Notice of Pre-AIA or AIA Status
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
DETAILED ACTION
In the amendments filed on 20 June 2025 the following has occurred: claims 1, 9 and 17-20 have been amended.
Now claims 1-20 are pending.
Claim Rejections - 35 USC § 101
35 U.S.C. 101 reads as follows:
Whoever invents or discovers any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title.
Claims 1-20 are rejected under 35 U.S.C. 101 because the claimed invention is directed to a judicial exception (i.e., a law of nature, a natural phenomenon, or an abstract idea) without significantly more.
Claims 1, 9 and 17 are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea without significantly more. The claims recite method, claims switch (i.e., a system), and a non-transitory computer-readable medium (CRM) for processing a claim. The limitations of:
Claim 1, which is representative of claims 9 and 17
[… obtaining …] a claim from a pharmacy […], wherein the claim identifies a claims processor and is associated with a patient; based on the identified claims processor, [… providing …] the claim to a third-party intermediary; halting or suspending, […], an existing claims processing workflow for the claim; [… obtaining …] from the third-party intermediary, an instruction to provide the claim to one or more alternative claims processors; for each of the one or more alternative claim processors, [… providing …] the claim to the alternative claims processor; for each of the one or more alternative claims processors, [… obtaining …] a response to the claim from the alternative claims processor; providing, […], each received response to the third-party intermediary; [… obtaining …] a response to the claim from the third-party intermediary; resuming, […], the existing claims processing workflow; and providing, […], the response from the third-party intermediary to the pharmacy prior to a timeout error for a connection with the pharmacy to process the claim using a single claim submission from the pharmacy, wherein the response from the third-party intermediary indicates one of the identified claims processor or the one or more alternative claims processors that will process the claim.
, as drafted, is a method, which, under the broadest reasonable interpretation, covers a method of organizing human activity (i.e., managing personal behavior including following rules or instructions) but for recitation of generic computer components. That is, other than reciting one or more processors and more memories, the claimed invention amounts to managing personal behavior or interaction between people, the Examiner notes as stated in in 2106.04(a)(2), “certain activity between a person and a computer… may fall within the “certain methods of organizing human activity” grouping”. For example, but for t one or more processors and more memories, the claim encompasses making a determination for a pharmacy on who will process and when to process a claim, by organizing data in a workflow between various entities. If a claim limitation, under its broadest reasonable interpretation, covers managing personal behavior or interactions between people but for the recitation of generic computer components, then it falls within the “method of organizing human activity” grouping of abstract ideas. Accordingly, the claim recites an abstract idea.
This judicial exception is not integrated into a practical application. In particular, the claim recites the additional elements of one or more processors and more memories, which implements the identified abstract idea. The one or more processors and more memories are recited at a high-level of generality (i.e., general purpose computers with processors and memory, performing/ implementing generic computer functions; see Applicant’s specification: Figure 3, paragraphs [0036]-[0040]) such that it amounts no more than mere instructions to apply the exception using generic computer components. Accordingly, this additional element does not integrate the abstract idea into a practical application because it does not impose any meaningful limits on practicing the abstract idea. The claim is directed to an abstract idea.
The claim recites the additional elements of “receiving… rerouting… sending…”. The “receiving… rerouting… sending…” steps are recited at a high level of generality (i.e., as a general means of receiving/transmitting data) and amounts to the mere transmission and/or receipt of data, which is a form of extra-solution activity. Accordingly, even in combination, these additional elements do not integrate the abstract idea into a practical application. The claim is directed to an abstract idea.
The claim does not include additional elements that are sufficient to amount to significantly more than the judicial exception. As discussed above with respect to integration of the abstract idea into a practical application, the additional elements of a computing device (claim 1), a processor with non-transitory CRM (claims 9 and 17), to perform the noted steps amounts to no more than mere instructions to apply the exception using a generic computer component. Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept (“significantly more”).
Also as discussed above with respect to integration of the abstract idea into a practical application, the additional elements of “receiving… rerouting… sending…” were considered extra-solution activity. The “receiving… rerouting… sending…” has been re-evaluated under the “significantly more” analysis and determined to amount to be well-understood, routine, and conventional elements/functions. As described in MPEP 2106.05(d)(II)(i) “Receiving or transmitting data over a network” is well-understood, routine, and conventional. Well-understood, routine, and conventional elements/functions cannot provide “significantly more.” As such the claim is not patent eligible.
