JP2019197440A - Batch management billing device, batch management billing method, and batch management billing program - Google Patents

Abstract

To centralize billing for service provision to reduce the complexity of a billing procedure, and ensure withdrawal of billed charges.SOLUTION: A batch management billing device receives data associating service contents with charges of the services from service providers, writes it in a table within a database, refers to the database, aggregates charges for each service provider and for each service receiver, presents it to each service receiver, automatically withdraws the total of charges aggregated for each service receiver from each service receiver's account, and automatically transfers the total of the charges aggregated for each service provider to each service provider's account.SELECTED DRAWING: Figure 1

Description

  The present invention collectively manages medical billing for home medical care in addition to regional comprehensive care costs, placement medicine costs, prescription drug charges, food charges, diaper charges, which are incurred when placement medicine companies perform community comprehensive care, The present invention relates to a collective management bill processing apparatus, a collective management bill processing method, and a collective management bill processing program for billing a care recipient and a patient.

  As the baby boomer generation in Japan is over the age of 2025, and the social problem of an aging society, the Ministry of Health, Labor and Welfare seems to be a self in an area where it has become accustomed to live even if it is in a severe care-necessary state. The goal is to build a comprehensive community care system that provides housing, medical care, nursing care, prevention, and daily life support so that you can continue your life to the end of your life.

    For this reason, the number of nursing care workers has more than doubled in the past few years, and the corresponding industries are also increasing. In the future, in the medical and nursing care-related business, new services and industry diversification will progress based on the field of expertise, and competition in each field is expected to intensify.

  Service recipients who enjoy medical and long-term care services repeatedly meet with diversified services through repeated meetings with doctors and care managers who plan long-term care plans so that the best services can be provided for them as they age. It is assumed that they will be exposed to a complicated mechanism in which it is required to select and combine them.

  Looking at the current medical / nursing care market, more than half of them are recognized as cognitive impairments, and in order to enjoy the above complicated services, complicated processing is required.

  In fact, even today, consideration payments for various services are distributed for each service, and transfer procedures and automatic payment procedures are also difficult and difficult for the elderly.

    Therefore, when considering measures to improve the quality of life in Japan, which is facing an aging society, that is, measures for quality of life, it is necessary to establish a contractor that undertakes all of these complicated procedures and a unified processing system. ing.

  On the other hand, apart from a series of home medical care, community comprehensive care, and home medical care frameworks, there are placement drug companies originating from “Toyama drug sales”.

  Placed drug dealers mainly visit their homes, install first aid kits, and provide daily necessities including medicines and bandages at “first-come-first-served benefits”. In particular, we do not have medical qualifications, so we are replenishing general drugs and checking survival.

Service providers, such as medical institutions, nursing homes, pharmacies, and care supply stores, that are required to build a comprehensive community care system, directly charge the billing fee for each patient or care recipient who is a care recipient. Therefore, the number of billing destinations increases, and the procedure is very complicated.
Even today, medical or nursing care service users are often persons with dementia or elderly people, so it is difficult to grasp the contents of the bill, payment of the billing fee is delayed, and the service provider pays the billing fee. Troubles such as not being able to receive the service, or if the memory of whether or not the service has been enjoyed is ambiguous.

  Furthermore, even if an automatic withdrawal contract is made as a payment method for the service beneficiary, there is a problem that the balance of the withdrawal account is insufficient after the service provider provides the service.

  The present invention has been made in view of the above points, and it is an object of the present invention to reduce the complexity of a billing procedure by unifying billing for service provision and to surely reduce the cost of billing.

  In order to solve the above-mentioned problem, the invention according to claim 1 is characterized in that a service provider ID assigned to a service provider who provides a service and a service recipient assigned to a service recipient who enjoys the service. Receiving means for receiving data associated with the contents of the service and the charge for the charge of the service, with an ID added thereto, the service provider ID, the service beneficiary ID, the contents of the service, and the price of the service Referencing a database in which the billing cost is recorded, a first aggregation unit that collects the billing fee for each service receiver ID, and a presenting unit that indicates the total amount of the billing fee grouped for each service receiver ID It is characterized by comprising.

According to the present invention, a service provider such as a medical institution, a care facility, a pharmacy, or a care supply store does not directly charge a charge request fee to each individual service recipient who is a patient or a care recipient, and stays at home. It is possible to make a batch with respect to the collective management billing processing apparatus having the above-mentioned characteristics that the placed drug trader or the like who visits has.
In addition, by handing over the bills collected to the service recipients, it is possible to grasp the contents of the bills in a list for those who suffer from dementia or elderly people.

The invention according to claim 2 is the collective management billing processing apparatus according to claim 1, wherein the sum of the billing charges collected for each service receiver ID is obtained from the account of the service receiver. A withdrawal means for automatically withdrawing, a second aggregation means for summarizing the charge billing fee for each service provider ID with reference to the database, and a sum of the charge billing costs gathered for each service provider ID Is transferred to the service provider's account automatically.

  ADVANTAGE OF THE INVENTION According to this invention, it is reduced that the payment of the consideration billing expense from a service user is reduced, and it can pay a compensation billing expense without omission to a service provider.

  The invention according to claim 3 is the collective management billing processing apparatus according to claim 1 or 2, wherein the use ticket necessary for the user of the service to receive the next service after receiving the service. A ticket issuing means for issuing a ticket, and a first confirmation means for certifying that the service recipient has enjoyed the service from the service provider based on the discovery means. Yes.

  According to the present invention, whether the patient who received the service or the care recipient actually proved the fact that he / she actually enjoyed the service, the service recipient himself / herself performed the request for his / her next ticket, and enjoyed the service. No, it is possible to avoid troubles at the time of payment of the billing fee, which occurs when the service recipient's memory is ambiguous.

  The invention according to claim 4 is the collective management claim processing device according to any one of claims 1 to 3, wherein the service recipient receives the pension transfer of the service recipient before the service enjoyment. It is characterized by comprising a second confirmation means for proving that it is possible to deduct the billing fee from the service beneficiary by submitting an application for an account, a salary transfer account, or an insurance receipt account. .

