JP2011076436A - Receipt processor - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To eliminate complicated operation when a medical institution or a pharmacy handles an online return receipt and a paper return receipt. <P>SOLUTION: The receipt processor includes: a medical data registration means inputting and registering medical data that is a basis for calculating medical expenses for each patient; a receipt generation means generating a receipt based on the registered medical data; a receipt storage means storing the generated receipt; a billing means collecting receipts for one month, generating a bill, and performing online billing for the medical expenses; a return receipt registration means registering the returned paper receipt; and a receipt correction means correcting the registered return receipt, to be billed again. The billing means bills the patient for the return receipt corrected to be billed again by the receipt correction means together with the receipt stored in the receipt storage means. <P>COPYRIGHT: (C)2011,JPO&INPIT

Description

  The present invention relates to a receipt processing apparatus for issuing a so-called receipt such as a medical fee remuneration statement and a dispensing fee bill.

  Medical office computers that register medical data of patients at medical institutions, calculate medical expenses, and issue a medical remuneration statement have become widespread (see Patent Document 1). Similarly, office computers that register dispensing data at dispensing pharmacies, calculate dispensing fees, and issue dispensing fee details (hereinafter referred to as “receipt together with medical fee details”) have become widespread. The receipt is a statement that summarizes the medical treatment (dispensing) results for one month for each patient, and the calculation and billing of the medical expenses are performed in units of one calendar month. At that time, a medical fee invoice or a dispensing fee invoice is compiled by summing up all the monthly receipts from the medical institution or dispensing pharmacy and submitted together with the receipt. The office computer also has the function of creating and issuing this bill.

  The recipient of the receipt (request) is the National Insurance Association Federation (National Health Insurance Association) for the National Health Insurance (National Health Insurance), and the Social Insurance Medical Fee Payment Fund for the Social Insurance (Social Insurance). These are called examination and payment institutions, and these are the primary reception desks. After the primary examination at the primary reception desk, if it is National Health Insurance, it will be sent to each municipality, if it is a company insurance, it will be sent to the respective insurer (health insurance association, etc.) and medical expenses will be paid after the secondary examination. .

  In the past, medical fees were billed by sending a receipt printed on paper or a magnetic storage medium storing the receipt data to the examination and payment institution, but in recent years, the receipt data is directly sent to the examination and payment agency via a communication network. So-called online billing, which is sent and billed, has become mainstream.

  By the way, the receipt has a field for entering basic data, a score field, and a summary field. Basic data includes information on the medical institution such as the name and location of the medical institution, information on the patient such as the patient's name and date of birth, information on the insurance such as the insurer number, symbol and number, etc. In addition, information related to medical care such as the medical treatment start date, the outcome, the actual number of medical treatment days, etc. is described. In the score column, the score and number of times of each medical practice are described. The medical fee is calculated by the sum of the score of the medical practice and the drug price score. If these data are incomplete, the receipt is returned to the issuing medical institution or dispensing pharmacy. This is referred to as a return of the receipt, and the returned receipt is referred to as a return receipt. The medical fee is paid by reducing the medical fee for this return receipt. The medical institution will resolve the deficiency of the return receipt and re-claim after the following month.

JP2000-181972

  Return from the primary reception desk, this is called primary return, but if you are charging online, this primary return is also done online. However, the receipt returned as a result of the secondary examination (secondary return) is a receipt printed on paper (paper receipt). For this reason, medical institutions and pharmacies have to deal with online return receipts and paper return receipts, and the processing is complicated.

  The present invention stores medical data registration means for inputting and registering medical data as a basis for calculating medical expenses for each patient, a receipt generating means for generating a receipt based on the registered medical data, and the generated receipt. A receipt storage means, a bill processing means for counting the receipts for one month to generate a bill and performing a medical billing process online; a return receipt registration means for registering a returned paper receipt; And a receipt modifying means for modifying the registered return receipt so that it can be reclaimed. The claim processing means, together with the receipt stored in the receipt storage means, is also a return receipt modified so as to be reclaimable by the receipt modifying means. The return receipt registration means also registers the receipt returned online and returns the registered paper. Concept and online the refunded receipt distinguishably each by and output to one list is intended to solve the above problems.

  According to the present invention, the online return receipt and the paper receipt return can be managed together, and the re-billing process is simplified. In addition, when outputting a list of return receipts, each return receipt is output so that it can be identified whether it is an online return or a paper receipt, so it is possible to see at a glance which return receipts are present. In addition, since the return receipts that have been reclaimed are deleted from the list, it is easy to see which receptors remain unprocessed.