Claims 2-8, 10-16 and 18-20 are similarly rejected because either further define the abstract idea and/or do not further limit the claim to a practical application or provide as inventive concept such that the claims are subject matter eligible.
Claims 2, 10 and 18 further describe data received, however do not recite any additional elements sufficient to provide a practical application/significantly more.
Claims 3-4, 11-12 and 19-20, further described who users are, however do not recite any additional elements sufficient to provide a practical application/significantly more.
Claims 5 and 13 recited making a selection, however do not recite any additional elements sufficient to provide a practical application/significantly more.
Claims 6-7 and 14-15 further describe the claim and a plurality of users, however do not recite any additional elements sufficient to provide a practical application/significantly more.
Claims 8 and 16 further described providing data to various users, however transmission of data over a network was already considered above and is incorporated herein.
Claim Rejections - 35 USC § 103
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action:
A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made.
The factual inquiries for establishing a background for determining obviousness under 35 U.S.C. 103 are summarized as follows:
1. Determining the scope and contents of the prior art.
2. Ascertaining the differences between the prior art and the claims at issue.
3. Resolving the level of ordinary skill in the pertinent art.
4. Considering objective evidence present in the application indicating obviousness or nonobviousness.
This application currently names joint inventors. In considering patentability of the claims the examiner presumes that the subject matter of the various claims was commonly owned as of the effective filing date of the claimed invention(s) absent any evidence to the contrary. Applicant is advised of the obligation under 37 CFR 1.56 to point out the inventor and effective filing dates of each claim that was not commonly owned as of the effective filing date of the later invention in order for the examiner to consider the applicability of 35 U.S.C. 102(b)(2)(C) for any potential 35 U.S.C. 102(a)(2) prior art against the later invention.
Claim(s) 1-20 are rejected under 35 U.S.C. 103 as being unpatentable over U.S. Patent Pub. No. 2021/0074401 (hereafter “Bezdek”), in view of U.S. Patent Pub. No. 20110029902 (hereafter “Bailey”), U.S. Patent App. No. 20120254291 (hereafter “Feldman”).
Regarding (Currently Amended) claim 1, Bezdek teaches a method for processing a claim using a single claim submission from a pharmacy (Bezdek: Figures 4-8, paragraph [0018], “a method to provide drug pricing to a pharmacy system for a drug requested by the user in a drug pricing environment”. Also see, paragraphs [0030] and [0512], for system and Non-transitory CRM, respectively), the method comprising:
receiving a claim from a pharmacy by one or more processors, wherein the claim identifies a claims processor and is associated with a patient (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0003], “prescription claims”, paragraph [0184]-[0188], “a system 600 that can be configured to receive a message from a pharmacy system 610 comprising a request for drug pricing… The pharmacy system 610 may include a router 612 and a database 614 to facilitate communications with the system 600”, paragraph [0197], “The BIN can be used to route electronic transactions from pharmacy systems 610 to the payer of the prescription, such as the PBM that the insurance pricing system 440 associated with the user's health plan has contracted with” paragraphs [0200]-[0202], “The pharmacy system 610 formats a data packet with the collected information to send to the system 600 for drug pricing information… The transmission from the pharmacy system 610 may comprise one or more of the following data fields”, paragraphs [0227]-[0228], “BIN… PCN”, [0277], “Patient ID”, paragraph [0478], “a drug pricing request to fill a prescription”. The Examiner notes BIN and PCN are claims processor identifiers in agreement with Applicant’s specification paragraph [0015]);
based on the identified claims processor, rerouting, by the one or more processors, the claim to a third-party intermediary (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0011], “The user's electronic claim is then routed to the system, which selects the appropriate PBM”, paragraphs [0200]-[0202], “The pharmacy system 610 formats a data packet with the collected information to send to the system 600 for drug pricing information”, paragraph [0012], “the system works with the multiple PBMs and a insurance pricing provider, which may be a PBM, a health insurance company or other third party provider of insurance pricing information… The user's electronic claim is then routed to the system, which may route the electronic claim to the insurance pricing provider”, paragraph [0478], “system 600 can communicate with the pharmacy system 610 through the API 630a. At block 802, the system 600 receives the data packet from the pharmacy system 610. The data packet may comprise the data fields in TABLE 2 according to the syntax of TABLE 1 and includes at least the unique BIN associated with the system 600 and a drug pricing request to fill a prescription. The transmission including the data packet from the pharmacy system 610 is routed according the BIN that the pharmacy system 610 retrieved from the user's unique set of identifiers”. Also see, paragraph [0441]. The Examiner notes as shown in at least Fig. 6, the data packet that comprises the claim is provided to the server which is a third-party intermediary between the pharmacy and claims processors, which teaches what is required under the broadest reasonable interpretation); […];
