JP2021111351A - Automatic adjustment machine, information processing method, and program - Google Patents

Abstract

To provide an automatic adjustment machine, an information processing method, and a program therefor arranged such that a refund is returned inexpensively.SOLUTION: An automatic adjustment machine according to the present invention has an acquisition unit, a first determination unit, a second determination unit, and a refund control unit. The acquisition unit acquires information for identifying, based on an insurance card, an insured person having the insurance card. The first determination unit, based on a medical fee receipt of the insured person identified by the information, specifies the amount the insured person paid at a hospital without using his/her insurance card, and determines, based on the amount paid at the hospital and information on co-payment rate for an insured person, the co-payment to be paid at the hospital by the insured person when the insured person has his/her insurance card. The second determination unit determines a refund amount by subtracting the co-payment determined by the first determination unit from the amount actually paid at the hospital. The refund control unit controls a refund unit to eject cash corresponding to the refund amount.SELECTED DRAWING: Figure 3

Description

The present invention relates to an automatic payment machine, an information processing method and a program.

If you forget your health insurance card and go to a medical institution, you will have to pay the full amount. In this case, you will have to visit the medical institution again at a later date and bring your health insurance card and the receipt when you paid the full amount to the accounting counter to have the surplus refunded. Patent Document 1 describes that the portal site server performs a replacement process when a patient receives medical treatment when he / she does not bring an IC card and bears the entire medical expenses. Transfer the advance amount from the account of the health insurance association to the user's account.

Japanese Unexamined Patent Publication No. 2014-157416

However, in the technique of Patent Document 1, a portal site server must be provided and linked with a financial institution server, which requires an initial cost. Also, if you do not have an account at a financial institution linked to the portal site server, you will not be able to get the surplus refunded.

The present invention has been made in view of such circumstances, and an object of the present invention is to provide a mechanism for returning a refund amount at low cost.

According to one aspect of the present invention, an automatic checkout machine is provided. This automatic settlement machine has an acquisition unit, a first determination unit, a second determination unit, and a refund control unit. The acquisition department acquires information that identifies the insured person of the health insurance card from the health insurance card. The first decision department identifies the amount paid by the insured at the hospital without using a health insurance card based on the insured's medical fee statement identified by the information, and the amount paid at the hospital and the insured. Based on the information on the out-of-pocket rate of the insured, the out-of-pocket amount to be paid at the hospital if the insured has an insurance card is determined. The second deciding department determines the refund amount by subtracting the out-of-pocket amount determined by the first deciding department from the amount paid at the hospital. The refund control unit controls the refund unit to discharge cash corresponding to the refund amount.

According to one of the present inventions, it is possible to provide a mechanism for returning the refund amount at low cost, which is an advantageous effect.

FIG. 1 is a diagram showing an example of a system configuration of an information processing system. FIG. 2 is a diagram showing an example of the hardware configuration of the automatic payment machine. FIG. 3 is a diagram showing an example of the functional configuration of the automatic payment machine. FIG. 4 is an activity diagram showing an example of information processing executed by the automatic payment machine. FIG. 5 is a diagram showing an example of the system configuration of the information processing system of the modified example 3. FIG. 6 is a diagram showing an example of the functional configuration of the automatic payment machine of the modified example 3. FIG. 7 is an activity diagram showing an example of information processing executed by the automatic settlement machine of the modification example 3.

Hereinafter, embodiments of the present invention will be described with reference to the drawings. The various features shown in the embodiments shown below can be combined with each other.

As used herein, the term "part" may include, for example, a combination of hardware resources implemented by circuits in a broad sense and information processing of software that can be specifically realized by these hardware resources. Further, in the present embodiment, various information is handled, and these information are represented by high and low signal values as a bit set of binary numbers composed of 0 or 1, and communication / calculation is executed on a circuit in a broad sense. Can be done.

A circuit in a broad sense is a circuit realized by at least appropriately combining a circuit, a circuit, a processor, a memory, and the like. That is, an integrated circuit for a specific application (Application Special Integrated Circuit: ASIC), a programmable logic device (for example, a simple programmable logic device (Simple Programmable Logical Device: SPLD), a composite programmable logic device (Complex Programg)). It includes a programmable gate array (Field Programmable Gate Array: FPGA) and the like.

