JP2004110348A - Mediating method and system for health insurance society and medical institution - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To provide a system for reducing the medical institution check work of a health insurance societies, and for improving the cooperation between the health insurance societies and the medical institutions. <P>SOLUTION: Evaluation points are calculated based on a decision reference preliminarily decided for medical institutions and the information of medical institutions beyond the evaluation points required by health insurance societies is provided to the health insurance societies. <P>COPYRIGHT: (C)2004,JPO

Description

[0001]
[Industrial applications]
The present invention relates to a system and method for reducing the healthcare provider's medical institution check operations and enhancing the link between a health insurance provider and a medical institution.
[0002]
[Prior art]
There are two types of medical insurance systems, regional insurance systems and employee insurance. Regional insurance is National Health Insurance. On the other hand, employee insurance consists of health insurance, seafarer insurance, mutual aid associations such as national public servants, mutual aid associations such as local public servants, and private school teachers' staff mutual aid associations. Health insurance includes government-managed health insurance and union-managed health insurance. In the present specification, a union or the like that manages the above insurance is a health insurance company.
[0003]
In medical insurance, for example, in union-managed health insurance, an employer and an employee usually pay insurance premiums to an insurer such as an insurance union.
[0004]
Therefore, when the employee receives medical treatment at a medical institution due to a disease or the like, the medical institution charges medical expenses to the employee except for a partial insurance contribution, and the employee pays the medical expenses. Then, the medical institution writes the medical treatment result of the employee in the receipt and submits it to the social insurance medical payment fund. On the other hand, if the social insurance medical payment fund examines and passes this claim, it will pay the medical institution a partial co-payment after calculating the score. The Social Insurance Medical Payment Fund, which paid the medical insurance facility co-payment, claims the insurer the insurance co-payment along with a claim. The insurer pays the requested insurance partial contribution to the social insurance medical payment fund from the accumulated premium.
[0005]
As a conventional technology, there is a system for introducing a dental clinic to a patient who is a subject to be examined (for example, see Patent Literature 1). However, there is no system that discloses an intermediary system between a health insurance company and a medical institution. Did not.
[0006]
[Patent Document 1]
JP-A-2002-83060 (page 5, FIG. 1)
[0007]
[Problems to be solved by the invention]
However, while medical expenses have increased over the long term due to the aging of the population, premium income has declined in the short term due to labor cost reductions due to the severe economic situation, and corporate-paid insurance has been implemented through corporate cost reduction measures. The demand for cost reduction will also increase. In addition, premium income has been declining over the long term due to a drop in the birth rate. Already, 91% of the 91 health insurance unions nationwide have a deficit finance. This ever-increasing medical costs will naturally lead to an increase in receipts. At present, complete computerization of the claim has not been advanced, and even if the computerization has been advanced, it is necessary to rely on humans to confirm the validity of the contents of the claim. For this reason, the labor cost for confirming the validity of the claim is a heavy burden on the insurance union and the like as the insurer. For example, there has been a case where the validity of a claim cannot be processed within the insurer, and even a case of outsourcing to an external processing company. In this respect as well, labor costs, especially for checking dental receipts, represent a large proportion.
[0008]
In addition, the burden on the insurer increases as the employee receives treatment at a plurality of medical institutions. However, at present, there is no effective means to restrain the treatment destination of the employee.
[0009]
On the other hand, since there are currently 27 dental schools in Japan, there are currently 62,000 dentists, but this number is increasing year by year. On the other hand, the number of patients is decreasing in the short term due to the severe economic situation. In addition, the number of patients tends to decrease over the long term due to the declining birthrate.
[0010]
As a result, the number of dentists per dentist decreases, and dentists are concentrated in urban areas, especially in populated areas, and the competition for patient acquisition is increasing.
[0011]
Under such circumstances, the insurance unions and medical institutions have not always been able to make full use of the relationship. In some cases, a business institution may designate a medical institution near a business in which a health insurance union exists as a designated medical institution. There was no change to provide better services from the dentist and no guarantee from the operator to provide a patient market.
[0012]
Accordingly, an object of the present invention is to provide a system and a method for reducing the number of medical institution check operations of a health insurance company and enhancing cooperation between the health insurance company and the medical institution.
[0013]
[Means for Solving the Problems]
The method for mediating between a health insurance company and a medical institution according to the present invention includes a step of calculating an evaluation score based on a predetermined criterion for the medical institution, and a process of calculating an evaluation score exceeding the evaluation score required by the health insurance business. Providing information to the health insurance entity.