  According to the present invention, it is possible to specify a pension transfer account, a salary transfer account, or an insurance receipt account of a service recipient who receives payment periodically, and services such as medical institutions, nursing care facilities, pharmacies, and care supply stores. Although the provider provided the service, it is possible to avoid the trouble that there is no balance in the debit account.

  The invention according to claim 5 is the collective management billing processing apparatus according to any one of claims 1 to 4, wherein when generating the service beneficiary ID, the my number is treated as a number and fixed. Computation means for performing computation, conversion means for converting the calculation result into an n-ary number, and storage means for storing the generated number as an ID are provided.

  According to the present invention, since the ID used in the invention described in claim 1 is generated from a unique number given to each citizen, this ID is also an ID that does not overlap depending on the method of fixed calculation. Therefore, even when a charge is received from various service providers such as medical institutions, care facilities, pharmacies, and care supply stores, duplicate IDs do not occur and the collective management request processing device can be operated without any trouble. it can.

  In the invention according to claim 6, the receiving means includes a service provider ID assigned to a service provider who provides a service and a service receiver ID assigned to a service receiver who enjoys the service. The step of receiving data associating the content of the service with the charge for the service charge, and the aggregation means include the service provider ID, the service receiver ID, the content of the service, and the charge for the service. An aggregation step of summarizing the billing costs for each service beneficiary ID with reference to a database in which the costs are recorded, and a presentation means presenting the sum of the billing costs summed up for each service beneficiary ID And a step.

  The invention according to claim 7 is the contents of the service in which the service provider ID assigned to the service provider who provides the service and the service receiver ID assigned to the service receiver who enjoys the service are added. Referring to a database in which receiving means for receiving data that associates the charge billing cost of the service, the service provider ID, the service beneficiary ID, the content of the service, and the charge billing cost of the service are recorded. , Functioning as aggregation means for summarizing the billing charges for each service beneficiary ID, and means for presenting the total amount of the billing charges summed up for each of the service beneficiary IDs.

  According to the present invention, a service provider such as a medical institution, a care facility, a pharmacy, or a care supply store can centralize the charge for service provision to the collective management bill processing apparatus, and the patient who enjoys the service Therefore, it is possible to reliably reduce the cost of billing from the care recipient.

It is a schematic block diagram using the regional comprehensive care collective management claim processing device according to one embodiment. It is a figure which shows the process from the usage registration of a management claim processing apparatus to a consideration expense claim. (A) has shown the structure of DB102b and DB102c in the memory | storage part 102 which the regional comprehensive care package management claim processing apparatus 10 has, (b) is a figure which shows the query after batch processing, or a view structure. It is a figure which shows an example of the bill for service beneficiaries. It is a block diagram which shows an example of schematic structure of the management claim processing apparatus 10 which concerns on embodiment. (A) is a figure which shows an example of the content registered into service provider DB102a, (b) is a figure which shows an example of the content registered into service receiver DB102b, (c) is a service It is a figure which shows an example of the content registered into provision performance DB102c. It is the flowchart figure which showed the example of the method which self proves that the service beneficiary actually enjoyed the service. It is a flowchart figure which shows an example of the step of service beneficiary initial registration. (A) is a flowchart figure which shows an example of the process in case the service beneficiary 1 receives a service, (b) is when service providers 3-6, such as a hospital, charge. (A) An example of a process for starting a batch process, (b) an example of a batch process in consolidating service beneficiary consideration billing costs, and (c) a batch in consolidating service provider consideration billing costs It is a flowchart figure which shows an example of a process. It is a flowchart figure which shows an example of the method of sending a bill to a service beneficiary. It is a flowchart figure of the example of a process at the time of withdrawing from a beneficiary's account automatically. It is a flowchart figure of the example of a process in the case of paying into a provider's account automatically. It is a flowchart figure of the example of a process which changes the service enjoyment rank of a service beneficiary.

  Hereinafter, embodiments of the present invention will be described with reference to the accompanying drawings. In addition, the following description does not limit the technical scope and terms used in the claims.

[1. Overview of configuration and function of management request processing device]
First, the configuration and functional overview of the management request processing system S according to the present embodiment will be described with reference to FIG. FIG. 1 is a diagram illustrating an example of a schematic configuration of a management request processing system S according to the present embodiment.

  As shown in FIG. 1, the management billing processing system S includes a regional comprehensive care collective management billing processing device 10 (hereinafter, abbreviated as a management billing processing device), a plurality of terminals 20 such as a plurality of arranged drug dealers, and a plurality of services provided. 3 to 6, a plurality of bank servers 70, and a plurality of administrative institution terminals 80. Then, the management billing processing device 10, the terminal 20 such as the placement drug dealer, the terminals 30 of the service providers 3 to 6, the server 70 such as the bank and the terminal 80 of the administrative organization are connected to the communication protocol via the network NW, for example. Data can be transmitted and received mutually using TCP / IP or the like. The network NW is constructed by, for example, the Internet, a dedicated communication line (for example, a CATV (Community Antenna Television) line), a mobile communication network (including a base station), a gateway, and the like.

  The management billing processing device 10 is a device managed or contracted by the placement medicine company 2 etc., and has a database, processing program, etc. for managing billing in the internal storage unit, and each service provider This is a device that receives a charge from a customer and performs a payment process.

  The terminal 20 is a general-purpose terminal that is used for a communication device owned or contracted by the placement medicine company 2 or the like, and may be a personal computer or a tablet. A service that is a patient or a care recipient who has a WEB browser application inside or has a dedicated application, and uses them to connect to the management request processing apparatus 10 via the network NW. Registration of the beneficiary 1 (hereinafter referred to as service beneficiary 1), check of the enjoyment of service, issuance of coupon code issuance, and the like.

  The management request processing device 10 and the terminal 20 are assumed to be managed, owned, or contracted by a placement chemical company or the like. The arranged medicine company visits home, installs first aid kits, and provides daily necessities including medicines and bandages. As the person in charge of the arranged medicine sales regularly visits the home for the purpose of replenishing general drugs and confirming the survival, it is easy to have a close relationship with the service receiver 1 and as the administrator of the management request processing system S As appropriate, it may be carried out by a care facility founder who performs home-visit care or a medical company.

