Patent ID: 8346570

Claim:
A method of using a computer to provide consistent drug pricing and medication prescription review for a plurality of pharmacies within a pharmacy network that have a contractual relationship with a managed care organization, the method comprising the steps of: transmitting a first medication prescription order over a communication network by a healthcare facility computer to a first pharmacy computer of a first of the plurality of pharmacies, wherein the healthcare facility is affiliated with a managed care organization (“MCO”); transmitting a second medication prescription order over the communication network by the healthcare facility computer to a second pharmacy computer of a second of the plurality of pharmacies; transmitting a first claim relating to the first medication prescription order over the communication network by the first pharmacy computer to a processing center computer of a prescription benefits manager contracted with the MCO; transmitting a second claim relating to the second medication prescription order over the communication network by the second pharmacy computer to the processing center computer; reviewing the first and second claims by the processing center computer according to predetermined claim review criteria for the drug pricing and the respective medication prescriptions; if either of the claims conform to the predetermined claim review criteria: transmitting over the communication network an approval notification for the respective claim by the processing center computer to the respective pharmacy computer, fulfilling the order for the respective prescription at the respective pharmacy, sending the fulfilled order from the respective pharmacy to the healthcare facility, and otherwise: transmitting a rejection notification and at least one basis for the rejection of the nonconforming claim over the communication network by the processing center computer to the respective pharmacy computer, correcting the non-conforming portion of the non-conforming claim at the respective pharmacy, transmitting the corrected claim over the communication network by the respective pharmacy computer to the processing center computer, repeating the step of reviewing the claim until the claim conforms to the predetermined claim criteria, and sending a filled respective prescription from the respective pharmacy to the healthcare facility; aggregating by the processing center computer a plurality of approved claims for each of the filled respective prescriptions, wherein the plurality of approved claims are aggregated for the healthcare facility; and transmitting an invoice for the aggregated claims over the computer network by the processing center computer to the healthcare facility computer.