[0014]
The mediation method may further include receiving a medical appointment reservation with a medical institution after a dental checkup for a member of the health insurance entity, and receiving a medical appointment with the medical institution using a video conference terminal.
[0015]
The mediation method may further include accepting an appointment for a medical treatment from a medical institution member regularly stationed at the health insurance business entity.
[0016]
Further, the medical treatment contents of the medical institution after the medical treatment may be confirmed, and the second evaluation point may be calculated from the contents based on a second determination criterion predetermined for the medical institution.
[0017]
An intermediary system between a health insurance entity and a medical institution according to the present invention includes a medical institution terminal provided at a medical institution, a health insurance entity terminal provided at the health insurance entity, and an intermediary server connected through an electric communication line. The mediation server is configured such that medical institution data is input from a medical institution terminal and recorded in a medical institution database on a web page provided in the mediation server, and an evaluation server electrically connected to the mediation server is determined in advance. The evaluation points of the medical institution are calculated based on the determined criterion and recorded in the medical institution database. introduce.
[0018]
In addition, the medical institution terminal is connected to the health insurance business terminal sub-terminal connected to the health insurance business terminal, accesses the mediation server simultaneously, and displays the calendar for reservation and timetable on both terminals on the web Then, the reservation information can be recorded in a reservation database connected to the mediation server.
[0019]
Further, the medical institution terminal and the health insurance business entity terminal sub-terminal may further be connected to an imaging device, a microphone, and headphones, and may be configured to be usable as a video conference terminal.
[0020]
The number of medical checkups and the number of visitors to medical institutions at health insurance entities are recorded in the database of health insurance entities, and the number of unknown consultations to health insurance entities by checking specific items of medical institutions is recorded in the database of medical institutions. Then, the evaluation server may calculate the health insurance company evaluation points from the health insurance business database, and the evaluation server may calculate the effective consultation rate from the medical institution database. Here, the specific item check means a chart check, a receipt check, and a customer satisfaction check. As a result of these checks, the number of cases and the like are input.
[0021]
Furthermore, the medical institution database examines the correspondence between the unknown consultation content chart and the receipt.
[0022]
BEST MODE FOR CARRYING OUT THE INVENTION
Hereinafter, an embodiment of the present invention will be described with reference to FIGS. 1 and 2 attached to a case where a medical institution is a dental clinic as an example. The mediation system between a health insurance company and a medical institution according to the present invention enhances the relationship between the health insurance company and the medical institution, improves its profits, and reduces unnecessary labor costs and medical costs. .
[0023]
First, the configuration of this system will be described, and then its flow will be described. FIG. 1 shows a block diagram of an intermediary system between a health insurance business entity and a medical institution according to the present invention.
[0024]
First, in the configuration of the present system, the mediation server 2 is connected to a network 4 such as the Internet, and a plurality of medical institution terminals 6 and health insurance company terminals 8 are connected to the network 4.
[0025]
The mediation server 2 is electrically connected to the evaluation server 10 as shown in FIG. A plurality of databases are connected to the mediation server 2, and include a health insurance company database 12, a medical institution database 14, a web database 16, and a reservation database 18. The mediation server 2 is managed by a mediator.
[0026]
The function of the mediation server 2 is as follows. Data is input from a web page corresponding to each database recorded in the web database 16, and any one of the health insurance company database 12, the medical institution database 14, and the reservation database 18 is used. The data is recorded in the. The mediation server 2 can also output and display the contents of each database on a web page corresponding to each database. The mediation server 2 can be automatically transmitted to a predetermined party by the e-mail function 19 in addition to the display on the web.
[0027]
The data to be calculated by the calculation is calculated by the evaluation server 10.
[0028]
The evaluation server 10 extracts data from each database connected to the mediation server 2 based on a calculation database 20 including a plurality of calculation methods and calculation standards recorded in advance, and uses the extracted calculation methods and calculation standards as a basis. Is calculated.
[0029]
The health insurance company database 12 registers the union name, the location, the e-mail address, the number of union members, the conditions for the medical institution, the medical checkup patient list, the medical institution examination results, and other information of the registered health insurance company. Is done. This content is registered by a web page. This content is restricted by the access authority.
[0030]
The medical institution database 14 includes registered medical institution names, addresses, e-mail addresses, dentist-owned technologies, chart reliability, admission preparation fund delivery status, in-hospital facilities, clinic appearance and interior, number of dental hygienists, Information such as the number of clerks and management policies is registered. This content is registered by a web page. This content is restricted by the access authority.
