JP2003281267A - Medical expense estimate system - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a medical expense estimate system counting expenses for the medical care for a patient before the accounting and displaying the counted estimate amount. <P>SOLUTION: The medical expense estimate system 1 comprises a hospital visiting 2 that the patient visits hospital for some treatment purpose, a medical examination 3 for examining the symptom of the patient, an examination 4 examining the symptom of the patient, dosing 5 dosing medicines corresponding to the result of the examination 4, the accounting 6 demanding the patient all the amount required for the medical examination 3, the examination 4, and the dosing 5, completion 7, and an estimate confirmation 8 estimating the medical expenses produced by the medical care for the patient. This system counts the estimate amount of the medical expenses when the estimate of the medical expenses is demanded by the estimate confirmation 8 before the accounting 6. <P>COPYRIGHT: (C)2004,JPO

Description

Detailed Description of the Invention

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a medical cost estimation system for estimating medical cost based on a medical treatment fee table.

[0002]

2. Description of the Related Art Conventionally, in hospitals, in order to charge various insurance organizations for the cost of performing medication, medical treatment, tests, etc. on a patient, the cost should be paid in accordance with predetermined drug price standards and medical fee standards. Calculate the billed amount. Specifically, regarding medication, a score table corresponding to the fee is set for each drug. Similarly, regarding medical examination and inspection, each score is set for each medical action and each inspection item. Then, the billed amount for each patient is calculated by a predetermined calculation method using each score table. In addition, the insured person (patient) pays the insured person (government, union, group) a fixed amount of insurance premiums every month, and the insurer collects the insurance premiums.
In a medical insurance system that issues a health insurance card and reduces the burden of medical expenses when the insured suffers from illness, the amount of medical expenses borne depends on the person or his / her family, and the amount charged according to each condition. Is calculated. According to the above calculation method, the billing amount of the medical bill billed by the patient is determined. The following is a brief description with reference to the drawings.

FIG. 8 is a diagram for explaining the procedure of the procedure from the visit to the end of the patient in the conventional medical treatment, and the medical treatment procedure 21 includes the visit 22, the medical examination 23, the examination 24, the medication 25, the checkout 26, and the end 27. The procedure consists of. Visit 22 means that the patient visits the hospital for a certain therapeutic purpose.
According to 3, the examination 24 corresponding to the symptom is performed. Then, the medication 25 corresponding to the result of the examination 24 is administered to the patient, and the total amount of the medical examination 23, the examination 24, and the medication 25 is charged to the patient by the checkout 26. As a result, the purpose of medical treatment is achieved and the procedure moves to the end 27. Figure 9
It is a figure explaining the flow of the counting process for calculating | requiring the billing amount at the time of accounting of the patient in the conventional medical treatment, and the counting process procedure 28 is medical examination 29, examination 30, medication 31, accounting reception 3.
2. It consists of the procedure of determining the amount 33 and accounting 34. Medical examination 2
When the procedures of 9, inspection 30, and medication 31 occur, costs corresponding to the respective processing are generated, and the respective costs are brought to the accounting reception 32 and the accounting amount is determined by the amount determination 33. Then, the procedure proceeds to the procedure of the accounting 34, and the total amount for each expense is charged based on the determined accounting amount.

[0004]

However, the conventional techniques have the following problems to be solved. Since the cost of medical treatment for patients is calculated at the time of accounting, it is not possible to know how much medical cost will be required until the time of accounting, so the patient will be billed for more than the cost that was prepared. Had problems such as not being able to deal with. In addition, since it is not possible to present the medical treatment amount of each hospital in advance, it is inconvenient for the patient side to estimate the next cost after the actual visit. Therefore, the present invention has been made in view of the above problems, and counts the cost of medical treatment of a patient as an estimated amount before accounting, and a medical expense that makes it possible to display the counted estimated amount. The purpose is to provide a quotation system.