<Embodiment 1>
1. 1. System Configuration FIG. 1 is a diagram showing an example of a system configuration of an information processing system. As shown in FIG. 1, the information processing system includes an automatic checkout machine 100 and a hospital server 110. The automatic checkout machine 100 and the hospital server 110 are communicably connected to each other via the network 120. The network 120 may be a dedicated line or a public line. It is assumed that the automatic payment machine 100 is installed, for example, at the reception desk of a hospital corresponding to the hospital server 110. However, this does not limit the present embodiment.

2. Hardware Configuration FIG. 2 is a diagram showing an example of the hardware configuration of the automatic checkout machine 100. As shown in FIG. 2, the automatic settlement machine 100 includes a control unit 201, a storage unit 202, a reading unit 203, a display unit 204, a communication unit 205, and a refund unit 206 as hardware configurations. include. The automatic settlement machine 100 includes hardware other than the hardware shown in FIG. 2, but is omitted here for the sake of brevity.

The control unit 201 controls the entire automatic payment machine 100. The control unit 201 executes the process based on the program stored in the storage unit 202. By executing the process based on the program stored in the storage unit 202, the control unit 201 performs the functional configuration of the automatic settlement machine 100 shown in FIGS. 3 and 6 described later and the activities shown in FIGS. 4 and 7 described later. Figures etc. are realized. The storage unit 202 stores data and the like used when the program and the control unit 201 execute processing based on the program. The reading unit 203 acquires information for identifying the insured person from the user's health insurance card. The reading unit 203 may acquire information for identifying the insured person by reading the two-dimensional code of the health insurance card, or images the health insurance card inserted in the slot with a camera (not shown) or the like. The captured image obtained by capturing the insurance card may be analyzed by optical character recognition or the like to acquire information for identifying the insured person. The display unit 204 displays the result of processing by the control unit 201 and the like. The communication unit 205 connects the automatic payment machine 100 to the network 120 and controls communication with an external device, an external system, and the like. The refund unit 206 discharges the amount of cash specified in the control unit 201 out of the money (cash) held in the automatic settlement machine 100 under the control of the control unit 201 to the refund port (not shown).

3. 3. Functional configuration FIG. 3 is a diagram showing an example of the functional configuration of the automatic payment machine 100. As shown in FIG. 3, the automatic settlement machine 100 includes an acquisition unit 301, a first determination unit 302, a second determination unit 303, and a refund control unit 304 as a functional configuration.

The acquisition unit 301 acquires the information that the reading unit 203 has read and acquired to identify the insured person of the health insurance card.

The first decision unit 302 identifies the amount paid by the insured person at the hospital without using the insurance card based on the medical fee statement of the insured person identified by the information acquired by the acquisition unit 301, and the hospital. Based on the amount paid in and the information on the insured's out-of-pocket rate, determine the out-of-pocket amount to be paid at the hospital if the insured has an insurance card. For example, the first determination unit 302 acquires the insured person's medical fee statement and the insured person's self-pay ratio information from the hospital server 110 based on the information identifying the insured person. The hospital server is an example of a hospital system.

On the hospital server 110, the insured person's past medical treatment type, consultation date, medical treatment content, medical expenses, and other medical fee statements, and information on the insured person's self-pay ratio are recorded as data. .. When the hospital server 110 receives an inquiry request including information for identifying the insured person from the automatic payment machine 100, the hospital server 110 searches the recorded data, and the medical fee statement of the corresponding insured person and the self-pay ratio. Information and reply.

The first decision unit 302 analyzes the received medical fee statement, totals the amounts for each medical treatment content, and obtains the amount paid by the insured at the hospital without using a health insurance card. Then, the first decision unit 302 is the case where the insured person has an insurance card from the amount paid by the insured person at the hospital without using the insurance card and the information on the insured person's self-pay ratio. Determine the out-of-pocket amount to be paid at the hospital. For example, if the amount paid by the insured person at the hospital without using the insurance card is 10,000 yen and the insured person's self-pay ratio is 30%, the insured person has the insurance card in the first decision unit 302. It will be decided that the out-of-pocket amount to be paid at the hospital will be 3000 yen.

