Importance

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Abstract

Systems and methods are provided for providing prior authorization support. The systems and methods may include receiving a first request for prior authorization assistance from a pharmacy computer, wherein the request for assistance includes claim identification information for a prior healthcare claim transaction; identifying a stored transaction history record for the prior healthcare claim transaction, where the stored transaction record is identified based at least in part on the claim identification information, where the stored transaction history record indicates a denial of coverage by a payor of a drug or product for a patient; delivering, to a prior authorization assistance computer, a second request for prior authorization assistance, where the information included in the second request enables the prior authorization assistance computer to initiate a process for completing a prior authorization form and for delivering the completed form to the payor; and delivering, to the pharmacy computer, a response indicating acceptance of the first request for assistance.

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First Claim