JP2003296441A5 - - Google Patents

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Publication number
JP2003296441A5
JP2003296441A5 JP2002094962A JP2002094962A JP2003296441A5 JP 2003296441 A5 JP2003296441 A5 JP 2003296441A5 JP 2002094962 A JP2002094962 A JP 2002094962A JP 2002094962 A JP2002094962 A JP 2002094962A JP 2003296441 A5 JP2003296441 A5 JP 2003296441A5
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Japan
Prior art keywords
receipt
insured
examination
institution
qualification
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JP2002094962A
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Japanese (ja)
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JP4248799B2 (en
JP2003296441A (en
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Priority to JP2002094962A priority Critical patent/JP4248799B2/en
Priority claimed from JP2002094962A external-priority patent/JP4248799B2/en
Publication of JP2003296441A publication Critical patent/JP2003296441A/en
Publication of JP2003296441A5 publication Critical patent/JP2003296441A5/ja
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Publication of JP4248799B2 publication Critical patent/JP4248799B2/en
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Claims (10)

医療機関などレセプト作成機関のサーバが、レセプトの送付先を被保険者毎に選択して適宜な処理を行う方法であって、
被保険者毎に予め選定された審査支払機関の情報を格納したデータベースから、レセプトの作成由来となる被保険者に応じた審査支払機関を選択するステップと、
選択された審査支払機関の端末のネットワーク上のアドレスを認識し、このアドレスに宛てて前記被保険者由来のレセプトを送信するステップと、
を含むことを特徴とするレセプト処理方法。
A server of a receipt creation organization such as a medical institution selects a delivery destination for each insured person and performs an appropriate process.
Selecting a screening / paying institution corresponding to the insured from which the receipt is created, from a database storing information on screening / paying institution selected in advance for each insured;
Recognizing an address on the network of the terminal of the selected examination and payment institution, and sending a receipt from the insured to this address;
And a receipt processing method.
前記レセプトの送信処理に先立つレセプト作成に際し、選択された審査支払機関向けに予め定められたレセプトフォーマットを、当該フォーマットと審査支払機関との関係を定めたフォーマットデータベースに該当審査支払機関の識別情報を照合させて検索するステップと、
検索されたレセプトフォーマットのデータを出力装置に出力するか、又は当該レセプトフォーマットに対して対応するレセプト用データをはめこんでレセプトを作成するステップと、
を含むことを特徴とする請求項1に記載のレセプト処理方法。
When creating a receipt prior to the receipt transmission process, the receipt format predetermined for the selected examination and payment institution is stored in the format database that defines the relationship between the format and the examination and payment institution. A step of matching and searching;
Outputting the retrieved receipt format data to an output device, or creating a receipt by inserting the corresponding receipt data for the receipt format; and
The receipt processing method according to claim 1, comprising:
前記審査支払機関の検索ステップにおける前記データベースが、被保険者属性や、請求点数や病傷名などのレセプト内容に対して、選定すべき審査支払機関を関連付けしたデータ構成をなし、
前記サーバは、被保険者由来の前記被保険者属性やレセプト内容に基づき、前記データベースにおける審査支払機関の選択を実行することを特徴とする請求項1に記載のレセプト処理方法。
The database in the search step of the examination and payment institution has a data structure in which the examination and payment institution to be selected is associated with the insured attribute, the receipt contents such as the number of claims and the name of the disease,
The receipt processing method according to claim 1, wherein the server executes selection of an examination / payment institution in the database based on the insured attribute derived from the insured person and the contents of the receipt.
被保険者毎の保険資格の有効性情報と前記データベースとを備える資格審査機関端末に対して、被保険者属性の情報を含む保険資格照会依頼を行うことで、該当被保険者の資格照会結果を取得する一方で、当該資格審査機関端末においてなされた被保険者に応じた審査支払機関の選択処理結果を取得することを特徴とする請求項1に記載のレセプト処理方法。  By submitting an insurance qualification inquiry request including information on the attributes of the insured person to the qualification examination organization terminal comprising the information on the validity of the insurance qualification for each insured person and the database, the qualification inquiry result of the insured person The receipt processing method according to claim 1, further comprising: acquiring a result of selection processing of an examination / payment institution in accordance with an insured person made at the qualification examination organization terminal. 前記データベース乃至資格審査機関端末の機能を前記審査支払機関の端末が備えることを特徴とする請求項1に記載のレセプト処理方法。  2. The receipt processing method according to claim 1, wherein a terminal of the examination / payment institution has a function of the database or qualification examination organization terminal. 前記サーバまたは資格審査機関端末が前記データベースにおける審査支払機関の選択を実行する際のキーとなる、被保険者属性やレセプト内容を、入力端末における入力動作を受付けて取得するか、又は当該被保険者が有する記録媒体に対する読取り動作で得られた情報を読取り装置から取得することを特徴とする請求項1に記載のレセプト処理方法。  The server or qualification examination authority terminal receives the input operation at the input terminal and acquires the insured person attribute and the receipt content, which are the keys when the examination payment organization in the database is selected, or the insured The receipt processing method according to claim 1, wherein information obtained by a reading operation on a recording medium held by a person is obtained from a reading device. レセプトの送付先を被保険者毎に選択して適宜なレセプト処理を行う方法を実現するシステムであって、