The second decision unit 303 determines the refund amount by subtracting the self-pay amount determined by the first decision unit 302 from the amount paid at the hospital by the insured identified by the information acquired by the acquisition unit 301. do. In the above example, since the amount paid by the insured person at the hospital without using the health insurance card is 10,000 yen and the self-pay amount is 3,000 yen, the second determination unit 303 determines the refund amount to be 7,000 yen.

The refund control unit 304 controls the refund unit 206 to discharge cash corresponding to the refund amount. For example, the refund control unit 304 notifies the refund unit 206 of the refund amount determined by the second determination unit 303. Then, the refund unit 206 discharges the notified amount of cash to the refund port.

4. Information processing FIG. 4 is an activity diagram showing an example of information processing executed by the automatic settlement machine 100.
In A501, the acquisition unit 301 determines whether or not the reading unit 203 has read the insurance card. When the acquisition unit 301 determines that the reading unit 203 has read the insurance card, it proceeds to the A502, and when it determines that the reading unit 203 has not read the insurance card, the acquisition unit 301 repeats the process of the A501.

In A502, the acquisition unit 301 acquires the information that the reading unit 203 has read and acquired to identify the insured person of the health insurance card. Information that identifies the insured includes, for example, name, date of birth, gender, and the like. Further, as information for identifying the insured person, the acquisition unit 301 includes information related to the insured person for identifying the insured person, for example, the name of the insurer's business establishment, the insurer number, the symbol of the insurance card, and the like. The number or the like may be acquired from the reading unit 203.

In A503, the first determination unit 302 identifies the amount paid by the insured at the hospital without using the insurance card, based on the insured's medical fee statement identified by the information acquired in A502. Based on the amount paid at the hospital and the information on the insured's out-of-pocket rate, determine the out-of-pocket amount to be paid at the hospital if the insured has a health insurance card. For example, the first determination unit 302 communicates with the hospital server 110 set in association with the automatic payment machine 100, and the medical fee statement of the insured person identified by the information identifying the insured person of the insurance card. The document and the information on the insured person's self-pay ratio are obtained from the hospital server 110. As another example, the first determination unit 302 communicates with the hospital server of the hospital selected on the screen displayed on the display unit 204, and is identified by the information that identifies the insured person of the insurance card. The insurer's medical fee statement and the insured's self-pay ratio information may be obtained from the hospital server of the hospital selected on the screen. In such a configuration, the automatic checkout machine 100 is not associated with the hospital on a one-to-one basis. Therefore, the automatic checkout machine 100 may be installed not in the associated hospital window or the like, but in, for example, in a ticket gate of a station, in a convenience store, or the like.

In A504, the second decision unit 303 subtracts the self-pay amount determined by the first decision unit 302 from the amount paid at the hospital by the insured identified by the information obtained in A502 to obtain the refund amount. decide.

In A505, the refund control unit 304 controls the refund unit 206 to discharge the cash corresponding to the refund amount.

According to the first embodiment, it is possible to provide the user with a mechanism for returning the refund amount in cash at low cost.

<Modification example 1>
Modification 1 will be described. The first determination unit 302 of the first embodiment acquired the insured person's self-pay ratio information from the hospital server 110. However, the first determination unit 302 of the first modification determines the information of the insured person's self-pay ratio based on the date of birth of the insured person of the health insurance card. When the reading unit 203 reads the health insurance card, the date of birth of the insured person written on the health insurance card can be obtained. The first determination unit 302 obtains the age of the insured person based on the date of birth of the insured person, and determines the information on the insured person's self-pay ratio based on this age. For example, the first determination unit 302 determines that if the insured person's age is 6 to less than 70 years old, the burden is 30% based on the insured person's date of birth.

According to the first modification, the insured person's self-pay ratio can be determined based on the information of the health insurance card without asking the hospital server 110. As a result, it is possible to provide the user with a mechanism for returning the refund amount in cash at low cost.

<Modification 2>
Modification 2 will be described. The first determination unit 302 of the first embodiment obtained the medical fee statement of the insured from the hospital server 110. However, the automatic payment machine 100 of the second modification may read the paper medical fee schedule brought by the insured person with a scanner. The first determination unit 302 of the second modification analyzes the medical fee schedule read through the scanner, totals the amounts for each medical treatment content, and calculates the amount paid by the insured at the hospital without using the insurance card. Ask.