[0005]

In order to solve the above problems, according to the present invention as set forth in claim 1, in a medical cost estimate system for estimating medical cost based on a medical care fee score table, the medical care fee points Medical medical care point retrieval means for retrieving medical medical treatment points corresponding to the patient's request based on the table, and medical expenses corresponding to the patient's request based on the medical medical treatment point table searched by the medical medical care point retrieval means. Medical cost counting means for counting, an insurance premium counting means for counting the insurance premium when the request of the patient includes at least a request for health insurance, the medical cost counting means, and the insurance premium counting means And a notifying means for notifying the patient of the estimated amount calculated according to the above. Further, according to the present invention as set forth in claim 2, in the medical cost estimation system for estimating the medical cost based on the medical care fee score table, the client's input request based on the medical care fee score table published on the Internet. Input request receiving means for receiving the input request receiving means, a medical medical care score searching means for searching for medical care points corresponding to the input request by the input request receiving means, and a medical medical care score searched by the medical care score searching means for the client. A medical cost estimation system comprising a client display means for displaying on a display device is a solution means.

According to the present invention as defined in claim 3,
In a medical cost estimation system for estimating a medical cost based on a medical care fee score table, an input request receiving means for receiving an input request of a client based on the medical care fee score table published on the Internet, and the input request receiving means. And a medical expense for counting the medical expense corresponding to the input request of the client based on the medical treatment score retrieved by the medical treatment score retrieval unit. The counting means, the insurance fee counting means for counting the insurance premium when the input request of the client includes at least the input relating to the health insurance, the medical expense counting means, and the insurance fee counting means And a display means for displaying the estimated amount on the display device of the client. Ri and solving means have a system.

[0007]

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS FIG. 1 is a diagram illustrating a procedure flow from a visit to an end in a medical cost estimation system according to an embodiment of the present invention. The medical cost estimation system 1 is composed of a visit 2, a medical examination 3, an examination 4, a medication 5, an accounting 6, an end 7, and an estimate confirmation 8. The visit 2 means that a patient visits a hospital with a certain therapeutic purpose. By the medical examination 3, the examination 4 corresponding to the symptom is performed. Next, inspection 4
The medication 5 corresponding to the result of (1) is administered to the patient, and the patient is invoiced for all the amounts for the medical examination 3, the examination 4, and the medication 5 according to the accounting 6. Then, the purpose of medical treatment is achieved, and the procedure moves to the end 7. The estimate confirmation 8 here is to count the medical expenses incurred by the medical treatment of the patient and provide the estimated amount to the patient, and estimate the amount of money according to each situation of the medical examination 3, the examination 4, and the medication 5. . As for the display form of the estimated amount, for outpatient treatment, the estimated amount is displayed by inserting the medical examination card into the terminal such as the medical reception desk that can estimate the medical cost and inputting the patient number etc. What is done, and what is displayed on the electronic bulletin board etc. at the time of accounting, such as the patient number and cost. In addition, regarding medical treatment of inpatients, the estimated amount is displayed by inputting the patient number into a personal computer or the like connected to the network installed in a nurse station or the like. Alternatively, a mobile terminal (mobile phone, PHS, etc.) in a format in which the electromagnetic waves generated do not adversely affect various medical devices in the hospital
Therefore, you may be able to obtain information on the estimated amount at that time by accessing the number or address of the prescribed inquiry reference in the hospital. The number or address of the mobile terminal to be registered is registered in advance, and thereafter, every time some action is completed (at the end of the first inspection, at the end of the second inspection, ...) It may be a system delivered to the terminal. The method of delivering the estimated amount information using these mobile terminals can be realized relatively easily because it is not necessary to arrange a terminal for confirming the estimate in the hospital.

