McKesson Corporation
Systems and methods for determining and communicating information to a pharmacy indicating patient eligibility for an intervention service

Abstract:

Systems and methods are provided for determining and communicating intervention service opportunities, such as medication therapy management services, that may be available for a patient, as part of processing a healthcare claim transaction. A healthcare claim transaction, such as a prescription benefit request transaction, may be received by the service provider computer from a healthcare provider computer. The service provider computer may determine if an intervention service is available for the patient and if an available intervention service notification has been transmitted to the pharmacy computer prior to the service provider computer receiving the healthcare claim transaction. The service provider computer may receive an approved adjudicated response and generate a patient intervention service form corresponding to the available intervention service for the patient. The service provider computer may transmit the patient intervention service form to the pharmacy computer and receive a completed patient intervention service form from the pharmacy computer.