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US-12626308-B2 - Process and system for the management, storage and automation of health care information and application program interface therefor

US12626308B2US 12626308 B2US12626308 B2US 12626308B2US-12626308-B2

Abstract

This disclosure relates to technologies for optimizing of computer systems where the generation and transfer of digital information between a plurality of software, stored in a plurality of databases must be coordinated. More precisely, in the field of health care, the use of software patches in conjunction with highjack of unique protocol features using, for example an Application Programming Interface (API) or similar software modification to leverage transmission segments of a protocol to generate information and automated responses in a second software for use in a first as part of a system, used in a process and method of use thereof.

Inventors

  • Stephen Barrett CICHY
  • Markus Daniel BOCKLE
  • Courtney Brooke JACKSON

Assignees

  • Monarch Specialty Group, Inc.

Dates

Publication Date
20260512
Application Date
20241014

Claims (20)

  1. 1 . A method, comprising: serving, by a server, a web page generated based on a set of data, wherein the web page is served based on a rules engine: receiving a request associated with a profile from a switch through an Application Programming Interface (API) after the switch receives the request from a first application program hosted on a computing terminal, wherein the computing terminal hosts a second application program, wherein the first application program is a pharmacy management program, wherein the second application program is a browser program; generating a response to the request such that the response contains a field populated with a tokenized Uniform Resource Locator (URL) unique to the request; and sending the response through the API to the switch such that the switch sends the response to the first application program and the tokenized URL is activatable at the first application program to be opened by the second application program without any other login credentials to the rules engine to cause the rules engine to retrieve the set of data which is specific to the request, wherein the web page is served to the second application program such that the web page is displayed by the second application program, wherein the API converts the request between a National Council for Prescription Drug Programs (NCPDP) format and a structured format when the request is sent from the switch to the rules engine through the API and the response is sent from the rules engine to the switch through the API, wherein the API receives the request from the switch in the NCPDP format, wherein the rules engine receives the request from the API in the structured format, wherein the API receives the response from the rules engine in the structured format, wherein the switch receives the response from the API in the NCPDP format.
  2. 2 . The method of claim 1 , wherein the computing terminal is a first computing terminal, and further comprising: enabling a second computing terminal hosting a third application program to activate the tokenized URL sourced from the response.
  3. 3 . The method of claim 2 , wherein the first computing terminal is collocated with the second computing terminal.
  4. 4 . The method of claim 2 , wherein the first computing terminal is not collocated with the second computing terminal.
  5. 5 . The method of claim 1 , wherein the field is an Additional Message Information (AMI) field.
  6. 6 . The method of claim 5 , wherein the AMI field is a 526-FQ field.
  7. 7 . The method of claim 1 , wherein the web page is programmed to receive a user input from the second application program, wherein the user input enables a level of verification for the request via the rules engine.
  8. 8 . The method of claim 7 , wherein the level of verification involves validating a parameter associated with the request and the profile.
  9. 9 . The method of claim 7 , wherein the level of verification involves inputting a set of alphanumerics associated with the request and the profile.
  10. 10 . The method of claim 7 , wherein the level of verification involves inputting an attestation associated with the request and the profile.
  11. 11 . The method of claim 1 , wherein the web page contains an entry form programmed for inputting a set of information associated with the request, wherein the rules engine enables the tokenized URL to be a one-time use link to the entry form, wherein the tokenized URL is active for a limited period of time.
  12. 12 . A method, comprising: hosting, by a first server, a rules engine programmed to enable: a first computing terminal hosting a first application program, a second computing terminal hosting a second application program in communication with the first application program, a second server, an Application Programming Interface (API), and a switch to operate such that the switch sends a request associated with a profile to the rules engine after the switch receives the request from the first application program such that (i) the rules engine generates a response to the request where the response contains a field populated with a tokenized Uniform Resource Locator (URL) unique to the request, (ii) the rules engine sends the response to the switch, and (iii) the switch sends the response to the first application program such that the tokenized URL is activatable at the second application program to be opened by the second application program without any other login credentials to the rules engine to cause the rules engine to retrieve a set of data specific to the request and enable the second server to serve a web page generated based on the set of data to the second application program such that the web page is displayed by the second application program, wherein the first application program is a pharmacy management program, wherein the second application program is a browser program, wherein the API converts the request between a National Council for Prescription Drug Programs (NCPDP) format and a structured format when the request is sent from the switch to the rules engine through the API and the response is sent from the rules engine to the switch through the API, wherein the API receives the request from the switch in the NCPDP format, wherein the rules engine receives the request from the API in the structured format, wherein the API receives the response from the rules engine in the structured format, wherein the switch receives the response from the API in the NCPDP format.
  13. 13 . The method of claim 12 , wherein the field is an Additional Message Information (AMI) field.
  14. 14 . The method of claim 13 , wherein the AMI field is a 526-FQ field.
  15. 15 . The method of claim 12 , wherein the web page contains an entry form programmed for inputting a set of information associated with the request, wherein the rules engine enables the tokenized URL to be a one-time use link to the entry form, wherein the tokenized URL is active for a limited period of time.
  16. 16 . The method of claim 12 , wherein the web page is programmed to receive a user input from the second application program, wherein the user input enables a level of verification for the request via the rules engine.
  17. 17 . The method of claim 16 , wherein the level of verification involves validating a parameter associated with the request and the profile.
  18. 18 . The method of claim 16 , wherein the level of verification involves inputting a set of alphanumerics associated with the request and the profile.
  19. 19 . The method of claim 16 , wherein the level of verification involves inputting an attestation associated with the request and the profile.
  20. 20 . The method of claim 12 , wherein the first computing terminal and the second computing terminal are collocated with each other.