receiving, by the one or more processors from the third-party intermediary, an instruction to provide the claim to one or more alternative claims processors; for each of the one or more alternative claim processors, sending by the one or more processors the claim to the alternative claims processor; for each of the one or more alternative claims processors, […] a response to the claim from the alternative claims processor […]; (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0003], “Pharmacy Benefit Managers (PBMs) contract with pharmacies to provide prescriptions at negotiated prices”, paragraphs [0018], “execute specific instructions stored in the memory and comprises receiving from the pharmacy system a transmission comprising at least a routing identifier identifying the drug pricing system as a recipient of the transmission and a request for the drug pricing of the drug”, paragraph [0042], “obtaining through an interface, such as a first application programming interface (API), a first set of PBM prices for the drug from a first PBM, obtaining through an interface, such as a second API, a second set of PBM prices for the drug from a second PBM”, paragraph [0055], “obtaining a first set of PBM prices for the drug from a first PBM; obtaining a second set of PBM prices for the drug from a second PBM”, paragraph [0157], “the system 400 submits the insurance information, the NDC of the drug, the quantity of the drug, and pharmacy information to the adjudication API, and the API returns the price for the drug”, paragraph [0440], “the transmission from the pharmacy system 610 is routed to a switch. A switch is an entity that routes claims from the pharmacy system 610 to the destination, where the destination is indicated by the BIN. The switch receives the transmission from the pharmacy system 610 and routes the transmission to the destination specified by the BIN”. The Examiner notes the system may use instructions to route data to the alternative claims processors and receives the responses, which teaches what is required under the broadest reasonable interpretation); […];
receiving, by the one or more processors a response to the claim from the third-party intermediary; and providing, by the one or more processors, the response from the third-party intermediary to the pharmacy prior to a timeout error for a connection with the pharmacy to process the claim using a single claim submission from the pharmacy, wherein the response from the third-party intermediary indicates one of the identified claims processor or the one or more alternative claims processors that will process the claim (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0016], “If the user profile indicates that the user prefers the lower-cost drug price, the system returns to the pharmacy the lower of the insurance price or the lower PBM rate from the aggregated PBM drug pricing information”, paragraph [0055], “determining the lowest drug price for the drug based at least in part on the insurance price and the lower PBM rate; sending a digital alert comprising at least the lowest drug price to a user interface to notify the user”, paragraph [0066], “display drug prices from multiple PBMs and/or an insurance price provider”, paragraph [0086], “user interface can display a portion of the drug pricing information from the PBMs 190, and/or other information to the user… the user interface can display the price of the drug under the user's health plan”, paragraph [0107], “the system 200 displays the lowest price for each of the portion of pharmacies displayed… If there are two or more same lowest prices, the system 200 may select one to display arbitrarily or based on a variety of factors”, paragraphs [0114]-[0116], “The system 200 displays a portion of the pharmacies that satisfy the selected user options. In an embodiment, the system 200 displays all of pharmacies that satisfy the selected user options… The system 200 may choose to display only one price from a ranking process in the user interface 210 (e.g., highest ranked or lowest ranked price from the ranking process, etc.)”. The Examiner notes the data is provided “prior to a timeout error for a connection” as no timeout error is explicitly taught and selection of the lowest via ranking teaches what is required under the broadest reasonable interpretation).
Bezdek may not explicitly teach (underlined below for clarity):
for each of the one or more alternative claims processors, receiving by the one or more processors a response to the claim from the alternative claims processor; providing, by the one or more processors, each received response to the third-party intermediary;
Bailey teaches for each of the one or more alternative claims processors, receiving by the one or more processors a response to the claim from the alternative claims processor; providing, by the one or more processors, each received response to the third-party intermediary (Bailey: paragraph [0191], “user system submits the response to the publisher system, which in turn forwards the response to the third-party system in act 1655. In act 1660, the third-party system evaluates the response forwarded by the publisher system (e.g., to determine whether the response is valid) and provides an appropriate evaluation result to the publisher system”);
One of ordinary skill in the art before the effective filing date would have found it obvious to include forwarding a response received as taught by Bailey within the claim evaluation of various claim processors as taught by Bezdek with the motivation of “improve efficiency” (Bailey: paragraph [0151]).
