James C Rowe

Address:

11114 Clayridge Dr, Tampa, FL 33635

Phone:

(727)5316784

VIN:

JM3ER293170157915

Make:

MAZDA

Model:

CX-7

Year:

2007

US Patent:

20020169955, Nov 14, 2002

Filed:

Apr 25, 2002

Appl. No.:

10/133001

Inventors:

Oliver Bryant - Rex GA, US
Scott Frazor - Amarillo TX, US
James Rowe - Sugar Hill GA, US

International Classification:

H04L009/00
G06F017/60

US Classification:

713/153000, 705/002000

Abstract:

Claim processing system providing an interface to permit pharmacy and medical management systems to use the Internet to transmit third-party insurance claims on a claim-by-claim basis in real-time or near-real-time to one or more claim servers that receive insurance claim requests over the Internet in an encrypted form. The one or more claim servers decrypt the claim requests and forward them to a health network application which facilitates the submission of the claims to insurance payers and the response of the insurance payers to the requests. Payer responses are received by the claim servers, encrypted and forwarded to the pharmacy and medical management systems in real-time or near real-time.

US Patent:

20030229519, Dec 11, 2003

Filed:

May 16, 2003

Appl. No.:

10/439423

Inventors:

Brian Eidex - Stockbridge GA, US
James Rowe - Sugar Hill GA, US

International Classification:

G06F017/60

US Classification:

705/002000

Abstract:

Systems and methods permit the identification of fraud and abuse in electronic prescription transactions by intercepting and analyzing prescription claims to determine the likelihood that a claim is fraudulent. A fraud scoring engine utilizes a compilation of expert rules and profiling engine methodologies to determine the likelihood that a transaction is the result of fraudulent or abusive behavior. The fraud scoring engine assigns a fraud score to rate the probability that a transaction is fraudulent in nature. The fraud score is compared against payer-defined business rules to determine if a claim is rejected as fraudulent. A fraud management interface enables payers to view a rejected claim and the reasons why a claim is rejected so that the reasons can be explained to a pharmacist, should the pharmacist contact the payer.

US Patent:

20070260486, Nov 8, 2007

Filed:

Apr 30, 2007

Appl. No.:

11/742235

Inventors:

Michael Urich - Suwanee GA, US
James Rowe - Sugar Hill GA, US

Assignee:

NDCHEALTH CORPORATION - Atlanta GA

International Classification:

G06Q 10/00
G06Q 40/00

US Classification:

705002000, 705035000

Abstract:

The invention is directed to systems and methods for monitoring, retrieving, and/or reporting a personal medical account balance such as an individual flexible spending account (FSA) balance. In an example of an embodiment of the invention the monitoring, retrieval, and/or display of the personal medical account balance may accompany the processing of a claim submitted by a healthcare provider (e.g., hospital, doctor's office, pharmacy, etc.) or vendor (e.g., retail store, drug store, etc.) to an insurance provider. In such embodiments, the monitoring, retrieval, and/or display of personal medical account balance may occur in real-time (or near real-time) with the submission of the claim.

US Patent:

20080208757, Aug 28, 2008

Filed:

May 2, 2008

Appl. No.:

12/114433

Inventors:

Oliver Ross Bryant - Rex GA, US
Scott N. Frazor - Amarillo TX, US
James Couser Rowe - Sugar Hill GA, US

Assignee:

McKesson Financial Holdings Limited - Hamilton

International Classification:

H04K 1/00

US Classification:

705 64

Abstract:

Claim processing system providing an interface to permit pharmacy and medical management systems to use the Internet to transmit third-party insurance claims on a claim-by-claim basis in real-time or near-real-time to one or more claim servers that receive insurance claim requests over the Internet in an encrypted form. The one or more claim servers decrypt the claim requests and forward them to a health network application which facilitates the submission of the claims to insurance payers and the response of the insurance payers to the requests. Payer responses are received by the claim servers, encrypted and forwarded to the pharmacy and medical management systems in real-time or near real-time.