  The terminal 30 is a general-purpose terminal for use with a communication device owned or contracted by a service provider such as a hospital 3, a care facility 4, a pharmacy 5, and a care product supplier 6, and may be a personal computer, a tablet, Etc. Has a WEB browser application inside or has a dedicated application, and uses them to connect to the management request processing apparatus 10 via the network NW to register the provided service and pay for the service Request expenses.

  The bank server 70 is a bank server of a bank account with which the service receiver 1 and the service providers 3 to 6 are contracted. It is a server that is operating for online transactions, and is connected to the management request processing apparatus 10 via the network NW, and deducts and transfers the charge for billing.

  The terminal 80 is a general-purpose terminal for a communication device owned or contracted by the administrative institution 8 which is a municipality, and may be a personal computer or a tablet. Has a WEB browser application inside, or has a dedicated application, and uses them to connect to the management request processing apparatus 10 via the network NW, etc. Specify the certification rank.

[2. From usage registration of management request processing device to billing for compensation cost]
Next, with reference to FIG. 2, a description will be given from use registration of the management billing processing device to billing for the compensation cost.
In order to enjoy medical and nursing care services at home, the service recipient 1 makes an application for using the management request processing system S to the placement drug dealer 2 who visited the home.

  Regarding applications for using this management request processing system S, in addition to the name, address, and my number for issuing IDs, in order to facilitate the withdrawal of the charge for billing, bank accounts, credit card numbers, etc. To be added.

The placement drug supplier 2 who has received the application uses the terminal 20 to connect to the management request processing apparatus 10 via the network NW, input necessary items, and the service recipient 1 who is a patient or a care recipient. Register for use.
When the application is made, an ID generated so as not to be duplicated is issued to the service recipient 1 even when there are a plurality of service providers.

  Similarly, a hospital 3 of a medical provider as a service provider makes an application for using the management request processing apparatus 10 of the present invention in advance and receives a service provider ID from the management request processing apparatus 10. Since this ID only needs to be managed in the management request processing apparatus 10, the issue logic may be provided independently.

  When the service provider 3 receives a service provision request from the service receiver 1, the hospital 3 uses the terminal 30 to connect to the management billing processing apparatus 10 via the network NW.

Here, description will be made with reference to FIG. 3 in addition to FIG. (A) of FIG. 3 shows the service beneficiary DB 102b and service provision result DB 102c structure in the storage unit 102 of the regional comprehensive care collective management claim processing device 10, and (b) is a query (Query) after batch processing. FIG. 4 is a diagram illustrating a view (Vew) structure.
Log in to the management billing processing apparatus 10 with the ID for the hospital 3 connected, and access the service beneficiary DB 102b of the service beneficiary 1 managed by the hospital 3 stored in the storage unit 102. The WEB browser application or the dedicated application in the terminal 30 may be streamlined in cooperation with an independent management billing system in the hospital.

  The hospital staff who has accessed the service beneficiary DB 102b of the service beneficiary 1 managed by the hospital 3 inputs the ID of the service beneficiary 1 on the screen for confirming the ID of the service beneficiary 1. The management billing processing apparatus 10 displays the registered information such as the service beneficiary ID and the name, address or date of birth of the service beneficiary 1 on the WEB browser application or the dedicated application in the terminal 30 owned by the hospital 3.

  Since the hospital staff has proved that the registration of use of the management request processing device 10 of the service beneficiary 1 is correctly performed if the contents of the service provision request application and the displayed contents match, The hospital 3 can provide services such as home medical care to the beneficiary 1.

  In addition, after providing the service to the service recipient 1, the hospital 3 may perform a coupon code issuance process for the next use on the management request processing apparatus 10 and deliver the coupon code to the service recipient 1. The coupon code issuance process is performed by the service providers 3 to 6 for the management billing processing apparatus 10, and the coupon code obtained by the service providers 3 to 6 is delivered to the service receiver 1 after the service is provided. When the beneficiary 1 presents a coupon code at the time of the next service application, it also serves as proof that the user has actually received the service.

After providing the service, the hospital 3 performs a service billing process for the management billing processing apparatus 10.
The hospital 3 connects to the management request processing apparatus 10 via the network NW using a WEB browser application or a dedicated application in the terminal 30 that the hospital 3 owns.
The hospital person in charge logs in the management request processing apparatus 10 with the ID for the hospital 3 connected, and from the terminal 30, the ID for the hospital 3, the patient ID that provided the service, the provided medical treatment, treatment, medicine, etc. Enter the billing costs for services such as medical fees, treatment costs, and drug charges.

  If there is no error in the input content, the fixed transmission process is performed. When the confirmation transmission process is performed, the terminal 30 adds the ID for the hospital 3 and the patient ID that has enjoyed the service, and transmits the data that associates the content of the service and the charge for the service charge to the management billing processing apparatus 10. To do.

  The management billing processing apparatus 10 writes the data of the charge billing cost with the received service provider ID and service beneficiary ID in the service provision record DB 102 c in the storage unit 102. At this point in time, proof of service enjoyment has not yet been obtained, so the charge for billing need not be finalized.

  Similarly, the care facility 4, the pharmacy 5, or the care product supplier 6 of the care provider who is the service provider makes an application in advance for using the management request processing apparatus 10 of the present invention, and the ID from the management request processing apparatus 10 In the same manner as the hospital 3 as described above.

  The management billing processing apparatus 10 refers to the service provision result DB 102c every month or on a predetermined date within a predetermined period, and collects the billing costs for each service provider ID and each service receiver ID. I do.

The charge request cost aggregation processing for each ID of service providers 3 to 6 such as medical institutions, care facilities, pharmacies, and care supply stores is to collect the service charge and transfer the charge charge to the service provider. Do.
The management billing processing apparatus 10 refers to the service provision record DB 102c in the storage unit 102, sets the service provider IDdF1 as an aggregation key, creates a query (Query) or a view (Veiw), and charges for the charge for data Are all added. The total billing cost for that period is stored in the storage unit 102 as the total billing cost within the period determined by the service provider ID.