Description

CROSS-REFERENCE TO RELATED PATENT APPLICATIONS This patent application is a Continuation of U.S. Nonprovisional patent application Ser. No. 18/646,511 filed 25 Apr. 2024; which is a Continuation of U.S. Nonprovisional patent application Ser. No. 17/399,178 filed 11 Aug. 2021; which claims a benefit of priority to U.S. Provisional Patent Application 63/208,861 filed 9 Jun. 2021; each of which is hereby incorporated by reference for all purposes. TECHNICAL FIELD The present disclosure relates to a new system, and process for the optimization of computer systems where the generation and transfer of digital information between a plurality of software, stored in a plurality of databases must be coordinated. More precisely, in the field of health care, the use of software patches in conjunction with highjack of unique protocol features using, for example an Application Programming Interface (API) or similar software modification to leverage transmission segments of a protocol, such as the NCPDP v. D.0 Telecommunication Standard, to generate information and automated responses in a second software for use in a first as part of a system, used in a process and method of use thereof. BACKGROUND In the United States, there is no simple governmental health care or often called “single payer” socialized solution. As a result, individuals use multiple resources to help pay for their health care services and the associated prescriptions often for procurement at pharmacies. At one end of the spectrum of Americans, some are not insured (no primary) and can use cash to payment or rely on other type of safety nets. At the other end of the spectrum, luckiest users rely on some benefit from enrolment into Medicare® and Medicaid®, governmental run systems which often covers services and drugs in a similar way as many socialized systems (e.g. where secondary payments can exist from mutual services or a larger co-pay for elected and non-prescribed services). In the larger center of this spectrum, where most people are found, many have either employer-sponsored primary coverage, secondary coverage, or a complex system of primary and secondary insurances. To put things mildly, in the United States the system is very complex, hospitals and service providers often send bills that few users understand and insurances often write to customers in ways that fool even the best. In the United States, systems which help any type of process from the side of the user or from the angle of a pharmacist is a great improvement to social welfare and well-being. In today's complex mosaic of payment structures, technologies which facilitate portions of this process are not obvious as they would have been uncovered and used because of the financial incentive involved. Also, such technologies in this field are not abstract and are substantially more than what is currently in operation and existence as evidenced by the complexity of this system and the financial interests involved. A primary coverage, or primary insurance is often defined as the insurance coverage that pays out regardless of whether there are other insurance policies covering the same risk. Primary coverage as it is often described is contrasted with secondary coverage, which only pays out after a primary insurance policy has paid out. The secondary insurances pay some or all of the costs left after the primary insured has paid (e.g. deductibles, copayments, coinsurances). For example, primary coverage may reimburse 95% of a cancer treatment but only pay for 50% of services linked with home care related to the cancer. A secondary insurance would then serve, if possible, to pay out of pocket costs of the 5% of the main treatment and the other 50% of the rest. In addition to payment of deductibles, copayments, or coinsurance, in the United States multiple third parties have tried to play a role to help make their drugs and services more affordable and more available to users. Unlike normal products that are sold unregulated at the price fixed by the retailer or manufacturer, the price of drugs is highly regulated and a great subject of controversy. For example, some drug manufacturer offer such deals as “if you cannot afford [drug X], then [manufacturer X] can help.” As one can imagine, the payment of rebates is optimized when only a drug is not covered by a primary or secondary insurance or that certain unique conditions are in play. As a consequence, the process and system of placing rebates aka ‘coupons’ for certain drugs is highly complex. Each time, the system must run complex algorithms to make sure the benefits are due. For example, Hoffman et al. secured in 2011 U.S. Pat. No. 7,957,983 directed to a new method for using an “administrator” to help manage medication therapy management, adherence to programs, and the implementation of pharmacosurveillance programs. Using a central pivot third party, multiple issues unique with the world of legal drugs can be manages such as the contro