Patent ID: 8190453

Claim:
A method for providing real time or near real time editing of prescription claim content prior to adjudication of a prescription claim, comprising: storing a plurality of pre-established prescription claim criteria associated with a payer system in memory, wherein the plurality of pre-established prescription claim criteria includes criteria previously submitted by the payer system to a host server computer system; receiving, at the host server computer system, a prescription claim from a pharmacy point-of-service (POS) device, wherein the prescription claim includes a plurality of prescription claim contents and wherein a portion of the prescription claim contents indicates that the prescription claim is directed to the payer; accessing, from the memory, the plurality of pre-established prescription claim criteria associated with the payer system; comparing, by the host server computer system, at least one of plurality of prescription claim contents to the plurality of pre-established prescription claim criteria associated with the payer system; determining, based on the comparison of at least one of the plurality of prescription claim contents to the plurality of pre-established prescription claim criteria associated with the payer system, that at least one of plurality of prescription claim contents should be compared to objective information accessible by the host server computer system and provided by at least one party other than the pharmacy associated with the pharmacy POS device or the payer; comparing, by the host server computer system, at least one of the plurality of prescription claim contents to the objective information; editing, by the host server computer system, at least one of the plurality of prescription claim contents in the prescription claim based on the comparison of at least one of the plurality of prescription claim contents to the objective information, wherein the editing modifies at least one of the plurality of prescription claim contents creating an edited prescription claim; and transmitting the edited prescription claim to the payer for subsequent adjudication.