JP4903981B2 - Receipt check device, receipt check method, and receipt check program - Google Patents

Description

[0001]
BACKGROUND OF THE INVENTION
The present invention relates to a receipt check method and apparatus, and more particularly to a receipt check method and apparatus for checking a receipt via a communication line.
[0002]
[Prior art]
When a medical institution such as a hospital or clinic conducts medical treatment for a patient, it creates a receipt (detailed medical fee description) and submits it to a payment fund or the National Health Insurance Federation. Payment funds and the National Health Insurance Association will check the contents of the receipt and submit the receipt to the appropriate insurer.
[0003]
The number of such receipts exceeds 100 million per month. Receipts are checked by paying funds, national insurance associations, medical institutions, and insurers using the computers and programs dedicated to visual inspection of each organization and receipt checks. It has been broken.
[0004]
Further, a pharmacist service support system that creates receipt request data based on prescription data is known (see, for example, Patent Document 1).
[0005]
The system described in Patent Document 1 includes a data center including an application management server that manages a pharmacist support application, and the data center uses a pharmacist support application and the like to connect from a client device installed in a pharmacy to the Internet. Check the contents of the prescription data transmitted via. Further, the data center creates receipt request data based on the prescription data, and transmits the receipt request data to the receipt request reception organization via the Internet.
[0006]
[Patent Document 1]
JP 2002-197184 A (FIG. 1)
[0007]
[Problems to be solved by the invention]
However, the visual check of the person in charge of each organization as described above depends on the skill of the person in charge, so the burden on the person in charge is large, and it takes time for the check, and an incorrect receipt is often not found.
[0008]
In addition, in the check using a dedicated computer and program, the purchase cost of the computer and the program is high, and it is necessary to replace it due to aging or failure, and in that case, the format of the receipt data differs depending on the device. Since data cannot often be inherited, the burden on users such as medical institutions and insurance associations is increasing.
[0009]
In addition, the system disclosed in Patent Document 1 is intended to support pharmacists and pharmacies such as pharmaceutical dispensing and inventory management, and medical institutions that perform medical treatment and treatment of patients, insurance that pay medical fees, etc. It is not intended for union operations.
[0010]
Further, in the system disclosed in Patent Document 1, since the check target is prescription data and the check on the receipt is not considered, there is a possibility that erroneous data is transmitted to the receipt requesting institution. If such erroneous data is transmitted, the amount of billing and the number of billing points increase and decrease as a result, and each organization spends a great deal of labor and time on post-processing.
[0011]
The present invention has been made in view of the above circumstances, and an object of the present invention is to provide a receipt check method and apparatus that appropriately check the accuracy of receipt data and reduce the burden on the user.
[0025]
[Means for Solving the Problems]
To achieve the above objective,Invention No.1The receipt check device according to the feature of the user terminalEquipmentVia communication linesentReceiving means for receiving receipt data; and the received receipt data;,Receipt check data prepared in advanceReceipt check data including check master data and user master data in which the check master data is customized for each userA receipt check means for checking the accuracy of the received receipt data by comparingReceipt check means checkedCheck result of the user's terminalapparatusAnd a first transmission means for transmitting via a communication line.
[0026]
  Invention No.1In the receipt check device according to the above-mentioned features, the user can check the receipt without checking the person in charge or using a dedicated computer and program, and can know the result, and the user himself / herself holds the check data. Since it is not necessary, burdens such as labor, time and cost required for the receipt check are reduced.In addition, by using check master data customized based on user instructions, it is possible to appropriately check the receipt data in consideration of different data for each user.
[0027]
In the receipt check device according to the seventh feature of the present invention, the receipt check data may be prepared according to the receipt data to be checked.
[0028]
Invention No.2The receipt check device according to the features of1In the receipt check device according to the features ofMeans for accumulating the user master data in a database; means for updating the user master data based on an instruction input by the user terminal device;It is characterized by including.
[0030]
  Invention No.3The receipt check device according to the features of1SpecialTo the pointIn such a receipt check device, the receipt check data includes past receipt data, and the receipt check means compares the received receipt data with the past receipt data to check the accuracy of the receipt. It is a feature.
[0031]
  Invention No.3In the receipt check device according to the characteristics of the above, since the receipt check is performed using the past receipt data, it is possible to perform an appropriate check in consideration of the consistency with the past receipt data, and for a certain period after the implementation. Appropriate checks can also be made on the receipt data relating to the medical practice requested after the elapse.
[0032]
  Invention No.4The receipt check device according to the features of1Features of the present invention3In the receipt check device according to the above feature, after checking the receipt dataAboveUser terminalSent by deviceInstruction to store checked receipt dataReceiveThen, the receipt dataAboveAs past receipt dataDeDatabaseIt is characterized by including data storage means for storing the data.
[0033]
  Invention No.4In the receipt check device according to the above feature, only the receipt data having no problem in the check result can be accumulated in the receipt check data, and an appropriate check can be performed based on the accumulated past receipt data.
[0034]
  Invention No.5The receipt check device according to the features of1Features of the present invention4In the receipt check device according to the features ofAboveUser terminalDevice outputReceipt data extraction instructionsReceiveThen, beforeDeDataThe databaseExtracted from,It is characterized by including the 2nd transmission means which transmits to the said terminal device of a user.
[0035]
  Invention No.5In the receipt check apparatus according to the above feature, receipt data may be extracted according to the user. That is, receipt data created by a medical institution such as a hospital can be extracted, or for insurance associations, receipt data relating to claims to the insurance association can be extracted. In addition, for a patient, the name of a medical institution used by the patient, the contents of a medical practice, and the like can be extracted.