The charge billing cost aggregation process for each service beneficiary ID is a bank that collects the charges received for the service, creates a bill as the charge bill for the service beneficiary 1, and has a bank account designated in advance. This refers to connecting to the server 70 and performing processing for deducting the billing fee.
The management billing processing apparatus 10 refers to the storage unit 102, sets the service beneficiary IDdF2 as an aggregation key, creates a query (Query) or a view (Veiw), and adds all the data billing costs. The total billing cost for the period is stored in the storage unit 102 as the total billing cost within the period determined by the service receiver ID.

The management billing processing device 10 collects the total amount held in the storage unit 102 as the total billing cost within the determined period of the service beneficiary ID, using the service beneficiary ID as an example in FIG. 4 as a key. It can be printed as a letter.
The placement drug dealer 2 who owns the management request processing device 10 sends the printed matter as a bill to the service user 1 by mail, so that the service user 1 confirms the contents of the service and the charge for the service in a list. It becomes possible to do.

  Placement drug dealers 2 possessing the management bill processing device 10 send the bill as electronic data attached to an e-mail or attach it to an SNS (Social Networking Service) service (hereinafter referred to as SNS) such as LINE or Messenger. It is also possible to distribute it. The management request processing apparatus 10 may have a function of automatically transmitting.

The management billing processing apparatus 10 connects the sum of the billing fee printed on the bill to the bank server 70 having a bank account or the like designated in advance, and performs a billing fee withdrawal process.
If the service recipient 1 has debited the pension transfer account or salary transfer account, etc., it is not possible to deduct the charge request fee by deducting the charge request fee immediately after the pension transfer date or pay day Can be avoided.

The management billing processing apparatus 10 that has deducted the billing fee from the service recipient 1 is the sum written in the storage unit 102 as the billing fee total for the period of the billing fee determined for each ID of the service providers 3 to 6. With reference to the amount, the service provider connects to the bank server 70 having a bank account or the like designated in advance by the service provider, and performs transfer processing of the total charge billing cost.
In this case, money is exchanged, and a human may be interposed to reduce risk, and the transfer may be performed after the management request processing apparatus 10 waits for a confirmation process by a human before automatic transfer.

  In addition, the administrative organization 8 such as a municipality receives information such as whether the service recipient 1 has been certified as requiring care / support or has been removed, suffered from illness, became a patient, recovered, or died. Received from a doctor or a care manager who is a person 1 or a service provider 3-6. Since this information is related to the application of insurance and largely related to the charge for compensation, the care manager and the administrative organization 8 are information that actively exchanges information.

  When the rank of authorization changes, the administrative organization 8 such as a municipality uses the terminal 80 to connect to the management request processing apparatus 10 via the network NW. The person in charge of the administrative institution logs in the management billing processing apparatus 10 with the ID for the connected administrative institution 8 and inputs from the terminal 80 that the service beneficiary ID and rank have been changed. The management request processing apparatus 10 rewrites the column of the authorized rank dFr in the service beneficiary DB 102b in the storage unit 102.

[3. Configuration of management request processing device]
Next, the configuration of the management request processing apparatus 10 will be described with reference to FIGS. 5 and 6.

FIG. 5 is a block diagram illustrating an example of a schematic configuration of the management requesting apparatus 10 according to the present embodiment. As illustrated in FIG. 5, the management request processing apparatus 10 includes a communication unit 101, a storage unit 102, an input / output interface 103, and a system control unit 104. The system control unit 104 and the input / output interface 103 are connected via a system bus 105.

  The communication unit 101 is connected to the network NW, and controls the communication state with the terminal 20 such as the placement drug supplier and the terminal 30 of the service provider.

  The storage unit 102 includes, for example, a hard disk drive and an SSD. In the storage unit 102, databases such as a service provider DB 102a, a service beneficiary DB 102b, a service provision result DB 102c, and a bank account DB 102d are constructed. “DB” is an abbreviation for database. The storage unit 102 is an example of a storage unit and a confirmation date storage unit in the present invention.

  FIG. 6A is a diagram illustrating an example of contents registered in the service provider DB 102a. In the service provider DB 102a, service receiver information regarding service providers 3 to 6 registered as service providers in the management billing processing system S is registered. Specifically, the service provider DB 102a includes a service provider ID, a password, a service provider name, a zip code, a location, a telephone number, a person in charge e-mail address, service provider transfer account information, and the like. Registered in association with every 3 to 6. The service provider ID is identification information of the service provider. The service provider transfer account information is bank transfer account information registered by the service provider. For example, bank information (bank code number), branch information (branch code), normal / current account, name of the holder, account number, etc. are set in the service provider account information. Bank information is information for identifying a bank. The service provider does not need to input the service provider transfer account information every time the service is provided by registering the service provider transfer account information in advance.

  FIG. 6B is a diagram illustrating an example of content registered in the service beneficiary DB 102b. In the service beneficiary DB 102b, service beneficiary information related to the service beneficiary 1 registered as a service beneficiary in the management billing processing system S is registered. Specifically, in the service beneficiary DB 102b, the service beneficiary ID, the service beneficiary name, the service beneficiary rank, the rank of the need for care support, the date of birth, the postal code, the address, the telephone number, the e-mail address, Service beneficiary debit account information and the like are registered in association with each service beneficiary 1. The service beneficiary ID is identification information of the service beneficiary 1. The service beneficiary account information is bank debit account information registered by the service beneficiary 1. For example, bank information (bank code number), branch information (branch code), normal / current account, name of the holder, account number, and the like are set in the service beneficiary debit account information. Bank information is information for identifying a bank. In order to prevent duplication, the service beneficiary ID may be generated from a My Number described later.

