McKesson Corporation
Systems and methods for determining product pricing for products in a healthcare transaction

Abstract:

Systems and methods are provided for determining and communicating proper pricing information and other pre- and post-adjudication information, such as an availability of a lower price for a prescription, as part of the processing of a healthcare transaction. A healthcare transaction, such as a healthcare claim transaction, may be received by the service provider computer from a pharmacy computer. The service provider computer may determine if an adjudication platform is available for the prescribed product. The service provider computer may generate a modified healthcare claim transaction and transmit the modified healthcare claim transaction to a claims processor computer for adjudication. The service provider computer may receive an approved adjudicated claim transaction response and perform any post-adjudication on the response. The approved adjudicated claim transaction response may be transmitted to the pharmacy.