It should be noted that here, the visit 2 by the confirmation of the estimate 8
Although the example of estimating the amount of money from to accounting 6 has been described, the amount of money may be estimated before the visit. FIG. 2 is a diagram showing a data table used when calculating an estimated amount of medical expenses under the health insurance of a health insurance certificate holder according to the embodiment of the present invention. This is an estimate of the amount of money for two indirect X-ray images taken by a urine test (qualitative determination fee test) at the outpatient's first outpatient examination under the health insurance policy. Further, since the health insurance of the holder of the health insurance certificate is borne by 20%, the amount can be estimated from the number of medical treatment points × 10 × 0.2. Specifically, it will be incurred when the first consultation fee is paid when the patient is treated at the hospital for the first time, the urine general substance qualitative judgment fee inspection of the cost incurred when performing the urine test, and the indirect X-ray imaging of two sheets. X-ray imaging (first and second images), which is the cost,
The number of medical treatment points corresponding to the X-ray diagnosis (first and second sheets) is searched, the number of medical treatment points 250 corresponding to the initial examination fee, the number of medical treatment points 28 corresponding to the urine general substance qualitative determination fee examination, and the X-ray imaging 33 medical examination points corresponding to (first image) and X-ray imaging (2
X-ray diagnosis (1st sheet) with 16 medical examination points corresponding to 1st sheet)
It is possible to obtain a medical care score 391 that is a total of the medical care score 43 corresponding to X and the medical care score 21 corresponding to the X-ray diagnosis (second image). Here, in order to count the estimate of the holder of the health insurance certificate, an amount of 782 yen is calculated as the estimated amount by the number of medical treatment points × 10 × 0.2.

Note that the estimated amount does not include consumption tax.
FIG. 3 is a diagram showing a data table used in calculating an estimated amount of medical expenses by the health insurance of the family of the health insurance card holder according to the embodiment of the present invention. This is an estimate of the amount of money for a single intravenous injection at the clinic in the outpatient visit with the health insurance of the family of the holder of a health insurance card. Also, since the family of the holder of a health insurance card bears 30% of the burden, the amount can be estimated from the number of medical treatment points x 10 x 0.3. Specifically, the medical examination points corresponding to the re-examination fee that will be incurred when receiving medical treatment again in the hospital, the cost that will be incurred when performing intravenous injection, and the medication fee that is administered by intravenous injection will be searched, 74 medical treatment points for re-examination fee and 30 medical treatment points for intravenous injection
It is possible to obtain the medical care score 254, which is the total of the medical care score 150 and the medical care score corresponding to the medication fee. Here, in order to count the estimate of the family of the health insurance card holder, the number of medical treatment points x 10
An amount of 762 yen is obtained as the estimated amount by × 0.3.

The estimated amount does not include consumption tax.
FIG. 4 is a configuration diagram illustrating a hospital management system using the medical cost estimation system according to the embodiment of the present invention. The hospital management system 9 includes a hospital information system 10 and
The radiation information system 11, the medical office terminal 12, the image server 13, the medical accounting system 14, the estimate creation server 15, the accounting terminal 16, and the external terminal 17,
The hospital information system 10 is a system in which all information related to the hospital is concentrated, and the radiation information system 11
And the medical office terminal 12 and the medical accounting system 14. The radiation information system 11 is a system that manages examination reservations in radiation diagnosis and is connected to the image server 13. The image server 13 is a storage device for storing images generated by radiological diagnosis,
The stored image is a diagnostic image generated by the MRI 18, the CT 19, the image interpretation terminal 20, and the like.

