1. A method of facilitating a request for prior authorization of insurance coverage for a prescribed drug, the method comprising:
receiving, with a computer over a communication network, a request to initiate preparation of the request for prior authorization;
based on data received over the communication network, identifying an appropriate submission protocol, from among a plurality of different submission protocols available to the computer, as having been approved by a party authorized to render a decision on the request for prior authorization for the prescribed drug;
transmitting content over the communication network to be utilized by a user computer for generating a user interface comprising a plurality of fields in which a user is to enter the patient-related information that is to be formatted into a desired format specific to the appropriate submission protocol as part of the request for prior authorization;
receiving the patient-related information entered into the plurality of fields in the user interface over the communication network; and
transmitting the patient-related information in a format compliant with the appropriate submission protocol to the deciding party authorized to render the decision on the request for prior authorization, wherein
the content transmitted to be utilized for defining the fields of the user interface presented to the user is to be used for generating the user interface to include common fields regardless of which of the plurality of different submission protocols is to be utilized, the different submission protocols including a standard submission and an ePA submission, providing a common user interface for use with each different submission protocols.
2. The method of claim 1, wherein said identifying the appropriate submission protocol comprises:
establishing a form, from a library of different forms available for submissions to request prior authorization for different prescription drugs, as a selected form to be submitted as part of the request for prior authorization for the prescribed drug; and
based on the selected form, selecting the appropriate submission protocol for that selected form from the plurality of different submission protocols to be used for different forms.
3. The method of claim 3, wherein said establishing the form comprises:
initiating a computer search of the library based on at least one of a name of the prescribed drug, a state in which the patient is insured, and an identity of an insurance provider; and
receiving a selection of the appropriate form from a search result by the user.
4. The method of claim 1, wherein said receiving the patient-related information comprises receiving the patient related information entered by the user into the fields of the user interface according to a standardized network communication protocol.
5. The method of claim 1, wherein said transmitting the patient-related information comprises assembling the patient-related information into a standardized data interchange file comprising the patient-related information in extractable form for electronic submission to the deciding party.
6. The method of claim 1 further comprising establishing a user account corresponding to the user, and updating the user account to indicate a status of the request for prior authorization.
7. The method of claim 6 further comprising:
receiving an unfavorable decision on the request for prior authorization;
updating the user account to reflect receipt of the unfavorable decision; and
transmitting content over the communication network to be utilized by the user computer to display an appeals interface to the user, the appeals interface comprising at least one field in which the user can specify supplemental information to be submitted to the deciding party as an appeal of the unfavorable decision.
8. The method of claim 1, wherein the different submission protocols further comprise an enhanced submission.
9. The method of claim 1, wherein a common user interface is utilized to elicit information to be submitted for requesting prior authorization of the prescribed drug and to elicit information to be included in other requests to be submitted: to request prior authorization of a plurality of different prescription drugs, andor to different deciding parties.
10. A computer system comprising:
a computer processor;
a network component for communicating with remotely-located computers over a communication network; and
a non-transitory, computer-readable medium programmed with computer-executable logic that, when executed, performs a method of facilitating a request for prior authorization of insurance coverage for a prescribed drug, the method comprising:
receiving, over the communication network using the network component, a request to initiate preparation of the request for prior authorization;
based on data received over the communication network, identifying an appropriate submission protocol, from among a plurality of different submission protocols available to the computer, as having been approved by a party authorized to render a decision on the request for prior authorization for the prescribed drug;
transmitting content over the communication network to be utilized by a user computer for generating a user interface comprising a plurality of fields in which a user is to enter the patient-related information that is to be formatted into a desired format specific to the appropriate submission protocol as part of the request for prior authorization;
receiving the patient-related information entered into the plurality of fields in the user interface over the communication network; and
transmitting the patient-related information in a format compliant with the appropriate submission protocol to the deciding party authorized to render the decision on the request for prior authorization, wherein
the content transmitted to be utilized for defining the fields of the user interface presented to the user is to be used for generating the user interface to include common fields regardless of which of the plurality of different submission protocols is to be utilized, the different submission protocols including a standard submission and an ePA submission, providing a common user interface for use with each different submission protocols.
11. The computer system of claim 10, wherein the computer-readable memory is further programmed with computer-executable instructions that, when executed, cause the computer system to identify the appropriate submission protocol by performing a method comprising:
establishing a form, from a library of different forms available for submissions to request prior authorization for different prescription drugs, as a selected form to be submitted as part of the request for prior authorization for the prescribed drug; and
based on the selected form, selecting the appropriate submission protocol for that selected form from the plurality of different submission protocols to be used for different forms.
12. The computer system of claim 10, wherein the network component receives the patient-related information entered by the user into the fields of the user interface according to a standardized network communication protocol.
13. The computer system of claim 10, wherein the computer processor assembles the patient-related information into a standardized data interchange file comprising the patient-related information in extractable form for electronic submission to the deciding party.