[0031]
The web database 16 includes a plurality of web page data. The web page is a medical institution registration web page, a health insurance company registration web page, a medical institution evaluation input and score calculation instruction web page, a medical institution score display web page, a medical institution result report mail transmission confirmation web page, a health insurance company Referral email transmission confirmation web page, medical institution contract web page, health insurance company contract web page, medical examination appointment web page after screening, regular medical institution test result input web page, health insurance company test result input web page, periodic medical care It consists of an institution reexamination display web page and a health insurance company inspection display web page.
[0032]
The medical institution registration web page is a web page for registering information such as a registered medical institution name, address, e-mail address, technology owned by the dentist, the number of dental hygienists, the number of clerks, and management policies.
[0033]
The health insurance company registration web page is a web page for inputting the name, location, e-mail address, number of members, and conditions for medical institutions of the registered health insurance company.
[0034]
The medical institution evaluation input and score calculation instruction web page is a web page for actually inputting evaluation results such as chart reliability, in-hospital funding status, in-hospital facilities, clinic exterior and interior, and the like.
[0035]
The medical institution score display web page is a web page that displays the evaluation score calculated by the evaluation server after the evaluation is input, and the viewing authority is limited.
[0036]
The medical institution result report e-mail transmission confirmation web page is provided to confirm an e-mail for transmitting the evaluation result to the medical institution after calculating the evaluation points before transmitting the e-mail to the medical institution terminal.
[0037]
The confirmation email transmission confirmation web page is provided to confirm the e-mail to introduce the medical institution to the health insurance company before sending it to the terminal of the health insurance company after calculating the evaluation score. is there.
[0038]
The medical institution contract web page is an input web page for making a contract with a health insurance company contract.
[0039]
The health insurance company contract web page is an input web page for making a contract with a medical institution contract.
[0040]
The post-examination medical treatment reservation web page is a web page for an examiner who needs treatment by a medical institution after an examination to make an appointment for treatment to a medical institution at an examination point as shown in FIG. This web page displays the calendar display, time display, and the image display of the video conference terminal connected to the reception of the medical institution. Enter the name or insurance card number and other information in the time slot where treatment can be reserved. This is a web page that allows the user to make a treatment appointment while receiving instructions at a medical institution reception and a video conference terminal.
[0041]
The regular medical institution test result input web page has a treatment result input field where you can enter the treatment results of employees who have been treated at a medical institution using this system, and a treatment result examination in which the presence or absence of impropriety in the treatment results is entered. This is a web page provided with an input field.
[0042]
The health insurance company test result input web page is a web page for inputting a person who has actually been treated and the date and time when the treatment was received among employees who have reserved on the medical treatment reservation web page after examination.
[0043]
The regular medical institution reexamination display web page is a web page for displaying the treatment result information and the treatment result examination information input on the regular medical institution examination input web page.
[0044]
The appointment database 18 is a database for recording when a medical institution makes a medical appointment reservation at the time of conducting a medical examination at a health insurance company and makes a reservation from the web. The patient name, health insurance number, examination result, patient appointment date and patient appointment time are recorded. Further, the contents of diagnosis and the contents of treatment as a result of the subsequent consultation are also recorded.
[0045]
The calculation database 20 includes a medical institution first determination table, a medical institution second determination table, and a health insurance company determination table.
[0046]
The first judgment table of the medical institution is the name, address, dentist's technology, chart reliability, admission preparation fund delivery status, in-hospital facilities, clinic appearance and interior, number of dental hygienists, number of clerks, management policy, etc. After the information is scored and weighted according to the request of the health insurance company, a reference value for calculating the physical distance between the medical institution and the health insurance company is recorded and the evaluation server 10 calculates This is a table in which data is recorded.
[0047]
The medical institution second determination table further records a determination standard for determining the reliability of the receipt and the customer satisfaction when the reliability and the receipt on the continuous medical record are available, and performs the second determination. 4 is a table in which a reference value is recorded and data when the evaluation server 10 calculates is recorded. Here, a question for quantifying the degree of customer satisfaction is prepared, and is quantified by investigating it with a questionnaire or the like for the customer. A criterion for determining the degree of customer satisfaction is provided for this numerical value, and the value is set so as to determine the level.
[0048]
The health insurance company determination table is a table in which a predetermined visit rate for calculating a visit rate from the number of patients undergoing a health checkup and the number of patients actually visiting a medical institution and comparing the calculated visit rate is recorded and referred to. It is.