According to the second modification, even if the insurer's medical fee statement is not requested from the hospital server 110, it is read by a scanner or the like, optical character recognition is performed, the amount of money for each medical treatment content is obtained, and the insured uses the insurance card. You can ask for the amount paid at the hospital. As a result, it is possible to provide the user with a mechanism for returning the refund amount in cash at low cost.

<Modification example 3>
Modification 3 will be described. FIG. 5 is a diagram showing an example of the system configuration of the information processing system of the modified example 3. In the information processing system shown in FIG. 5, the hospital server 110 is replaced with the dispensing pharmacy server 130 as compared with the information processing system shown in FIG.

FIG. 6 is a diagram showing an example of the functional configuration of the automatic settlement machine 100 of the modification 3. As shown in FIG. 6, the automatic settlement machine 100 of the modification 3 has the acquisition unit 601, the first determination unit 602, the second determination unit 603, and the refund control unit 604 as functional configurations. include.

The acquisition unit 601 acquires the information that the reading unit 203 has read and acquired to identify the insured person of the health insurance card.

The first decision unit 602 identifies the amount paid by the insured at the dispensing pharmacy without using the insurance card, based on the insured's dispensing fee statement identified by the information acquired by the acquisition unit 601. Based on the amount paid at the dispensing pharmacy and the information on the insured's out-of-pocket rate, determine the out-of-pocket amount to be paid at the dispensing pharmacy if the insured has a health insurance card. For example, the first determination unit 602 acquires the insured person's dispensing fee statement and the insured person's self-pay ratio information from the dispensing pharmacy server 130 based on the information identifying the insured person. The dispensing pharmacy server is an example of a dispensing pharmacy system.

The dispensing pharmacy server 130 records the insured's past dispensing fee statement and the insured's self-pay ratio information as data. When the dispensing pharmacy server 130 receives an inquiry request including information for identifying the insured person from the automatic payment machine 100, the dispensing pharmacy server 130 searches the recorded data, and the dispensing fee statement of the corresponding insured person and the self-pay Reply with the percentage information.

The first decision unit 602 analyzes the received dispensing fee statement, totals the dispensing fee points for each prescribed drug, and obtains the amount paid by the insured at the dispensing pharmacy without using the insurance card. Then, the first decision unit 602 indicates that the insured person has an insurance card from the amount paid by the insured person at the dispensing pharmacy without using the insurance card and the information on the insured person's self-pay ratio. Determine the out-of-pocket amount to be paid at the dispensing pharmacy. For example, if the amount paid by the insured at the dispensing pharmacy without using the insurance card is 1000 yen and the insured's self-pay ratio is 30%, the insured will issue the insurance card in the first decision unit 602. If you have one, you will have to pay 600 yen at the dispensing pharmacy.

The second decision unit 603 subtracts the self-pay amount determined by the first decision unit 602 from the amount paid by the insured identified by the information acquired by the acquisition unit 601 at the dispensing pharmacy to obtain the refund amount. decide. In the above example, the amount paid by the insured at the dispensing pharmacy without using the insurance card is 10,000 yen, and the out-of-pocket amount is 6000 yen. Therefore, the second determination unit 603 determines the refund amount to be 7,000 yen. ..

The refund control unit 604 controls the refund unit 206 to discharge cash corresponding to the refund amount. For example, the refund control unit 604 notifies the refund unit 206 of the refund amount determined by the second determination unit 603. Then, the refund unit 206 discharges the notified amount of cash to the refund port.

FIG. 7 is an activity diagram showing an example of information processing executed by the automatic settlement machine 100 of the modification example 3.
In A701, the acquisition unit 601 determines whether or not the reading unit 203 has read the health insurance card. When the acquisition unit 601 determines that the reading unit 203 has read the insurance card, the process proceeds to A702, and when the reading unit 203 determines that the insurance card has not been read, the process of A701 is repeated.

In A702, the acquisition unit 601 acquires the information that the reading unit 203 has read and acquired to identify the insured person of the health insurance card. Information that identifies the insured includes, for example, name, date of birth, gender, and the like. In addition, as information for identifying the insured person, the acquisition unit 601 includes information related to the insured person for identifying the insured person, for example, the name of the insurer's business establishment, the insurer number, the symbol of the insurance card, and the like. The number or the like may be acquired from the reading unit 203.