14. The computer system of claim 10, wherein the computer-readable memory is further programmed with computer-executable instructions that, when executed, cause the computer system to further establish a user account corresponding to the user, and updating the user account to indicate a status of the request for prior authorization.
15. The computer system of claim 14, wherein the computer-readable memory is further programmed with computer-executable instructions that, when executed, cause the computer system to perform additional steps comprising:
receiving an unfavorable decision on the request for prior authorization;
updating the user account to reflect receipt of the unfavorable decision; and
transmitting content over the communication network to be utilized by the user computer to display an appeals interface to the user, the appeals interface comprising at least one field in which the user can specify supplemental information to be submitted to the deciding party as an appeal of the unfavorable decision.
16. The computer system of claim 10, wherein the different submission protocols further comprise an enhanced submission.
17. The computer system of claim 10, wherein the computer-executable instructions, when executed, transmit content for a common user interface to be utilized to elicit information to be submitted for requesting prior authorization of the prescribed drug and to elicit information to be included in other requests to be submitted: to request prior authorization of a plurality of different prescription drugs, andor to different deciding parties.
The claims below are in addition to those above.
All refrences to claim(s) which appear below refer to the numbering after this setence.
1. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, that comprises a reservoir where an air pump or an electric or automated compressor that promotes the pressurization inside the reservoir is assembled, in the interior of it a pressure chamber is defined, in which water and a chemical concentrated product are contained, a tightly closed pressure chamber being provided with a trapping pipe connected outside the pipe provided with an actuating trigger of drive and a spraying nozzle at its opposite end, characterized by the fact that the reservoir (10) is only and exclusively designed for supplying water (Ag), and the chemical concentrated product(CCP) is contained in a tightly closed pliable container (12) subjected to the action of the internal pressures of the water reservoir (10); so that the same pressure defined inside the reservoir (10) is applied to the pliable container (12) simultaneously, the end of which is provided with an outlet connected to the inlet of a mixing device (20), which another inlet (22) connects to a trapping pipe inside the water reservoir (10) that goes through the interior of the mixing device and the outlet (30) which is connected through a pipe (24) to the hose provided with the actuating trigger (30) and spraying nozzle (27) disposed at its free end thereof.
2. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, according to claim 1, characterized by the fact that the pliable container (12) is assembled inside the reservoir (10) and it is submerged or not in the water (Ag), so that the reservoir (10) and the pliable container (12) define together a single pressure chamber of the spraying device.
3. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, according to the claim 1, characterized by the fact that the pliable container (12) is assembled inside a tightly closed housing (40) that is assembled outside the reservoir (10), but provided with an air inlet (41) that is connected to the reservoir (10) by a pipe, thus assuring a free fluid communication between the reservoir (10) and the housing (40) so that the pressure inside the latter one and the pressure of the reservoir (10) are the same.
4. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, according to claim 1 or 2 or 3, characterized by the fact that the pliable container (12) is tightly closed and having its outlet end is connected, by means of pipe (13) to the inlet (21) of a mixing device (20), whose another inlet (22) defines the trapping pipe inside the water reservoir (10); wherein the outlet (23) of the mixing device (20) is connected to an actuating trigger (30) through a pipe or a hose (24).
5. \u201cSAFE HANDLING SPRYING DEVICE\u201d, according to claim 1 or 2 or 3, characterized by the fact that the actuating lever (1) actuates on an air pump (2) that conveys the air (2) through the pipe (3) to a return valve (4) assembled on the internal side of the reservoir (10), so that the valve (4) allows the air to be injected into the water reservoir (10), pressurizing it.
6. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, according to claim 1 or 2 or 3, characterized by the fact that the mixing device (20) is provided with a screw (25) with a needle (21b) at the end that defines its calibrated inlet and it fits into a plug (21a) wherein the end of the output pipe (13) of the pliable container (12) is disposed, the flow of (CC) being fully stopped when the screw (25) is pressed against the plug (21a), making the outflow control of the (CC) possible
7. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, according to claim 1 or 2 or 3, characterized by the fact that the pliable container (12) is suspended from its upper end (16) on a cover (5) provided in the reservoir (10) where it is suspended, provided with a connecting nozzle (14) connected by a cover (15) to the output pipe (13).
8. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, according to the claim 7, characterized by the fact that the pliable container (12) may be replaced when it is empty, by detaching its upper end (16) from the cover (5) detaching the cover (15) from the connecting nozzle (14).
9. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, according to the claim 6, characterized by the fact that the orifice diameter of the plug (21a) and the needle diameter (21b) that is disposed at the tip of the screw (25) are sized differently to satisfy different viscosities of the (CCP) that will be used, and they may be changed.
10. \u201cSAFE HANDLING SPRAYING DEVICE\u201d, according to claim 1 or 6 or 7, characterized by the fact that the controlling device (20) is provided with several inlets which two or more different chemicals with different viscosities may be sprayed simultaneously.