It is a block block diagram of the receipt processing apparatus of embodiment. It is a figure which shows the process sequence of the receipt processing apparatus of embodiment. It is a figure which shows the example of an output of the list of embodiment.

  FIG. 1 shows a block configuration of a receipt processing apparatus 10 according to an embodiment of the present invention. In the figure, 4 is a display device as information display means constituted by an LCD or the like, 5 is a keyboard as data input means, 6 is a pointing device such as a mouse, 1 is a CPU 2 as control means, and a memory 3 such as ROM and RAM. And 7 is a file device composed of storage means such as a hard disk device. The file device 77 stores a master file 11, a patient file 12, a medical information file 13, a receipt file 14, a return receipt file 15, and a management setting file 16. The file device 7 functions as a receipt storage unit and a return receipt storage unit.

  The control device 1 has a function of receiving input from the keyboard 5 and the pointing device 6, a function of controlling display on the display device 4, a function of controlling storage in the file device 7, and a function of controlling the entire device 10. The keyboard 5 and the pointing device 6 function as input means in the following description. The receipt processing apparatus 10 may be a basic computer such as a general computer such as a personal computer. Then, a program having a function specific to this apparatus may be installed in the ROM or the file apparatus 7 in advance, or may be supplied by being stored in a storage medium such as a CD-ROM. Or you may make it downloadable via a network. The control device 1 is configured to exhibit functions peculiar to this device by introducing and executing the program.

  The master file 11 stored in the file device 7 is a file in which names such as medical fees, guidance, and other medical practices, medicines, prescriptions, and the like that may be used in this medical institution are registered in advance together with a unique medical code. The patient file 12 is a file that stores patient-specific information such as a patient's name and address, and insurance information. The medical information file 13 is a file that stores information related to medical care such as treatments, prescriptions, tests performed on the patient, and the name of the patient's disease, for each patient and each medical day. These data are medical data that are the basis for calculating medical costs. The receipt file 14 is a file for storing the receipt data created based on the medical information recorded in the medical information file 13, and stores the receipt data for each patient for each billing month. The return receipt file 15 stores the returned receipt data. The patient file 12, the medical information file 13, the receipt file 14, and the return receipt file 15 are associated with each other by a unique patient number. The management setting file 15 is a file that stores various setting information that defines the operation of the medical assistance device.

  Next, the operation of this embodiment will be described with reference to FIG. The control device 1 functions as a medical data registration unit 20 together with the keyboard 5, the display device 4, and the medical information file 13. The dispensing pharmacy inputs medical data such as dispensing data / prescription data based on the out-of-hospital prescription. The input data is registered and stored in the medical information file 13. At that time, the medical data registration means 20 refers to the master file 11 and reads out the medical price of the medicine and the insurance points of the technical fee such as the dispensing basic fee and registers them in the medical information file 13. In addition, medical data is registered for each patient in a prescription unit, that is, a consultation unit, but data related to the patient is registered before the medical data is input. Patient information is registered in the patient file 12. Thus, every time a prescription is brought in, the medical data is registered.

  Then, when the month changes and the beginning of the following month, the receipt generation means 30 creates receipt data based on the medical data stored in the medical information file 13. Here, the control device 1 functions as the receipt generation means 30 together with the keyboard 5 and the display device 4. The receipt generation means 30 generates the detailed data by collecting the medical data for one month for each patient with the previous month as the processing target month, and registers the data in the receipt file 14 as the patient-specific reception data. This is performed for all patients who have a track record in the processing month. In this way, all receipts for the processing month are registered together. In this embodiment, the receipt can be stored for a plurality of months.

  Next, the bill processing means 60 reads all the receipts for the processing month from the receipt file 14 and totals them to create a bill that summarizes all of them. This is a summary of the number of receipts, number of days, points, patient contributions, etc. for each type. In dispensing pharmacies, it is a dispensing fee bill. In medical institutions, it is called a medical fee bill. is there. When creating the invoice, the receipt data (return receipt data) is read from the return receipt file 15 and totaled together. Then, the bill data is attached as a header of the receipt data of the processing month, and transmitted to the examination and payment institution 70 to execute the medical billing processing. That is, make an online request. Here, the control device 1 functions as the claim processing means 60 together with the keyboard 5 and the display device 4.

  By the way, if the receipt sent to the examination and payment institution 70 is incomplete, the receipt is returned. If you request online, the primary return will be online. That is, the deficient receipt data is sent back online as it is. On the other hand, in the case of secondary return, even if it is requested online, it is returned with a receipt (paper receipt) output on paper.

