. Requests associated with fulfillments are received over a network from requestor systems, and the requests are queued in a data structure of a queue. Information that includes geolocation information from a user device of a user that is associated with the fulfillment, temporal information from the user device, or related request information associated with another request is then received over the network, and a fulfiller and a fulfillment time for the fulfillment are determined from the information. The request is provided from the queue to the fulfiller at the fulfillment time over the network.

公开(公告)号：US12253986B1

公开(公告)日：2025-03-18

申请号：US18342455

申请日：2023-06-27

Applicant: Surescripts, LLC

Inventor： Norman S. Adams ,  Vareck Shawn Bostrom

IPC: G06F16/215 ,  G06F16/27 ,  G06F16/28

Abstract: Methods, systems, apparatuses, and computer program products for building records from false positive matches are disclosed. A master record is identified that incorrectly groups a plurality of source records in a database, where the plurality of source records contain demographic information for multiple people. In the database, a first record, a second record, and exclusion data are created, where the first and second records contain demographic information for each person and the exclusion data indicates that the first record should not be linked to the second record. A matching criteria is applied to each record of a collection of source records that includes the first and second records and the plurality of source records to identify a set of connections. The first record and the second record are built based at least on the set of connections and stored in the database.

公开(公告)号：US20160188820A1

公开(公告)日：2016-06-30

申请号：US14986064

申请日：2015-12-31

Applicant: Surescripts LLC

Inventor： Melissa M. Brown ,  Santosh N. Kalkar ,  Shannon E. Olson

IPC: G06F19/00

CPC classification number: G06F19/328

Abstract: Methods, systems, and apparatuses are described for real time benefit check (RTBC). Described method, system, and apparatus embodiments are provided to enable real-time request/response transactions initiated by a prescriber to a pharmacy benefits management (PBM). The described embodiments enable RTBC transactions that may be request/response transactions to provide the requester with formulary and coverage status and estimated patient cost for a patient and drug within a fulfillment method such as retail pharmacy, 90 day supply retail pharmacy, or mail order pharmacy.

Abstract translation: 描述了用于实时利益检查（RTBC）的方法，系统和装置。 提供了描述的方法，系统和装置实施例，以使处方者对药房利益管理（PBM）发起的实时请求/响应交易。 所描述的实施例使得RTBC交易可以是请求/响应交易，以在满足方法（例如零售药店，90天供应零售药店或邮购药店）内向患者和药物提供处方和覆盖状态以及患者和药物的估计患者成本 。

公开(公告)号：US20230085426A1

公开(公告)日：2023-03-16

申请号：US17476721

申请日：2021-09-16

Applicant: Surescripts, LLC

Inventor： Joseph Jerome Athman ,  Jeffrey Paul Larsen ,  Michael James Androff ,  Matthew Alen Bates ,  Eric James Mulek ,  Kelly Frances Bundy

IPC: G16H10/60 ,  G06F16/9035 ,  G06F16/9038

Abstract: Systems, methods, and devices are described for efficient and intelligent source reductions for querying multiple sources over an external network. A medical history request for a patient is received from a requestor via a network. A set of providers is identified from a provider database based at least on the history request, and a set of physical addresses is generated based at least on the set of providers. The set of physical addresses are filtered according to filter criteria to generate a filtered set of physical addresses. Computing systems, of respective providers, which respectively correspond to the filtered set of physical addresses are queried over an external network to generate a query result that includes history information for the patient and that is representative of querying each computing system associated with the unfiltered set of physical addresses.

公开(公告)号：US10964430B2

公开(公告)日：2021-03-30

申请号：US15153147

申请日：2016-05-12

Applicant: Surescripts LLC

Inventor： Keith Willard ,  Brad Simons

IPC: G16H40/63 ,  G16H40/67 ,  G06F9/445

Abstract: Systems and methods, as well as devices, are described for computer system compatibility. Computer systems exchange messages over a network or communication link according to a communication standard. A declarations of how a communication standard is implemented by a trading partner computer system is received by a host provider computer system, and an ontology model of the implementation is generated based at least in part on information in the declaration. The ontology models are queried to cause the provision of query responses indicative of differences between the trading partner implementation and a host provider implementation of the communication standard. Indications of communication compatibility between the computer systems are generated based on results of the queries against the ontology model. The indications may include augmented enforcement libraries to be implemented by the trading partner for messaging interoperability.

公开(公告)号：US20240370873A1

公开(公告)日：2024-11-07

申请号：US18312992

申请日：2023-05-05

Applicant: Surescripts, LLC

Inventor： Bradley Carter Simons ,  Robert Driskill

IPC: G06Q20/40

Abstract: Methods, systems, apparatuses, and computer program products for discovering fraudulent account usage are disclosed. In an example, a database is queried to identify a list of accounts and transaction categories. A first table is generated based on the transaction categories. A second table is generated by populating the first table based on a response to querying the database for a first set of historical transactions over a first period of time. A third table is generated by populating the first table based on a response to querying the database for a second set of historical transactions over a second period of time. A measure of similarity for each of the accounts is generated based on the second table and the third table. For each account with a corresponding measure of similarity below a threshold, the account is identified as a fraudulent account candidate.

公开(公告)号：US20240273540A1

公开(公告)日：2024-08-15

申请号：US18486705

申请日：2023-10-13

Applicant: Surescripts, LLC

Inventor： Andrew Foster Mellin ,  Todd Michael Anderson

IPC: G06Q20/40

CPC classification number: G06Q20/405

Abstract: Methods, systems, and apparatuses are described for filtering a transaction over a network, according to embodiments. In an example system, a transaction request is retrieved over a network. A model that is configured to predict a likelihood associated with automatic adjudication of transactions is accessed. Based at least on the transaction request and the model, a likelihood that the transaction request can be adjudicated automatically is determined. If the likelihood that the transaction request can be adjudicated automatically is above a threshold, one or more actions are performed, such as generating an indication that a portion of the transaction request can be adjudicated automatically or generating an automatic adjudication indicating whether the transaction request should be approved. In response to generating the indication or the automatic adjudication, the transaction request and the indication or the automatic adjudication are forwarded over the network to an endpoint associated with the transaction request.

公开(公告)号：US20220399086A1

公开(公告)日：2022-12-15

申请号：US17342973

申请日：2021-06-09

Applicant: Surescripts, LLC

Inventor： Bradley Carter Simons ,  Robert Driskill ,  Andrew Mellin

IPC: G16H10/20 ,  G06F16/36 ,  G06F16/33 ,  G06F16/35 ,  G06N20/00 ,  G16H10/60 ,  G16H50/20 ,  G16H30/20 ,  G06F40/30

Abstract: Systems, methods, and devices are described for classifying and answering medical inquiries based on machine-generated data resources and machine learning models. A CCDA document including clinical information and observations of a patient are received from a requestor and utilized to generate a FHIR model instance specific to the CCDA document. Question text having medical inquires for the patient, and received with the CCDA document, is processed by a machine learning model to determine question categories for the medical inquiries which are utilized to map the inquires to objects of the model instance using another machine learning model. The model instance is queried based on the mapping to return values associated with the inquiries. The values are transmitted back to the requestor.