The medical accounting system 14 is a system for performing accounting processing based on information related to the medical expenses of the hospital, and an estimate making server 15 and an accounting terminal 16 for the patient to refer to the estimated amount in the hospital. It is connected to the. The estimate creation server 15 stores the medical care score table described with reference to FIGS. 2 and 3, is a server for estimating medical expenses, and corresponds to the medical expense estimation system according to the present invention. The estimate creation server 15 is connected to the external terminal 17 via a telephone line, and is available to a user who has a mobile terminal in a hospital requesting an estimate of medical expenses, or outside the hospital (home or outside). It is possible to notify the user of the estimated amount. The accounting terminal 16 is a terminal provided with an input / output unit for inputting and outputting information regarding accounting. In addition, if the number of medical care points is revised, it will be
The estimation server 15 receives the information distributed via N,
The data in the medical care score table shown in FIG. 2 and FIG. 3 is rewritten. After that, the estimated amount will be provided based on this rewritten medical care score table. here,
Information about revision of medical care points from related ministries is not limited to distribution via the Internet, but may be stored in a storage medium such as an FD or a CD.

This makes it possible to access the homepage provided by the hospital via the Internet or the like before receiving medical treatment, and to know the approximate amount of money required in advance from the list of medical points provided and medical cost estimation. Figure 5
It is a figure explaining the process in the stage which has not yet reserved medical treatment in the medical cost estimation system using the internet etc. by other embodiments. Step S11
Then, the input request from the accessing side is sent to the quotation system. Next, in step S12, in response to the input request, the estimation system side notifies the access side of necessary items. Then, in step S13, an input corresponding to the notified required item is performed and the quotation system side is notified again. It should be noted that the necessary items here include the minimum information necessary for the estimation, such as the symptoms of the access side and information regarding health insurance. Step S
At 14, the estimated amount is counted from the input necessary items and the access side is notified. As a result, the estimated amount is displayed on the access side.

According to the above embodiment, the user can compare the hospitals by obtaining the estimated amount from several hospitals. Therefore, there is an effect that it can be used as one of the judgment factors for determining which hospital is appropriate. FIG. 6 is a diagram illustrating a process assuming a case where a medical treatment reservation has been made to a specific hospital and the patient is about to undergo an examination in the medical cost estimation system using the Internet or the like according to another embodiment. In step S21,
Input requests from the accessing side are sent to the quotation system. Next, in step S22, the estimation system side receives the input request and notifies the access side of the inspection item. Then, in step S23, an input corresponding to the notified inspection item is performed and the estimation system side is notified again. The inspection items referred to here include a list displayed for each item so that the accessing side can select desired inspection contents.

In step S24, the estimated amount is counted from the input inspection items and notified to the access side. As a result, the estimated amount is displayed on the access side. From the above,
When going to the examination from now on, it is possible to know the approximate cost to be prepared, so that there is no need to worry about lack of cost at the hospital. FIG. 7 is a diagram illustrating post-examination processing of the medical cost estimation system using the Internet or the like according to another embodiment. In step S31, the input request from the accessing side is sent to the estimation system. Next, in step S32, upon receiving the input request, the necessary items are notified to the access side. Then, in step S33, the notified necessary items and the patient information for identifying the patient other than the necessary items are input and notified to the estimation system. It should be noted that here, an example in which identification is performed by inputting a medical examination card number and a personal identification number as patient information for identifying a patient is described, but in addition, identification is performed by a magnetic card reader or the like. It can be one.

Next, in step S34, the result of the practice examination of the patient is retrieved based on the identified patient information,
Present to the access side. Then, in step S35, the item of the implementation inspection required for the accessing side is selected from the presented results of the implementation inspection, and the estimation system is notified. Next, in step S36, the estimated amount is counted based on the selected item of the implementation inspection, and the access side is invoiced as the invoiced amount. Thereby, the billing amount is presented to the access side. As described above, the estimated amount in consideration of the contents of the actual examination is presented, so that the patient can know the estimated amount with relatively high accuracy and can prepare for the accounting procedure in the hospital. According to the embodiment of the present invention described above, a medical cost estimation system is provided that enables the cost of medical treatment of a patient to be counted as an estimated amount before accounting and to display the counted estimated amount. can do.

The above-described embodiments are described for facilitating the understanding of the present invention, and are not described for limiting the present invention. Therefore, each element disclosed in the above-described embodiments is intended to include all design changes and equivalents within the technical scope of the present invention.