In A703, the first decision unit 602 identifies the amount paid by the insured at the dispensing pharmacy without using the insurance card, based on the insured's dispensing fee statement identified by the information obtained in A702. Based on the amount paid at the dispensing pharmacy and the information on the insured's out-of-pocket ratio, determine the out-of-pocket amount to be paid at the dispensing pharmacy if the insured has an insurance card. For example, the first determination unit 602 communicates with the dispensing pharmacy server 130 set in association with the automatic checkout machine 100, and the dispensing fee of the insured person identified by the information identifying the insured person of the insurance card. The statement and the information on the insured person's self-pay ratio are acquired from the dispensing pharmacy server 130. As another example, the first determination unit 602 communicates with the dispensing pharmacy server of the dispensing pharmacy selected on the screen displayed on the display unit 204, and is identified by the information that identifies the insured person of the insurance certificate. The insured person's dispensing fee statement and the insured person's self-pay ratio information may be obtained from the dispensing pharmacy server of the dispensing pharmacy selected on the screen. In such a configuration, the automatic checkout machine 100 is not associated with the dispensing pharmacy on a one-to-one basis. Therefore, the automatic checkout machine 100 may be installed not in the associated dispensing pharmacy window or the like, but in, for example, in a ticket gate of a station, in a convenience store, or the like.

In A704, the second decision unit 603 subtracts the self-pay amount determined by the first decision unit 602 from the amount paid by the insured identified by the information obtained in A702 at the dispensing pharmacy, and the refund amount. To determine.

In A705, the refund control unit 604 controls the refund unit 206 to discharge cash corresponding to the refund amount.

The third modification can also provide the user with a mechanism for returning the refund amount in cash at low cost.

<Modification example 4>
Modification 4 will be described. The first determination unit 602 of the modification 3 acquired the information of the insured person's self-pay ratio from the dispensing pharmacy server 130. However, the first determination unit 602 of the modified example 4 determines the information of the insured person's self-pay ratio based on the date of birth of the insured person of the health insurance card. When the reading unit 203 reads the health insurance card, the date of birth of the insured person written on the health insurance card can be obtained. The first determination unit 602 determines the age of the insured person based on the date of birth of the insured person, and determines the information on the insured person's self-pay ratio based on this age. For example, the first determination unit 602 determines that if the insured person's age is 6 to less than 70 years old, the burden is 30% based on the insured person's date of birth.

According to the fourth modification, the insured person's self-pay ratio can be determined based on the information of the health insurance card without asking the dispensing pharmacy server 130. As a result, it is possible to provide the user with a mechanism for returning the refund amount in cash at low cost.

<Modification 5>
Modification 5 will be described. The first determination unit 602 of the modification 3 acquired the insured person's remuneration statement from the dispensing pharmacy server 130. However, the automatic settlement machine 100 of the modification 5 may read the paper dispensing fee statement brought by the insured person with a scanner. The first determination unit 602 of the modification 5 analyzes the dispensing fee statement read through the scanner, totals the dispensing fee points for each dispensing, and the insured pays at the dispensing pharmacy without using the insurance card. Ask for the amount.

According to the fifth modification, the insurer's dispensing fee statement is read by a scanner or the like without asking the hospital server 110, optical character recognition is performed, and the dispensing fee points for each dispensing are obtained, and the insured person has an insurance card. You can find the amount paid at the hospital without using. As a result, it is possible to provide the user with a mechanism for returning the refund amount in cash at low cost.