Bezdek and Bailey may not explicitly teach (underlined below for clarity):
halting or suspending, by the one or more processors, an existing claims processing workflow for the claim; […]; resuming, by the one or more processors, the existing claims processing workflow; […] prior to a timeout error for a connection […].
Feldman teaches halting or suspending, by the one or more processors, an existing claims processing workflow for the claim; […]; resuming, by the one or more processors, the existing claims processing workflow; […] prior to a timeout error for a connection […] (Feldman: paragraphs [0023]-[0025], “Workflow management system executes actions, queues user actions for a user to view and complete, tracks and triggers timeouts, handles and reports execution errors… pause execution of the workflow”, paragraphs [0053]-[0056], “execution of the workflow is suspended by plan engine 40. In some embodiments, the plan may be restarted via a management console… information associated with the partially executed workflow plan allows plan engine 40 to unload the workflow plan until the user action (or some other event, time-out, etc.) occurs, at which time the partially executed plan stored in workflow execution history database 44 is reloaded into plan engine 40 for further execution. In addition, the transactional nature of the workflow execution history database 44 provides fault tolerance in the event of a workflow management system fault. Information stored in workflow execution history database 44 can be used to restore operations following a fault condition”).
One of ordinary skill in the art before the effective filing date would have found it obvious to use suspending and resuming workflows as well as timeout errors as taught by Feldman within the claim management and processing as taught by Bezdek and Bailey with the motivation of “improve the distribution and efficiency of workflow implementation” (Feldman: paragraph [0003]).
Regarding (Original) claim 2, Bezdek, Bailey and Feldman teach the limitations of claim 1, and further teach wherein the response from the third-party intermediary further indicates a price that the patient should pay the pharmacy for a prescription identified by the claim (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0016], “If the user profile indicates that the user prefers the lower-cost drug price, the system returns to the pharmacy the lower of the insurance price or the lower PBM rate from the aggregated PBM drug pricing information”, paragraph [0055], “determining the lowest drug price for the drug based at least in part on the insurance price and the lower PBM rate; sending a digital alert comprising at least the lowest drug price to a user interface to notify the user”, paragraph [0066], “display drug prices from multiple PBMs and/or an insurance price provider”, paragraph [0086], “user interface can display a portion of the drug pricing information from the PBMs 190, and/or other information to the user… the user interface can display the price of the drug under the user's health plan”, paragraph [0107], “the system 200 displays the lowest price for each of the portion of pharmacies displayed… If there are two or more same lowest prices, the system 200 may select one to display arbitrarily or based on a variety of factors”, paragraphs [0114]-[0116], “The system 200 may choose to display only one price from a ranking process in the user interface 210 (e.g., highest ranked or lowest ranked price from the ranking process, etc.)”).
The motivation to combine is the same as in claim 1, incorporated herein.
Regarding (Original) claim 3, Bezdek, Bailey and Feldman teach the limitations of claim 1, and further teach wherein the third-party intermediary is a pharmacy claims processor or a pharmacy benefits manager (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0003], “”Pharmacy Benefit Managers (PBMs) contract with pharmacies to provide prescriptions at negotiated prices to patients, paragraph [0012], “works with the multiple PBMs and a insurance pricing provider, which may be a PBM, a health insurance company or other third party provider of insurance pricing information”, paragraph [0076], “a PBM 190 may administer and/or process claims relating to drugs (e.g., prescription drugs)”, paragraph [0082], “the system 100 processes prescription drug claims and may communicate with a pharmacy's system”).
The motivation to combine is the same as in claim 1, incorporated herein.
Regarding (Original) claim 4, Bezdek, Bailey and Feldman teach the limitations of claim 1, and further teach wherein the identified claims processor is an insurance payor (Bezdek: Figures 1, 4-6, 8, 10-11, paragraphs [0012], “In addition to entering information about the prescription and a location, the user enters health insurance information”, paragraph [0017], “indicates that the user prefers to fill prescriptions using the prescription benefit plan of the insurance company”, paragraph [0020], “obtaining the insurance price from the insurance pricing system based on the insurance information of the user”, paragraph [0139], “Insurance pricing system 440 represents an entity, such as a PBM, health insurance provider associated with the users' health plan or the users' prescription benefit plan”).
The motivation to combine is the same as in claim 1, incorporated herein.