  FIG. 6C is a diagram illustrating an example of contents registered in the service provision result DB 102c. Registered in the service provision record DB 102c is what the service providers 3 to 6 have transmitted to the management request processing system S as the record of providing the service after providing the service. Specifically, in the service provision record DB 102c, provision date, provision time, provision contents, provision service provider ID, service beneficiary ID, consideration billing cost, service enjoyment check, and the like are associated with each service provision record. Registered. The provided contents are the contents of the services provided by the service providers 3 to 6 to the service receiver 1. For example, “medical care” is registered for the hospital 3 and “helper provided” is registered for the care facility. The

  Next, other information stored in the storage unit 102 will be described. The storage unit 102 stores various data such as an HTML (HyperText Markup Language) document, an XML (Extensible Markup Language) document, image data, text data, and an electronic document for displaying a WEB page.

The storage unit 102 stores various programs such as an operating system, a WWW (World Wide Web) server program, a DBMS (Database Management System), a service providing processing program, and an n-ary conversion program. Service provision processing program includes service content and cost reception processing, consideration cost billing aggregation processing, service total amount presentation processing, account automatic withdrawal processing, account automatic transfer processing, coupon code generation processing and confirmation processing, withdrawal possibility proof processing, My This is a program for executing processing for generating an ID from a number.
The service provision processing program is an example of an information processing program in the present invention. Note that the various programs may be acquired from another server device or the like via the network NW, or may be recorded on a recording medium such as a DVD (Digital Versatile Disc) and read via the drive device. You may do it.

  The input / output interface 103 performs interface processing between the communication unit 101 and the storage unit 102 and the system control unit 104.

The system control unit 104 includes a CPU 104a, a ROM (Read Only Memory) 104b, a RAM (
Random Access Memory) 104c and the like. Then, the system control unit 104 reads out and executes various programs by the CPU 104a, so that the receiving means, the aggregation means, the presenting means, the withdrawal means, the transfer means, the first confirmation means, the second confirmation means, and the calculation means in the present invention. , Functioning as conversion means and storage means.

  The management claim processing device 10 may be configured by a plurality of server devices. For example, a service content receiving server device, a server device that performs bank account management processing, a server device that transmits a WEB page in response to a request from the terminal 20 and the terminal 30, a server device that manages a database, etc. It may be connected.

[4. Operation of the management billing system]
With reference to FIG. 5, a method for generating service receiver IDs that are not duplicated in Japan will be described.

  Placed drug supplier 2 who has received an application for receiving medical service or nursing care service from patient or care recipient 1 who is a care recipient, uses My Number Reader connected to terminal 20 or My 20 from My Number Reader. The number is read, connected to the management request processing apparatus 10 via the network NW, and the applied my number is input to the input / output interface 103 in the management request processing apparatus 10. Since My Number is a number assigned to all citizens who have a resident card without duplication, if a number can be generated starting from this number, a unique ID can be created in Japan.

  The CPU 104a in the system control unit 104 calculates a fixed value programmed in advance from the input my number. For example, after adding a fixed value to My Number, the number can be multiplied by an integer. By setting one fixed calculation in the management request processing system S according to the present invention, it is possible to perform number conversion uniquely. In addition, by performing an operation unknown to the outside, even if the service beneficiary ID leaks to the outside, there is an advantage that the My Number is not estimated from the service beneficiary ID.

  The CPU 104a in the system control unit 104 reads an n-ary conversion program, and converts the fixed number My number into an n-ary. In addition to decimal numbers from 0 to 9, n-ary numbers can be set to 36 numbers by adding 26 English alphabets that can be entered with a standard keyboard. By setting one n-ary number in one system according to the present invention, it is possible to perform number conversion uniquely. In addition, there is an advantage that the larger the value of n in the n-ary number, the smaller the number of digits and the easier the handling of the user ID.

  The RAM 104c in the system control unit 104 stores the service receiver ID generated above. The generated service receiver ID is transferred from the input / output interface 103 to the storage unit 102 via the system bus 105 and registered in the service receiver DB 102b. By this registration, the service beneficiary ID is confirmed, and after registering other information associated with this ID, the service beneficiary 1 can enjoy the service.

Next, referring to FIG. 7, an example of a method for proving that the service receiver 1 has actually enjoyed the service will be described.
After service providers 3 to 6 such as medical institutions, nursing homes, pharmacies, and care supply stores actually provide services, there are few service users 1 who memorize the services received in their daily lives. . Therefore, it is proved by own processing that the service is enjoyed by the following flow.

Before the hospital 3 as a service provider provides a medical service, the terminal 30 is used to connect to the management request processing apparatus 10 via the network NW and register that the service is provided. In response to this, the management billing processing apparatus 10 generates a coupon code (step S11), and the hospital 3 obtains the coupon code in advance.
For example, the coupon code may be generated by performing a fixed operation using the number of the provided date and the ID of the service user 1 as keys so that the date on which the service is provided can be understood.

  After the hospital 3 as the service provider provides the medical service, the hospital 3 presents a coupon code for receiving the next service to the service receiver 1. As a presentation method, what is printed on a paper medium may be directly handed over, or may be notified by e-mail or SNS.

  The service beneficiary 1 who enjoyed the service adds the coupon code by a predetermined date, and applies for the next service enjoyment use ticket to the placed drug dealer 2 who has visited at home. The placement medicine supplier 2 uses the terminal 20 to connect to the management request processing apparatus 10 via the network NW, and transmits the service enjoyment application data with the coupon code added to the management request processing apparatus 10 ( Step S12). At this time, the management bill processing apparatus 10 confirms whether or not a coupon code is appended (step S13), and an application not appended cannot be accepted by the management bill processing apparatus 10. In that case, the arrangement drug supplier 2 can accept the use application again after confirming, for example, having the service receiver 1 enter the content and date of the previous service in the application form.

  By taking the above steps, the service recipient 1 cannot receive the next service unless he / she proves the fact that he / she has enjoyed the service. Can continue to provide services with peace of mind.

    Similarly to the hospital 3, the care facility 4, the pharmacy 5, or the care product supplier 6 of the care provider who is the service provider can also perform the above steps.