It may be provided in each of the following aspects.
In the automatic settlement machine, the first determination unit is an automatic settlement machine that acquires information on the insured person's self-pay share from the hospital system.
In the automatic payment machine, the first determination unit determines information on the insured person's self-pay ratio based on the date of birth of the insured person on the health insurance card.
It is an automatic payment machine and has an acquisition unit, a first determination unit, a second determination unit, and a refund control unit, and the acquisition unit identifies the insured person of the health insurance card from the health insurance card. The first decision-making unit identifies the amount paid by the insured at the dispensing pharmacy without using the insurance card based on the insured's dispensing fee statement identified by the information. Based on the amount paid at the dispensing pharmacy and the information on the out-of-pocket ratio of the insured, the out-of-pocket amount to be paid at the dispensing pharmacy when the insured has an insurance card is determined, and the above-mentioned The second determination unit determines the refund amount by subtracting the self-pay amount determined by the first determination unit from the amount paid at the dispensing pharmacy, and the refund control unit determines the cash corresponding to the refund amount. An automatic checkout machine that controls the refund section to discharge.
In the automatic payment machine, the first determination unit is an automatic payment machine that acquires information on the insured person's self-pay portion from the system of the dispensing pharmacy.
In the automatic payment machine, the first determination unit determines information on the insured person's self-pay ratio based on the date of birth of the insured person on the health insurance card.
In the automatic settlement machine, the acquisition unit acquires information for identifying the insured person of the insurance card from the insurance card by reading the two-dimensional code of the insurance card.
In the automatic payment machine, the acquisition unit acquires information for identifying the insured person of the insurance card from the insurance card by analyzing the captured image obtained by capturing the insurance card.
An information processing method executed by an automatic payment machine, which includes a first step, a second step, a third step, and a fourth step. Information for identifying the insured person of the health insurance card is acquired, and in the second step, the insured person does not use the health insurance card and the hospital is based on the medical fee statement of the insured person identified by the information. Based on the amount paid at the hospital and the information on the insured's out-of-pocket ratio, the out-of-pocket payment to be paid at the hospital when the insured has an insurance card. The amount is determined, and in the third step, the refund amount is determined by subtracting the self-pay amount determined by the second step from the amount paid at the hospital, and in the fourth step, the refund amount is determined. An information processing method that controls the refund unit to discharge the corresponding cash.
An information processing method executed by an automatic payment machine, which includes a first step, a second step, a third step, and a fourth step. Information that identifies the insured person of the insurance card is acquired, and in the second step, the insured person does not use the insurance card at the dispensing pharmacy based on the insured person's dispensing fee statement identified by the information. Identify the amount paid, and based on the amount paid at the dispensing pharmacy and the information on the out-of-pocket ratio of the insured, the self to pay at the dispensing pharmacy when the insured has an insurance card. The burden amount is determined, and in the third step, the refund amount is determined by subtracting the self-pay amount determined by the second step from the amount paid at the dispensing pharmacy, and in the fourth step, the refund amount is determined. An information processing method that controls the refund department to discharge cash corresponding to the refund amount.
A program for causing a computer to function as the acquisition unit, the first determination unit, the second determination unit, and the refund control unit of the automatic payment machine.
Of course, this is not the case.

For example, it may be provided as a computer-readable non-temporary storage medium for storing the above-mentioned program.
Further, the above-described embodiments and modifications may be arbitrarily combined and carried out. For example, the automatic payment machine 100 displays a screen for selecting a hospital and a dispensing pharmacy on the display unit 204, acquires information from the server of the selected hospital and the server of the dispensing pharmacy via the screen, and obtains information from the hospital. The amount paid at the pharmacy or the dispensing pharmacy, the ratio of self-pay, etc. may be obtained to determine the refund amount. With such a configuration, the user can receive the extra amount paid at the hospital and the dispensing pharmacy at one time as the refund amount.

Further, in the above-described embodiment and modification, the amount paid at the hospital without using the health insurance card and the amount paid at the dispensing pharmacy without using the health insurance card were obtained from the medical fee statement and the dispensing fee statement. However, the automatic payment machine 100 reads a paper receipt issued by a hospital or a dispensing pharmacy with a scanner or the like and reads the amount paid at the hospital without using a health insurance card or the amount paid at a dispensing pharmacy without using a health insurance card. You may ask for it.

Finally, various embodiments of the present invention have been described, but these are presented as examples and are not intended to limit the scope of the invention. The novel embodiment can be implemented in various other embodiments, and various omissions, replacements, and changes can be made without departing from the gist of the invention. The embodiments and modifications thereof are included in the scope and gist of the invention, and are included in the scope of the invention described in the claims and the equivalent scope thereof.