[0049]
In addition to the mediation server 2 and the evaluation server 10 described above, the medical institution terminal 6 and the health insurance company terminal 8 are connected via the electric communication line 4.
[0050]
The medical institution terminal 6 is a terminal electrically connected to the telecommunication line 4, and is composed of a general personal computer such as a PC / AT compatible machine. The medical institution terminal 6 is further connected to a television camera 22 and headphones 24 with a microphone. As shown in FIG. 1, the medical institution terminal 6 has both a web page browsing function and a video conference terminal function, and can execute both functions at the same time.
[0051]
The health insurance company terminal 8 is a terminal that is electrically connected to the telecommunication line 4 and includes a personal computer such as a general PC / AT compatible machine. The health insurance company terminal 8 can be electrically connected to the portable terminal 26.
[0052]
The portable terminal 26 is connected to a television camera 28 and a headphone 30 with a microphone, has a web page browsing function and a video conference terminal function, and can be executed simultaneously. The portable terminal 26 is connected to the telecommunication line 4 via the health insurance company terminal 8, but may be connected to the telecommunication line 4 independently.
[0053]
Each of the television cameras 22 and 28 is a camera that can be used as a video conference terminal via a network, and includes a CCD receiver and a connection line.
[0054]
The headphones with microphones 24 and 30 are microphones and headphones capable of converting audio signals and electric signals at a video conference terminal via a network, and include a condenser microphone and small speakers.
[0055]
FIG. 4 shows a method using the system of the present invention with the above configuration. The procedure of this method is roughly the steps of registering a medical institution and a health insurance entity, and examining, mediating, screening, and reexamining the medical institution. These input / output data on a web page on the mediation server 2.
[0056]
The first step is a step of registering medical institution data in the medical institution database 14 (A1). The web page on which this registration is made is a medical institution registration web page. When information such as the medical institution name, address, e-mail address, technology owned by the dentist, the number of dental hygienists, the number of clerks, and the management policy is input on this web page, it is recorded in the dental care database 14.
[0057]
The second step is a step in which the data of the health insurance company is registered in the health insurance company database 12 (A2). The web page where this registration is made is the health insurance company registration web page. When information such as the union name, location, e-mail address, number of union members, conditions for medical institutions, etc. of the health insurance company is input on this web page, it is recorded in the health insurance company database 12.
[0058]
The third step is a step of calculating an evaluation score from medical institution data (A3). Here, the mediator visits and interviews the actual medical institution, observes the reliability of the medical record, the status of funding for admission preparation, in-hospital facilities, the clinic exterior and interior, and evaluates the situation by the medical institution. Input and input to the point calculation instruction web page. The input data is recorded in the dental care database 14. At this time, before being recorded, each situation is compared with the medical institution first determination table, and the evaluation server 10 calculates an evaluation score. The calculated evaluation score is recorded in the dental care database 14.
[0059]
The fourth step is a step of determining an optimal medical institution (A4). After calculating the evaluation scores for the plurality of medical institutions in the third step, selection of an optimal medical institution for a specific health insurance company is started. The conditions for the medical institution registered in the second step, the location of the specific health insurance company or the distance from the establishment designated by the specific health insurance company to the medical institution, etc. are also the medical institution first determination table. Then, the evaluation server 10 calculates a score by comparing the score. At this time, each item is calculated by weighting. The medical institution with the highest total score is determined as the optimal medical institution.
[0060]
The fifth step is a step in which the e-mail function 19 generates a selection result report e-mail and transmits it to each dental care terminal 6 (A5). The content of whether or not the result determined in the fourth step is selected by a specific health insurance company for each medical institution is prepared in advance in a form and transmitted to each dental care terminal 8 destination address. Here, before the e-mail is sent, the contents of the e-mail to be sent can be checked on the medical institution result report e-mail transmission confirmation web page, and the contents can be checked and added before automatic transmission. It is possible.
[0061]
The sixth step is a step in which the e-mail function 19 generates an e-mail recommending the medical institution determined to be optimal and transmits it to the specific health insurance company terminal 8 (A6). Here, the content of the transmitted e-mail can be confirmed on the introduction mail transmission confirmation web page to the health insurance company, and the content can be checked or added before automatic transmission.
[0062]
The seventh step is to access the health insurance company contract web page from the health insurance company terminal 8 once the consent of the specific health insurance company terminal 8 has been obtained for the contract with the medical institution introduced in the sixth step. This is the step in which the mediation server 2 waits for an input (A7). Here, the authentication information of the health insurance company, the contract period, and the contract conditions can be input. Here, the inputted authentication information of the health insurance company, the contract period, and the contract conditions are recorded in the health insurance company database 12 by the mediation server 2. After the record is confirmed, proceed to the next step. In the contract conditions, for example, the lower limit of the consultation rate among employees and the consultation rate among treatment reservation persons is set.