[0017]

According to the present invention, it is possible to provide a medical cost estimation system capable of counting the cost of medical treatment of a patient as an estimated amount before accounting and displaying the counted estimated amount. it can.

[Brief description of drawings]

FIG. 1 is a diagram illustrating a procedure flow of a medical cost estimation system according to an embodiment of the present invention.

FIG. 2 is a diagram showing a data table used when calculating an estimated amount of medical expenses under the health insurance of a health insurance card holder according to the embodiment of the present invention.

FIG. 3 is a diagram showing a data table used when calculating an estimated amount of medical expenses by the health insurance of a family of a health insurance certificate holder according to the embodiment of the present invention.

FIG. 4 is a configuration diagram illustrating a hospital management system using the medical cost estimation system according to the embodiment of the present invention.

FIG. 5 is a diagram illustrating a process at a stage where a medical treatment is not yet reserved in the medical cost estimation system using the Internet or the like according to another embodiment.

FIG. 6 is a diagram illustrating a process assuming a case where a medical treatment reservation has been made to a specific hospital and a medical examination is scheduled to start in a medical cost estimation system using the Internet or the like according to another embodiment.

FIG. 7 is a diagram illustrating post-inspection processing of a medical cost estimation system using the Internet or the like according to another embodiment.

FIG. 8 is a diagram illustrating a flow of a procedure from a patient visit to an end in conventional medical care.

FIG. 9 is a diagram illustrating a flow of a counting process for obtaining a billing amount at the time of accounting for a patient in conventional medical care.

[Explanation of symbols]

1 ... Medical cost estimation system, 2 ... Visit, 3 ... Medical examination, 4 ...
Inspection, 5 ... Medication, 6 ... Accounting, 7 ... End, 8 ... Quotation confirmation, 9 ... Hospital management system, 10 ... Hospital information system,
11 ... Radiation information system, 12 ... Clinic room terminal, 13 ...
Image server, 14 ... Medical accounting system, 15 ... Quote making server, 16 ... Accounting terminal, 17 ... External terminal, 18 ... M
RI, 19 ... CT, 20 ... Interpretation terminal

Claims (3)

[Claims] 1. A medical cost estimation system for estimating a medical cost based on a medical care remuneration score table, and a medical care medical point retrieving means for retrieving a medical medical care score corresponding to a patient request based on the medical medical remuneration score table. , Medical cost counting means for counting medical costs corresponding to the request of the patient based on the medical care score table searched by the medical care score search means, and the request of the patient includes at least a request for health insurance. If there is an insurance premium counting means for counting the insurance premiums, the medical cost counting means, and a notifying means for notifying the patient of the estimated amount counted by the insurance premium counting means Medical cost estimation system. 2. A medical cost estimation system for estimating a medical cost based on a medical treatment fee score table, and an input request receiving means for receiving an input request from a client based on the medical treatment fee score table published on the Internet. And a medical-medical-care-score searching unit that searches for a medical-medical-care-score corresponding to the input request by the input-request receiving unit; and a client display unit that displays the medical-medical-care-score retrieved by the medical-medical-care-score searching unit on the display device of the client. A medical cost estimation system comprising: 3. A medical cost estimation system for estimating a medical cost based on a medical treatment fee score table, and an input request receiving means for receiving an input request from a client based on the medical treatment fee score table published on the Internet. A medical treatment point retrieval unit for retrieving a medical treatment point number corresponding to the input request by the input request receiving unit; and a medical expense corresponding to the input request of the client based on the medical treatment point number retrieved by the medical treatment point retrieval unit. Medical fee counting means for counting the insurance fee, insurance fee counting means for counting the insurance premium when the input request of the client includes at least an input relating to health insurance, the medical expense counting means, and the insurance fee counting Display means for displaying the estimated amount counted by the means on the display device of the client. Medical cost estimation system that.