100: Automatic payment machine 110: Hospital server 120: Network 130: Dispensing pharmacy server 201: Control unit 202: Storage unit 203: Reading unit 204: Display unit 205: Communication unit 206: Refund unit 301: Acquisition unit 302: First Determination unit 303: Second determination unit 304: Refund control unit 601: Acquisition unit 602: First determination unit 603: Second determination unit 604: Refund control unit

Claims (11)

It ’s an automatic checkout machine.
It has an acquisition unit, a first determination unit, a second determination unit, and a refund control unit.
The acquisition department acquires information that identifies the insured person of the health insurance card from the health insurance card.
The first determination unit identifies the amount paid by the insured person at the hospital without using the health insurance card based on the medical fee statement of the insured person identified by the information, and pays at the hospital. Based on the amount of money and the information on the out-of-pocket rate of the insured, the out-of-pocket amount to be paid at the hospital when the insured has an insurance card is determined.
The second decision unit determines the refund amount by subtracting the self-pay amount determined by the first decision section from the amount paid at the hospital.
The refund control unit controls the refund unit to discharge cash corresponding to the refund amount.
Automatic payment machine. In the automatic settlement machine according to claim 1,
The first decision-making unit acquires information on the insured person's self-pay ratio from the hospital system.
Automatic payment machine. In the automatic settlement machine according to claim 1,
The first determination unit determines the information of the insured person's out-of-pocket share based on the date of birth of the insured person on the health insurance card.
Automatic payment machine. It ’s an automatic checkout machine.
It has an acquisition unit, a first determination unit, a second determination unit, and a refund control unit.
The acquisition department acquires information that identifies the insured person of the health insurance card from the health insurance card.
The first determination unit identifies the amount paid by the insured at the dispensing pharmacy without using the insurance card based on the insured's dispensing fee statement identified by the information, and pays at the dispensing pharmacy. Based on the amount of money and the information on the out-of-pocket ratio of the insured, the out-of-pocket amount to be paid at the dispensing pharmacy when the insured has an insurance card is determined.
The second determination unit determines the refund amount by subtracting the self-pay amount determined by the first determination unit from the amount paid at the dispensing pharmacy.
The refund control unit controls the refund unit to discharge cash corresponding to the refund amount.
Automatic payment machine. In the automatic settlement machine according to claim 4,
The first decision-making unit acquires information on the insured's out-of-pocket share from the dispensing pharmacy system.
Automatic payment machine. In the automatic settlement machine according to claim 4,
The first determination unit determines the information of the insured person's out-of-pocket share based on the date of birth of the insured person on the health insurance card.
Automatic payment machine. In the automatic settlement machine according to any one of claims 1 to 6,
The acquisition unit acquires information for identifying the insured person of the health insurance card from the health insurance card by reading the two-dimensional code of the health insurance card.
Automatic payment machine. In the automatic settlement machine according to any one of claims 1 to 6,
The acquisition unit acquires information for identifying the insured person of the health insurance card from the health insurance card by analyzing the captured image obtained by capturing the health insurance card.
Automatic payment machine. It is an information processing method executed by an automatic payment machine.
The first step, the second step, the third step, and the fourth step are included.
In the first step, information for identifying the insured person of the health insurance card is acquired from the health insurance card.
In the second step, the amount paid by the insured person at the hospital without using the health insurance card is specified based on the medical fee statement of the insured person identified by the information, and the amount paid at the hospital. Based on the information on the out-of-pocket rate of the insured, the out-of-pocket amount to be paid at the hospital when the insured has an insurance card is determined.
In the third step, the refund amount is determined by subtracting the self-pay amount determined by the second step from the amount paid at the hospital.
In the fourth step, the refund unit controls the cash corresponding to the refund amount to be discharged.
Information processing method. It is an information processing method executed by an automatic payment machine.
The first step, the second step, the third step, and the fourth step are included.
In the first step, information for identifying the insured person of the health insurance card is acquired from the health insurance card.
In the second step, the amount paid by the insured at the dispensing pharmacy without using the insurance card is specified based on the insured's dispensing fee statement identified by the information, and the amount paid at the dispensing pharmacy. And, based on the information on the out-of-pocket rate of the insured, the out-of-pocket amount to be paid at the dispensing pharmacy when the insured has an insurance card is determined.
In the third step, the refund amount is determined by subtracting the self-pay amount determined by the second step from the amount paid at the dispensing pharmacy.
In the fourth step, the refund unit controls the cash corresponding to the refund amount to be discharged.
Information processing method. The program, the computer, the acquisition unit, the first determination unit, the second determination unit, and the refund control unit of the automatic settlement machine according to any one of claims 1 to 8. A program to function as.

Images