  Therefore, the return receipt registration means 40 registers a return receipt. At this time, the control device 1 functions as a return receipt registration means 40 together with the keyboard 5 and the display device 4. This return receipt registration work is not limited to the beginning of the month and can be performed at any time. When returned online, the return receipt is taken online and the data is registered in the return receipt file 15. At that time, mark and register so that it can be returned online.

  When the paper receipt is returned, the patient number of the patient related to the return receipt is input from the keyboard. The return receipt registration means 40 copies the patient receipt data of the patient number from the receipt file 14 and registers it in the return receipt file 15. The patient number is usually printed in the patient description column of the paper receipt.

  The return receipt registration means 40 can also output a list of registered return receipts. The list is composed of at least one information for each receipt, including patient number, dispensing date, scheduled re-billing month, patient name, insurer number, and medical institution name. If it's returned online, it puts a mark at the beginning of the line so that you can see it, and outputs it to the list. When returning a paper receipt, nothing is added at the beginning of the line. The output destination may be the display device 4 or a printer (not shown). This list makes it possible to identify how many return receipts are present and whether they are online or paper receipts. In addition, when a re-billing process is performed, the return receipt is not output to the list. Therefore, it is possible to easily determine which return receipt remains unprocessed by this list, and it is possible to always know the scheduled re-billing month. FIG. 3 shows an output example of the list. The leftmost circle is a mark indicating an online return receipt.

  After registering the return receipt in this way, the receipt correction means 40 corrects the return receipt to eliminate the deficiencies. The receipt correction means 40 is achieved by the control device 1, the keyboard 5, and the display device 4. The receipt correction means 40 displays a list of return receipts registered in the return receipt file 15 on the display device 4, displays a return receipt correction screen in accordance with a selection input for a desired return receipt to be corrected, and receives the receipt data. It can be modified. At that time, if a return reason is attached to the return receipt, it can be referred to. In addition, a month (re-billing scheduled month) for re-billing the revised return receipt is set. In this way, the receipt correction means 40 corrects the return receipt on the return receipt file 15, sets the scheduled re-billing month, and sets the return receipt in a rechargeable state.

  As a result, when the scheduled re-billing month becomes the processing month, the billing processing means 60 reads all the corresponding return receipts from the return receipt file 15 and together with the normal receipt read from the receipt file 14, The billing process is executed.

DESCRIPTION OF SYMBOLS 1 Control apparatus 4 Display apparatus 5 Keyboard 7 File apparatus 11 Master file 12 Patient file 13 Medical information file 14 Receipt file 15 Return receipt file 20 Medical data registration means 30 Receptacle generation means 40 Return receipt registration means 50 Receipt correction means 60 Claim processing means

Claims (6)

Medical data registration means for inputting and registering medical data as a basis for calculating medical expenses for each patient, a receipt generating means for generating a receipt based on the registered medical data, and a receipt storage means for storing the generated receipt A bill processing unit that aggregates one month's receipts to generate a bill and performs online medical billing processing, a return receipt registration unit that registers a returned paper receipt, and a registered return And a receipt modifying means for modifying the receipt so that it can be reclaimed, the claim processing means together with the receipt stored in the receipt storage means together with the return receipt modified by the receipt modifying means so as to be reclaimable. In addition, the return receipt registration means also registers the receipt returned online and returns the registered paper. Receipt processing device and outputs receipts and online the refunded receipt each distinguishably in the single table. The receipt storage means stores a receipt in a calendar month unit, the receipt correction means sets a re-scheduled scheduled month for the return receipt, and the claim processing means performs a process for billing medical expenses. The receipt processing apparatus according to claim 1, wherein a return receipt in which a month corresponds to a scheduled re-billing month is billed together with a receipt of the processing month stored in the receipt storage unit. The receipt processing apparatus according to claim 2, wherein the return receipt registration unit outputs the list by including the scheduled re-billing month in the list when outputting the list. The return receipt registration means includes return receipt storage means for storing return receipt data. When registering a paper return receipt, the return receipt registration means is stored in the receipt storage means, and copies the receipt data corresponding to the return receipt. 3. The receipt processing apparatus according to claim 2, wherein the receipt processing device is registered in the return receipt storage means. 5. The receipt processing apparatus according to claim 4, wherein the return receipt registration unit outputs the list excluding the return receipt that has been reclaimed by the claim processing unit. 5. The receipt processing apparatus according to claim 4, wherein the medical data, the receipt data, and the return receipt data are managed in association with each other by a patient number.

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