[0063]
The eighth step is a step in which the medical institution contract web page is accessed from the dentist terminal 6 and the mediation server 2 waits for an input (A8). Here, the authentication information of the dentist and the agreed contract conditions can be input. The terms of the contract include the implementation of a free dental check-up and a request for a healthy and minimal score claim. Here, the input authentication information of the dentist and the agreed contract conditions are recorded in the medical institution database 14 by the mediation server 2. After the record is confirmed, proceed to the next step.
[0064]
The ninth step is a treatment reservation step after a physical examination (A9). When the contract agreement between the health insurance company and the medical institution is established, the mediator dispatches the dental hygienist under the mediator to the health insurance company with the examination device and the portable terminal 26 carried. The dental hygienist is not limited to regular employees, and is more preferably a dental hygienist registered with a temporary staffing agency. This dental hygienist performs a dental check-up at a factory or the like of a health insurance company for employees who are also factory employees. The cost of dental checkups should be borne by the medical institution and free of charge to health insurance providers. After the dental checkup, the reservation made for the employee who needs treatment is the reservation for this process. The dental hygienist electrically connects the health insurance company terminal 8 to the portable terminal 26 and connects to the mediation server 2 via the network. Further, it is electrically connected from the mediation server 2 to the contracted medical institution terminal 6. Here, the mobile terminal 26 displays a medical treatment reservation web page after the medical examination. The post-examination medical appointment reservation web page displays a calendar display, a time display, and an image display unit of the video conference terminal connected to the reception of the medical institution.
[0065]
The calendar display and the time display are reservation screens, in which a reservable time zone and a non-reservable time zone due to a prior contract or the like are identifiably displayed.
[0066]
On the other hand, the video conference terminal displays an image of the receptionist of the connected medical institution, and the user can make a face-to-face reservation in the same way as when making a reservation at a medical institution.
[0067]
Here, the mediation server 2 records the information, date and time, and name information reserved on the medical examination reservation web page after the examination in the medical institution database 14.
[0068]
Here, a dental checkup was conducted for employees who are also factory employees at the health insurance company's factory, etc. It is also possible to arrange for a health insurance company to carry a screening device and a portable terminal 26 with a health insurance company and accept reservations.
[0069]
The tenth step is a regular medical institution inspection step (A10). After the ninth step, the intermediary performs a follow-up survey on the medical treatment after the examination. The subjects of the survey are the treatment results of employees who have been treated at medical institutions. That is, the mediator determines the validity of the medical record that is the result of the treatment. Further, the validity of the claim as to whether or not a minimum claim has been made is determined. In addition, customer satisfaction may be checked by investigating patient satisfaction. All of these are entered by the mediator on the regular medical institution inspection input web page. The mediation server 2 records information on the validity of the input medical record and the validity of the receipt and customer satisfaction data in the medical institution database 14. This data is further recorded in accordance with the medical institution second determination table, the reliability on the continued medical record and, if a receipt is available, a determination criterion for determining the reliability of the receipt, and a criterion for making the second determination. The value is recorded, and the evaluation server 10 calculates. Here, the validity check of the receipt and the medical record and the evaluation score based on the customer satisfaction are transmitted from the intermediary server 2 to the health insurance company terminal 8, so that the health insurance company's receipt work is reduced and the health insurance company Labor costs can be reduced.
[0070]
The eleventh step is a step in which the result of the intermediary inspecting the health insurance company is input (A11). The intermediary inputs the name information and the date and time information of the person who was actually treated among the employees who made an appointment on the medical appointment appointment web page after the examination to the health insurance company examination input web page. The mediation server 2 records the name information of the person who actually received the treatment and the date and time information of the time when the treatment was received in the health insurance company database 12. Furthermore, the evaluation server 10 calculates a visit rate using the health insurance company determination table from the recorded name information of the person and the information on the date and time of receiving the treatment. If the visit rate is lower than the lower limit of the initial contract, the result is displayed on the health insurance company test input web page as a calculation result of the evaluation server 10 after input. The health insurance company can improve the consultation rate by feeding back the dental consultation information of the employees who have been consulted to improve the consultation rate to the health insurance company terminal 8 and granting a health insurance benefit. Also, in medical institutions, it is possible to improve the consultation rate by further reducing the claim insurance point of 10 points per claim to 10 yen, or returning profits to employees by discounting free medical treatment costs or cashback. In addition, the medical treatment cost can be reduced by a uniform 10%.