被保険者毎に予め選定された審査支払機関の情報を格納したデータベースから、レセプトの作成由来となる被保険者に応じた審査支払機関を選択する手段と、
選択された審査支払機関の端末のネットワーク上のアドレスを認識し、このアドレスに宛てて前記被保険者由来のレセプトを送信する手段と、
を備えたことを特徴とするレセプト処理システム。
A system that realizes a method of selecting an address for receiving a receipt for each insured and performing an appropriate receipt process,
Means for selecting an examination / payment institution corresponding to the insured from which the receipt is created, from a database storing information of an examination / payment institution selected in advance for each insured;
Means for recognizing an address on the network of the terminal of the selected examination and payment institution and transmitting a receipt from the insured to this address;
A receipt processing system comprising:
レセプトの送付先を被保険者毎に選択して適宜なレセプト処理を行う方法をコンピュータ上で実現するプログラムであって、
被保険者毎に予め選定された審査支払機関の情報を格納したデータベースから、レセプトの作成由来となる被保険者に応じた審査支払機関を選択するステップと、
選択された審査支払機関の端末のネットワーク上のアドレスを認識し、このアドレスに宛てて前記被保険者由来のレセプトを送信するステップと、
を含むことを特徴とするレセプト処理プログラム。
A program that realizes on a computer a method for selecting a delivery destination for each insured person and performing an appropriate receipt process ,
Selecting a screening / paying institution corresponding to the insured from which the receipt is created, from a database storing information on screening / paying institution selected in advance for each insured;
Recognizing an address on the network of the terminal of the selected examination and payment institution, and sending a receipt from the insured to this address;
And a receipt processing program.
請求項8に記載のレセプト処理プログラムを記録したコンピュータ読み取り可能な記録媒体。  A computer-readable recording medium on which the receipt processing program according to claim 8 is recorded. 被保険者毎の保険資格の有効性情報と前記データベースとを備え、
前記サーバからの被保険者属性の情報を含む保険資格照会依頼を受け付けて該当被保険者の資格照会処理を行う手段と、
その処理結果をサーバに返信する一方で、被保険者に応じた審査支払機関の前記選択処理を行う手段と、
を備えたことを特徴とする資格審査機関端末。
Comprising the validity information of the insurance qualification for each insured and the database;
Means for accepting an insurance qualification inquiry request including information on insured person attributes from the server and performing qualification inquiry processing of the insured;
Means for performing the selection process of the examination and payment institution according to the insured person while returning the processing result to the server;
A qualification examination organization terminal characterized by comprising.
JP2002094962A 2002-03-29 2002-03-29 Receipt processing method and system Expired - Fee Related JP4248799B2 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
JP2002094962A JP4248799B2 (en) 2002-03-29 2002-03-29 Receipt processing method and system

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
JP2002094962A JP4248799B2 (en) 2002-03-29 2002-03-29 Receipt processing method and system

Publications (3)

Publication Number Publication Date
JP2003296441A JP2003296441A (en) 2003-10-17
JP2003296441A5 true JP2003296441A5 (en) 2005-08-11
JP4248799B2 JP4248799B2 (en) 2009-04-02

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Family Applications (1)

Application Number Title Priority Date Filing Date
JP2002094962A Expired - Fee Related JP4248799B2 (en) 2002-03-29 2002-03-29 Receipt processing method and system

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Families Citing this family (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2006030760A1 (en) 2004-09-13 2006-03-23 Matsushita Electric Industrial Co., Ltd. Speaker system
JP2006085554A (en) * 2004-09-17 2006-03-30 Oki Electric Ind Co Ltd Form classification system, and method for creation and delivery of electronic medium form
KR100597289B1 (en) 2006-03-03 2006-07-04 건강보험심사평가원 The method for electronic examination of medical fees
JP5292189B2 (en) * 2009-06-01 2013-09-18 日本電信電話株式会社 Certification system and certification method
JP7089247B2 (en) * 2018-05-30 2022-06-22 東亜システム株式会社 Personal number usage support system

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