Regarding (Original) claim 5, Bezdek, Bailey and Feldman teach the limitations of claim 1, and further teach wherein the one or more alternative claims processors are selected by the third-party intermediary (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0007]-[0010], “the system may obtain, calculate, and/or estimate drug prices that are available under contracts or agreements between PBMs and various pharmacies… the system contracts with multiple PBMs such that the system can pass the PBM savings onto the users”, paragraphs [0011]-[0013], “The user's electronic claim is then routed to the system, which selects the appropriate PBM and PBM fee schedule to process the electronic claim and then routes the electronic claim to a specific PBM and PBM fee schedule to be processed at the selected price… The user's electronic claim is then routed to the system, which may route the electronic claim to the insurance pricing provider to be processed at the insurance price for that pharmacy, or select the appropriate PBM and PBM fee schedule to process the electronic claim at an unfunded rate and then routes the electronic claim to a specific PBM and PBM fee schedule to be processed at the selected price at that pharmacy”).
The motivation to combine is the same as in claim 1, incorporated herein.
Regarding (Original) claim 6, Bezdek, Bailey and Feldman teach the limitations of claim 1, and further teach wherein the claim includes an identifier of an insurance payor and further comprising selecting the third-party intermediary from a plurality of third-party intermediaries based on the identifier (Bezdek: Figures 1, 4-6, 8, 10-11, paragraphs [0139]-[0140], “the system 400 can communicate with multiple insurance pricing systems 440. Insurance pricing system 440 represents an entity, such as a PBM, health insurance provider associated with the users' health plan or the users' prescription benefit plan or other third party that provides insurance pricing to the system 400”, paragraph [0197], “The BIN can be used to route electronic transactions from pharmacy systems 610 to the payer of the prescription, such as the PBM that the insurance pricing system 440 associated with the user's health plan has contracted with” paragraphs [0200]-[0202], “The pharmacy system 610 formats a data packet with the collected information to send to the system 600 for drug pricing information… The transmission from the pharmacy system 610 may comprise one or more of the following data fields”, paragraphs [0227]-[0228], “BIN… PCN”).
The motivation to combine is the same as in claim 1, incorporated herein.
Regarding (Original) claim 7, Bezdek, Bailey and Feldman teach the limitations of claim 6, and further teach wherein the identifier is one or more of a BIN or a PCN (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0197], “The BIN can be used to route electronic transactions from pharmacy systems 610 to the payer of the prescription, such as the PBM that the insurance pricing system 440 associated with the user's health plan has contracted with” paragraphs [0200]-[0202], “The pharmacy system 610 formats a data packet with the collected information to send to the system 600 for drug pricing information… The transmission from the pharmacy system 610 may comprise one or more of the following data fields”, paragraphs [0227]-[0228], “BIN… PCN”).
The motivation to combine is the same as in claim 1, incorporated herein.
Regarding (Original) claim 8, Bezdek, Bailey and Feldman teach the limitations of claim 1, and further teach wherein the instruction to provide the claim to one or more alternative claims processors comprises a plurality of follower claims, wherein each follower claim is associated with one of the one or more alternative claims processors; and wherein, for each of the one or more alternative claim processors, sending the claim to the alternative claims processor comprises sending each of the plurality of the follower claims to an associated alternative claims processor (Bezdek: Figures 1, 4-6, 8, 10-11, paragraph [0092], “obtain the drug pricing information through an API. The PBM system 290A, 290B may provide an API, which includes functions that can be called by the system 200. The system 200 can call various functions to obtain relevant information … submitting information relating to drug name, form, dosage, quantity, pharmacy, etc. The National Drug Code (NDC)… the system 200 submits the NDC of the drug, the quantity of the drug, and pharmacy information to the mock adjudication API, and the API returns the price for the drug”, paragraphs [0126]-[0130], “the system 200 obtains a first set of prices for the first drug that is associated with a first PBM… at least one price in the first set of prices is obtained by performing of a mock adjudication of a claim relating to the first drug using an API provided by the first PBM… he system 200 obtains a second set of prices for the first drug that is associated with a second PBM… the at least one price in the second set of prices is obtained by performing of a mock adjudication of a claim relating to the first drug using an API provided by the second PBM”. The Examiner notes the information submitted via the API to each alternative claim processor reads on the follower claim, under the broadest reasonable interpretation).
The motivation to combine is the same as in claim 1, incorporated herein.
REGARDING CLAIM(S) 9 AND 17
Claim(s) 9 and 17 is/are analogous to Claim(s) 1, thus Claim(s) 9 and 17 is/are similarly analyzed and rejected in a manner consistent with the rejection of Claim(s) 1.