Next, referring to FIG. 8, an example of initial registration steps performed by the service beneficiary 1 in order to use the management request processing apparatus 10 for the placement drug supplier 2 will be described.
When the service beneficiary 1 wants to use the management request processing device 10 of the arrangement drug supplier 2 etc., the service recipient 1 visits the arrangement drug company 2 etc. who visited the home, or the service beneficiary 1 himself / herself, and applies for the service. .

Of course, the address, name, age, occupation, etc. will be written on the application form, but if there is a certain age or past history at that time, conditions will be set in the account for deduction of the billing fee.
The condition is that the debit account has money transferred at a certain period, a certain balance is deposited for a certain period, and the like. The account assumes a salary transfer account, an annuity transfer account, or a nursing care insurance transfer account.

  The placement drug supplier 2 that has received the application use uses the terminal 20 to connect to the management request processing apparatus 10 via the network NW, and then transmits the application content data to the management request processing apparatus 10 ( Step S21). The management request processing apparatus 10 that has received the data determines whether there is a certain age or more and a past history (step S22).

  By taking the above steps, it is possible to avoid the risk that the account balance is insufficient and cannot be withdrawn when automatically deducting the charge for the charge.

  As a means of confirming the conditions of the debit account, attach a copy of the passbook that describes the history of the account for more than one year, or attach a copy of the application form for the pension transfer account. , Etc. can be considered. The management processing server determines the presence or absence of the attachment (step S23), and if these are not attached, the application for use can be rejected (step S24).

  By taking the above steps, the service provider 3-6 such as a medical institution, a care facility, a pharmacy, or a care supply store provides a service, but there is a problem that there is no balance in the debit account of the service recipient 1. It can be avoided.

Next, a billing cost management processing method by the management billing processing apparatus 10 according to the present embodiment will be described.
FIG. 9 is a flowchart showing a processing example when the service beneficiary 1 receives a service and the service providers 3 to 6 such as a hospital make a charge by the management request processing apparatus 10 according to one embodiment. FIG. 9A is a diagram when the service receiver 1 receives the service, and FIG. 9B is a diagram when the service providers 3 to 6 such as a hospital make a bill.
When the service beneficiary 1 enjoys a service such as receiving medical care or purchasing a product or the like, the service beneficiary ID is indicated to the hospital 3 that is the service provider. The hospital person in charge showing the service beneficiary ID connects to the management billing processing apparatus 10 via the network NW using the WEB browser application or the dedicated application in the terminal 30, and displays the service beneficiary ID input screen. Open the service recipient ID, name, date of birth, etc. A service receiver ID may be indicated on the card surface, or a card or the like in which ID information is magnetically written may be indicated.
Through the above process, the management billing processing apparatus 10 receives the ID and additional information of the service beneficiary 1 (step S31).

  In the management request processing apparatus 10 in which the service beneficiary ID, name, date of birth, etc. are input, the service beneficiary ID stored in the service beneficiary DB 102b in the storage unit 102 matches the other input information. Is determined (step S32). If they match, the management request processing apparatus 10 notifies the WEB browser application or the dedicated application in the terminal 30 owned by the hospital 3 that it is proved that the payment means has been secured and the service can be enjoyed ( Step S33). If they do not match, it is notified that the service of the management billing processing system S cannot be enjoyed until the payment means is secured (step S34).

  After providing the medical service, the hospital 3 that is the service provider applies and acquires a coupon code in advance, and if the management request processing device 10 has issued the coupon code (step S35), the service receiver 1 On the other hand, present a coupon code to receive the next service. The hospital 3 may keep a copy by having the service user 1 sign or check the paper-based usage certificate. When the check or signature is performed (step S36), the hospital 3 uses the WEB browser application or the dedicated application in the terminal 30 and the management request processing apparatus 10 stores the service receiver 1 in the service provision result DB 102c in the storage unit 102. Records that the user has enjoyed the service (step S37).

Next, an example when the service provider performs the expense billing process on the management billing processing apparatus 10 will be described.
The hospital 3 that provided the service uses the WEB browser application in the terminal 30 or a dedicated application to connect to the management request processing apparatus 10 via the network NW in order to charge the compensation cost. The cost which is the consideration is input together with the service user ID and the provided service.
Through the above processing, the management billing processing apparatus 10 receives the hospital 3 ID, the consideration cost, and the provided service name (step S41).

  Upon receiving the request, the management request processing apparatus 10 determines whether or not there is a record indicating that the service receiver 1 has received the service content as a service in the service provision result DB 102c in the storage unit 102 ( Step S42). When the service is received, the amount charged is described in the billing field of the service provision result DB 102c in the storage unit 102 (step S43). If the service has not been received, a coupon code input waiting state is entered, and a message is displayed on the WEB browser application or dedicated application in the terminal 30 indicating that the request is waiting to be confirmed (step S44).

  The service recipient 1 applies for the coupon code provided by the hospital 3 when the service was received last time when applying directly to the placement medicine company 2 or the hospital 3 providing the service. Fill out the form. The arrangement medicine company 2 that received the application, or the hospital 3 that provides the service, connects to the management request processing apparatus 10 via the network NW using the WEB browser application or the dedicated application in the terminal 30, The issuance processing of the use ticket is performed, and the management request processing device 10 receives the enjoyment application with the coupon code added (step S45).

After the above steps, the management billing processing apparatus 10 checks whether the coupon code has been generated by the management billing processing apparatus 10 (step S46). If the coupon code has not been entered or the code has not been generated by the management request processing device 10, no particular processing is performed (step S47). When it is estimated that a human operation error such as the number of digits of the code does not match, the management request processing apparatus 10 may notify to that effect.
When the coupon code is generated by the management request processing device 10, the same processing as that for entering a check that the service linked to the coupon code has been enjoyed is performed.

  The charge confirmed that the service has been enjoyed in the above steps becomes a fixed charge, and the confirmation column of the charge request cost is checked, and the charge charge for each service provider ID and service receiver ID is calculated. The list is added to the list to be aggregated (step S49).