[0071]
【The invention's effect】
ADVANTAGE OF THE INVENTION According to this invention, reduction of the medical institution check operation | work of a health insurance enterprise and cooperation between a health insurance enterprise and a medical institution can be improved.
[0072]
For a medical institution, it is possible to secure a certain number of patients for a long time without advertising.
[0073]
Furthermore, the provision of additional services allows the patient to be enclosed.
[0074]
On the other hand, for health insurance companies, costs can be reduced by reducing dental examination costs.
[0075]
In addition, not only can the specific medical institution and the claim be minimized, but also the receipt check can be made unnecessary for the dentist, so that personnel costs, insurance points, and costs can be reduced.
[0076]
Furthermore, by specifying medical institutions, medical institutions can be narrowed down and medical costs can be reduced.
[0077]
At the same time, employees can manage their health with peace of mind.
[Brief description of the drawings]
FIG. 1 is a block diagram of an intermediary system between a health insurance business entity and a medical institution according to the present invention.
FIG. 2 is a configuration diagram of a mediation server and an evaluation server in a mediation system between a health insurance business entity and a medical institution according to the present invention.
FIG. 3 is a monitor screen of a video conference terminal in an intermediary system between a health insurance business entity and a medical institution according to the present invention.
FIG. 4 is a flowchart of a method for mediating between a health insurance business entity and a medical institution according to the present invention.
[Explanation of symbols]
2 Mediation server
4 Network network
6 medical institution terminals
8 Health insurance company terminals
10 Evaluation server
12 health insurance company database
14 Medical Institution Database
16 Web Database
18 Reservation database
19 E-mail function
20 Calculation database
22 TV Camera
24 headphones
26 Portable terminal
28 TV Camera
30 Headphones with microphone

Claims (10)

A health insurance entity including a step of calculating an evaluation score based on a predetermined criterion for the medical institution, and a process of providing the health insurance entity with information on the medical institution exceeding the evaluation score required by the health insurance entity. How to mediate with medical institutions. 2. The method according to claim 1, wherein the mediation method further comprises receiving a medical appointment reservation with a medical institution after a dental checkup for a member of the health insurance entity. 2. The method according to claim 1, wherein the mediation method further comprises receiving a medical appointment reservation from a medical institution from a medical institution member regularly stationed at the health insurance business. The medical treatment content after medical treatment of the medical institution is confirmed, and a second evaluation point is further calculated from the content based on a second determination criterion predetermined for the medical institution. Intermediary method between the health insurance business entity and the medical institution described. A medical institution terminal provided in a medical institution, a health insurance business entity terminal provided in a health insurance business entity, and a mediation server are connected through an electric communication line, and the mediation server uses a web page provided in the mediation server to perform medical treatment. Institutional data is input from the medical institution terminal and recorded in the medical institution database, and an evaluation server electrically connected to the mediation server calculates evaluation points for a plurality of medical institution based on predetermined criteria, and The results of the calculation are recorded in the institutional database, the calculated results are compared, and the most appropriate medical institution is selected from among the medical institutions. Intermediary system with institutions. The medical institution terminal is connected to the health insurance company terminal sub-terminal connected to the health insurance company terminal, accesses the intermediary server, and displays the calendar and timetable for reservation on the web on both terminals and makes a reservation 6. The mediation system between a health insurance business entity and a medical institution according to claim 5, wherein the information is recorded in a reservation database connected to the mediation server. 7. The health insurance business entity and the medical institution according to claim 6, wherein the medical institution terminal and the health insurance business entity terminal sub terminal are further configured to be connected to an imaging device, a microphone, and a headphone so as to enable a video conference terminal. Mediation system. 8. The intermediary system between a health insurance business entity and a medical institution according to claim 6, wherein the number of unknown consultations to the health insurance business by checking specific items of the medical institution is recorded in a medical institution database. The number of screening patients and the number of hospital visits to medical institutions are recorded in the health insurance company database, the evaluation server calculates the health insurance company evaluation points from the health insurance company database, and the evaluation server 8. The mediation system between a health insurance business entity and a medical institution according to claim 6, wherein the effective consultation rate is calculated from an institution database. 9. The intermediary system between a health insurance business entity and a medical institution according to claim 8, wherein the medical institution database examines the correspondence between the unknown consultation content chart and the claim.

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