REGARDING CLAIM(S) 10-12 AND 18-20
Claim(s) 10-12 and 18-20 is/are analogous to Claim(s) 2-4, thus Claim(s) 10-12 and 18-20 is/are similarly analyzed and rejected in a manner consistent with the rejection of Claim(s) 2-4.
REGARDING CLAIM(S) 13-16
Claim(s) 13-16 is/are analogous to Claim(s) 5-8, thus Claim(s) 13-16 is/are similarly analyzed and rejected in a manner consistent with the rejection of Claim(s) 5-8.
Response to Arguments
Applicant's arguments filed 20 June 2025 have been fully considered but they are not fully persuasive. Applicants’ arguments will be addressed herein below in the order in which they appear in the response filed on 20 June 2025.
Rejections under 35 U.S.C. § 101
Regarding the rejection of claims 1-20, the Examiner has considered the Applicant’s arguments but does not find them persuasive. Any arguments inadvertently not addressed are unpersuasive for at least the following reasons:
Applicant argues:
Even assuming arguendo that claim 1 recites a judicial exception, claim 1 is not directed to an abstract idea under Prong Two, because the claim as a whole integrates the judicial exception into a practical application of the exception by improving a technical field… the claimed invention improves pharmacy claims processing systems by rerouting the claim and halting or suspending an existing claims processing workflow for the claim, so that the claim can be processed using a single claim submission from the pharmacy without the connection with the pharmacy timing out. In this manner, the claimed invention is able to communicate with multiple claims processors to obtain an optimal result from a single claim submission from the pharmacy… Applicant's specification at par. 2 explains… To address this issue, Applicant's specification at par. 3 states… Applicant's specification at par. 32 further explains… one of ordinary skill in the art would understand that typical Internet communications require a response within a particular time period or the request times out1. To address this problem, the specification explains that a switch halts or suspends the workflow, thereby preventing timeout. As a result, the switch has enough time to request responses from multiple claims processors to identify the claims processor providing the optimal response. Then the switch resumes the workflow and can respond to the request from the pharmacy without losing the connection with the pharmacy.
The Examiner respectfully disagrees.
It is respectfully submitted, that the argued limitations of “halting or suspending” and “resuming” of a workflow are not currently drafted as additional elements, these limitations as currently drafted amount to organization of a human user’s activity in a workflow, and are not additional elements capable of providing a technical improvement to a technical problem in Applicant’s specification. Furthermore, the argued paragraphs do not actually detail any technical problems rooted in computer communication technology, instead the agued paragraphs at best address human activity problems of price and human user productivity, however pricing and human user productivity are not a technical problem rooted in computer hardware technology, the claims may improve upon the abstract idea, nevertheless an improved abstract idea is still an abstract idea, as none of the claimed additional elements recite a technical solution to a technical problem recited in Applicant’s specification, the argument is not persuasive.
Rejections under 35 U.S.C. § 103
Regarding the rejections of claims 1-20, the Examiner has considered the applicant’s arguments; however, the arguments are not persuasive as addressed herein. The Examiner has attempted to address all of the arguments presented by the Applicant; however, any arguments inadvertently not addressed are not persuasive for at least the following reasons:
Applicant argues:
More specifically, as agreed upon during the interview, neither Bezdek nor Bailey, alone or in combination discloses "halting or suspending, by the one or more processors, an existing claims processing workflow for the claim," "resuming, by the one or more processors, the existing claims processing workflow," and "providing, by the one or more processors, the response from the third-party intermediary to the pharmacy prior to a timeout error for a connection with the pharmacy to process the claim using a single claim submission from the pharmacy."
The Examiner respectfully disagrees.
It is respectfully submitted, the amended limitation is taught by the combination of newly added Feldman as necessitated by amendment within the teachings of Bezdek and Bailey, and would be prima facie obvious to include with the motivation of “improve the distribution and efficiency of workflow implementation” (Feldman: paragraph [0003]), as such in view of the new grounds of rejection as necessitated by amendment the argument is not persuasive.
Conclusion
Applicant's amendment necessitated the new ground(s) of rejection presented in this Office action. Accordingly, THIS ACTION IS MADE FINAL. See MPEP § 706.07(a). Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a).
A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action.
Any inquiry concerning this communication or earlier communications from the examiner should be directed to Andrew E Lee whose telephone number is (571)272-8323. The examiner can normally be reached M-Th 9-5:00 PM.
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/A.E.L./Examiner, Art Unit 3684
/Shahid Merchant/Supervisory Patent Examiner, Art Unit 3684
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