Next, a method for consolidating billing costs by the management billing processing apparatus 10 according to the present embodiment will be described.
FIG. 10 is a flowchart showing an example of processing performed when the management bill processing apparatus 10 according to one embodiment automatically aggregates the charge billing fees when a certain date of a certain period comes. (A) is an overview of batch processing, (b) is a transfer aggregation for a service provider, and (c) is a withdrawal aggregation for a service receiver 1.
Here, it is common for the fixed period to be processed on a monthly basis, but it is considered that elderly people often pay compensation charges from the pension. A fixed period is assumed, and the fixed date is explained as the pension transfer date.

  Once every two months, the batch process of the aggregation process runs on the 14th day before the 15th, which is the transfer day of the pension transfer month (if 15th is a Saturday, the day before the holiday) (step S51). This processing is aggregated for each service provider ID and each service receiver ID described in FIG. 3 with reference to the service provision result DB 102c in the storage unit 102 in the management request processing apparatus 10. .

First, aggregation for each service provider ID will be described with reference to the service provision result DB 102c in the storage unit 102 illustrated in FIG.
The charge request expense data dF3 having the same ID is aggregated using the service provider ID column dF1 of the service provision record DB 102c as a key, and a query or a view (Veiw) is created (step S52). A billing list is created based on the created query or view (step S53). This query or view aggregates only the data containing the check dFc that has been confirmed by the service receiver 1 that the service has been received.
A new transfer table shown in FIG. 3B is added as the total charge amount for two months of this service provider ID by adding all the amounts in the charge billing cost field dF3 in the billing list (step S54). Qr1 is created (step S55), and the service provider ID and the consideration charge total cost column are recorded (step S56).

Similarly, the aggregation for each service beneficiary ID is described with reference to the service provision result DB 102c described in FIG.
Using the service beneficiary ID column dF2 of the service provision record DB 102c as a key, the consideration charge column dF3 having the same ID is aggregated to create a query or view (step S57). A billing list is created based on the created query or view (step S58). This query or view aggregates only the data containing the check dFc that has been confirmed by the service receiver 1 that the service has been received.
All the amounts in the charge billing cost field dF3 in the billing list are added (step S59), and the withdrawal table Qr2 shown in FIG. It is created (step S60), and the service beneficiary ID and the compensation charge total cost column are recorded (step S61).

Next, a method for sending a bill to the service recipient 1 by the management bill processing apparatus 10 according to the present embodiment will be described.
FIG. 11 is a flowchart showing an example of processing by the management billing processing apparatus 10 according to one embodiment to send the billing cost for each aggregated service user as a bill when a certain date of a certain period comes. It is.
Similarly to the above, the pension transfer period is assumed to be two months, and the fixed date is described as the pension transfer date.

  The withdrawal table Qr2 of FIG. 3 created above on the 14th the day before the 15th, which is the transfer date of the annuity transfer month in which the batch processing is performed (15th is Saturday, the day before the holiday) Based on the above, the total amount is entered in the prepared invoice table (electronic data or paper medium) for each ID of the service recipient 1 (step S71). As shown in the example of FIG. 4, as a bill specification, a service provision name, a service provision date, a consideration billing cost on a query or view created by aggregating consideration billing cost data based on a service beneficiary ID. Are listed in the invoice table (step S72).

After the details are listed, based on the service beneficiary ID, the name and address (or e-mail address, SNS ID) of the service beneficiary 1 are entered in the invoice table (step S73).
Since the invoice has been completed in the above steps, the invoice is sent via an e-mail or SNS attached with an invoice data attached with a password by mail or an envelope in which only the name and address are visible from the outside (step S74).

Next, a method for deducting billing costs by the management billing processing apparatus 10 according to the present embodiment will be described.
FIG. 12 shows an example of processing when the management bill processing apparatus 10 according to one embodiment automatically deducts the charge for billing from the account of the service receiver 1 when a certain date of a certain period comes. It is a flowchart which shows.
Similarly to the above, the period of pension transfer is set as a fixed period, and the fixed date is described as the pension transfer date.

  On the 15th day (the 15th is a Saturday, the day before the holiday) on the day after the above batch processing and invoice is created or sent, the payment day of the pension payment month, and for the withdrawal shown in Figure 2 above Based on the table Qr2, the debit amount for each service receiver ID is checked (step S81). A query or view is generated for each debit bank account described in the debit table Qr2 (step S82), and for example, a list of service recipients 1 specifying the bank A is collected. A withdrawal process is performed on bank A based on the created list (step S83). Similarly, bank B and bank C are debited.

It is confirmed whether or not the withdrawal is possible (step S84). If the withdrawal is successful, no particular processing is performed. When the withdrawal cannot be made, a check is made in the non-withdrawable column dF7 in the table of the service beneficiary ID that has not been withdrawn (step S85). If a check is entered here, restrictions on future use may be provided, or it may be used for processing such as stopping the service itself.
In this case, the management request processing apparatus 10 notifies the service recipient 1 that the withdrawal could not be made by mail in an envelope in which only the name and address are visible from the outside, or by e-mail or SNS. Is sent (step S86).
Further, thereafter, a process of reducing the transfer amount of the service providers 3 to 6 described in the transfer table Qr1 is performed (step S87). Then, a process of informing the service providers 3 to 6 together with the service receiver ID and other information that could not be withdrawn by e-mail or the like (step S88).

Next, a method for transferring a billing fee by the management billing processing apparatus 10 according to the present embodiment will be described.
FIG. 13 shows a process performed when the management bill processing apparatus 10 according to an embodiment automatically transfers the charge for billing to the account of the service provider when a certain date is reached for a certain period. It is a flowchart.

  The next day after the withdrawal, the transfer amount for each service provider ID is checked based on the transfer table Qr1 of FIG. 3 created above (step S91). Among them, a query or view is created for each bank account that is listed in the bank transfer table Qr1, and a list is created by collecting, for example, service providers that specify bank A. Based on the created list, a transfer process is performed for bank A (step S92). Similarly, transfer processing is performed with bank B and bank C.

  After performing the transfer, the management request processing apparatus 10 sends a message describing that the transfer has been performed by e-mail and the amount of money transferred to the service providers 3 to 6 (step S93).

Next, the service authorization rank (rank of care required support etc.) setting change work of the service beneficiary 1 by the management request processing apparatus 10 according to the present embodiment will be described.
FIG. 14 is a flowchart showing a process of changing the service enjoyment rank of the service beneficiary 1 by the management request processing apparatus 10 according to one embodiment.

  The administrative organization 8 such as a municipality changes the accreditation rank of the service beneficiary 1, so the burden of the insurance premium will be changed, so the network NW can be set up using the WEB browser application or dedicated application in the terminal 80 Then, the management request processing apparatus 10 is connected to open the rank change application screen (step S101).

  If the service beneficiary 1 has died (step S102), a message to that effect is entered. However, since the bank account or the like may be frozen, the management request processing device 10 determines whether there is an undrawn money. Is immediately examined (step S103). If there is an undrawn money, an aggregation process is immediately performed before the account is frozen, and a withdrawal process is performed (step S104).

  After the withdrawal process is successfully completed or when there is no unpaid money, the management request processing apparatus 10 deletes the data of the corresponding beneficiary from the service beneficiary management DB 102b (step S105).

  If the authorization rank change is not “death processing”, an authorization rank application input is received, and it is confirmed whether the authorization rank has been raised or lowered (step S106). If the rank goes up, it means that care is required, support is needed, and the severity of the patient becomes heavy. In general, there are many cases where insurance money and subsidies increase. The processing is simply to write to the user management DB 102b (step S107).

  When the certification rank changes, the need for nursing care, support required, and the severity of the patient become lighter. In general, there are many cases where insurance money and subsidies are reduced. (Step S108). If there is an undrawn money, an aggregation process is immediately performed before the authorized rank is changed, and a withdrawal process is performed (step S109).

  After the withdrawal process is completed successfully or when there is no undrawn money, the management request processing apparatus 10 writes the change of the authorized rank dFr in the service user management DB 102b. (Step S107).

1 Service beneficiaries who enjoy services 2 Placed pharmaceutical companies, care facility establishments, or medical-related businesses 3 Hospitals that have medical doctors, nurses, etc. that provide medical services and perform medical care and treatment 4 Nursing care services Establishing a nursing care facility that mainly provides home care services 5 Pharmacies that provide drug sales services, have pharmacists, etc., and sell medicines 6 Mainly care products (nursing diapers, etc.) Nursing care products dealers 8 Administrative agencies such as municipalities 10 Comprehensive comprehensive care management request processing equipment 20 General-purpose terminals owned by drug placement companies 2 (PCs, tablets, etc.)
30 General-purpose terminals (computers, tablets, etc.) held by service providers such as hospitals and nursing care facilities
70 A server that provides and receives money that is managed and held by financial institutions such as banks 80 General-purpose terminals (computers, tablets, etc.) held by the administrative organization 8
101 communication unit 102 storage unit 102a service provider DB
102b Service beneficiary DB
102c Service provision results DB
103 I / O interface 104 System control unit 104a CPU
104b ROM
104c RAM
105 System Bus NW Network Qr1 Transfer Table Qr2 Debit Table S Management Request Processing System

Claims (7)

Service contents and service billing costs to which a service provider ID assigned to a service provider that provides a service and a service receiver ID assigned to a service receiver that enjoys the service are added. Receiving means for receiving data associated with the;
First aggregation for collecting service charge IDs for each service user ID with reference to a database in which the service provider ID, the service receiver ID, the contents of the service, and the service charge charges are recorded. Means,
Presenting means for indicating the total amount of the charge billing costs collected for each service beneficiary ID;
A collective management claim processing apparatus comprising: The collective management claim processing apparatus according to claim 1,
A withdrawal means for automatically withdrawing the sum of the billing charges collected for each service beneficiary ID from the account of the service beneficiary;
Referring to the database, a second aggregation means for summarizing the charge for each service provider ID;
A transfer means for automatically transferring the total amount of the billing fee collected for each service provider ID to the account of the service provider;
A collective management claim processing apparatus comprising: The collective management billing processing apparatus according to claim 1 or 2, wherein a ticket is issued when a user who has received the service requests a use ticket necessary for receiving a next service after receiving the service. First confirmation means for proving that the service recipient has enjoyed the service from the service provider, based on the ticket issuing means and the ticket issuing means;
A collective management claim processing apparatus comprising: The collective management claim processing apparatus according to any one of claims 1 to 3, wherein the service recipient receives the pension transfer account, salary transfer account, or insurance receipt of the service recipient before receiving the service. A second confirmation means for demonstrating that it is possible to deduct the billing fee from the service recipient by submitting an application for an account;
A collective management claim processing apparatus comprising: The collective management billing processing apparatus according to any one of claims 1 to 4, wherein when generating the service beneficiary ID, an arithmetic unit that handles a my number as a number and performs a fixed arithmetic operation;
Conversion means for converting the calculation result into an n-ary number;
Storage means for storing the generated number as an ID;
A collective management claim processing apparatus comprising: A collective management billing method,
The contents of the service and the service, in which the receiving means includes the service provider ID assigned to the service provider that provides the service and the service receiver ID assigned to the service receiver who enjoys the service Receiving data associated with the cost of billing for
Aggregating means refers to a database in which the service provider ID, the service beneficiary ID, the contents of the service, and the charge charge for the service are recorded, and calculates the charge charge for each service beneficiary ID. Aggregation steps to summarize,
A presentation step in which the presenting means indicates a combined amount of the charge billing costs collected for each service user ID;
Processing method for collective management, characterized in that Computer
Associating the contents of the service with the service charge ID assigned to the service provider who provides the service and the service beneficiary ID assigned to the service receiver who enjoys the service. Receiving means for receiving the received data,
Aggregating means for collecting the fee charged for each service beneficiary ID with reference to the database in which the service provider ID, the service beneficiary ID, the content of the service, and the fee charged for the service are recorded;
Presenting means for indicating the sum of the billing charges collected for each service beneficiary ID;
Collective management claim processing program characterized by functioning as

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