[0036]
  Invention No.6The receipt check device according to the features of1Features of the present invention5In the receipt check device according to the feature of the above, the terminal of the user after transmitting the check resultSent by deviceSending checked receipt dataReceiveThen, the terminal of the billing institution that predetermined the receipt dataapparatusIt includes a third transmission means for transmitting to.
[0037]
  Invention No.6In the receipt check apparatus according to the above feature, it is possible to transmit only the receipt data having no problem in the check result, and the reception destination of the receipt data is not erroneous.
[0038]
DETAILED DESCRIPTION OF THE INVENTION
Hereinafter, preferred embodiments of the present invention will be described in detail with reference to the accompanying drawings.
[0039]
FIG. 1 shows an overall configuration of a receipt processing system 10 to which the present exemplary embodiment is applied.
[0040]
The receipt processing system 10 includes a receipt check system 12, a server 200 of the medical institution 1, a server 202 of the insurance association 2, a server 204 of the billing institution 3, a server 206 of the external institution 4, and a PC 300 of the patient 5. In addition, they are connected to each other via the Internet 400 or an ISP (Internet connection service provider) not shown.
[0041]
A user such as the medical institution 1 uses the receipt check system 12 via a web browser installed in its own server such as the server 200. As this web browser, a general browser that is used as an application for browsing a website and can use technologies such as HTML (Hyper Text Markup Language), CGI (Common Gateway Interface), XML (eXtensible Markup Language), and Java. Can be used.
[0042]
The user terminal device such as the server 200 includes an input / output device such as a display for display, a printer, and a recording device (not shown).
[0043]
The receipt processing system 10 can include one or a plurality of user servers including the server 200 of the medical institution 1 and the server 202 of the insurance association 2. Similarly, the receipt processing system 10 may include one or more receipt check systems, including a receipt check system 12.
[0044]
FIG. 2 shows the configuration of the receipt check system 12.
[0045]
The receipt check system 12 includes a receipt check server 20, a receipt database server 40, and a system management terminal 60, which are connected to each other via a LAN 90 so as to communicate with each other.
[0046]
The receipt check server 20 includes a central processing unit (hereinafter referred to as a CPU) 22 that controls each component, and the CPU 22 is connected to a common bus 32.
[0047]
In addition to the CPU 22, the common bus 32 stores a ROM 24 that stores system programs, parameters, and the like, a RAM 26 that is used as a temporary storage and processing area for receipt data, and a receipt check program and a receipt check database. The magnetic disk 28 is connected to a network interface unit 30 that communicates via the LAN 90 and the Internet 400 (in the following text and drawings, the interface is expressed as I / F).
[0048]
The receipt check system 12 is applied with the receipt check method and apparatus according to the present invention, functions as a so-called ASP (Application Service Provider), and provides the functions of a receipt check program to each user via the LAN 90 and the Internet 400. To do.
[0049]
The receipt check program is activated by a request from the user terminal device, checks the accuracy of the receipt data input from the user terminal device with reference to the check database and the check data extracted from the receipt database, and the result Is transmitted to the terminal device of the user. Such receipt data input and check result transmission are performed using the above-described technologies such as HTML and CGI so as to be compatible with the web browser installed in the user terminal device.
[0050]
Further, the receipt check program stores the inputted receipt data and the check result in a receipt database in the receipt data server 40, and further updates the contents of the user master data based on an instruction input from the user terminal device.
[0051]
The receipt check database includes check master data and user master data customized by the user. The check master data is created by the system management terminal 60 based on the master creation data acquired from the external organization 4. The user master data is customized by the user such as the medical institution 1 or the insurance association 2 via the server 200 or the server 202 based on the check master data.
[0052]
FIG. 5 shows an example of the user customization screen of the check master. Fig. 5 (a) is a screen for customizing the check master "Fine Exam A" and Fig. 5 (b) is a check screen for the "Internal Medicine B". The number of hospitalizations and outpatients is changed, and the name of the disease is added. / Deleted.
[0053]
FIG. 6 shows a screen for customizing the check master “internal medicine B”, which shows an example of customizing the correspondence between the medicine name and the name of the wound.
[0054]
The receipt database server 40 includes a CPU 42 that controls each component, and the CPU 42 is connected to a common bus 52.
[0055]
In addition to the CPU 42, the common bus 52 stores a ROM 44 in which system programs, parameters, and the like are stored, a RAM 46 that is used as a temporary storage and processing area for receipt data, a receipt database, and a database management program. The magnetic disk 48 and a network I / F unit 50 that communicates via the LAN 90 and the Internet 400 are connected.
[0056]
In response to a request from the receipt check server 20, the receipt database management program extracts data necessary for the receipt check from the receipt database, stores the receipt data and the check result in the receipt database, and stores the receipt data in the server of the billing institution 3. 204.
[0057]
The reception database management program further extracts browsing data from the reception database in response to a request from the user, transmits it to the user's terminal device via the reception check server 20, and, based on an instruction input from the user, the user Create and update custom data.
[0058]
The receipt database includes the receipt data in which the past receipt data is accumulated, the format of the receipt data, the medical data such as the name of the disease, the name of the medicine, the name of the equipment, and the user custom data in which these data are customized by the user. Furthermore, a receipt data check history and a database management history are included.
[0059]
The system management terminal 60 includes a CPU 62 that controls each component, and the CPU 62 is connected to a common bus 84. The common bus 84 includes a ROM 64 that stores control programs and system parameters for the system management terminal 60, a RAM 66 that is used as a temporary storage and processing area for data, a magnetic disk 68, and a display for display (hereinafter referred to as CRT). ) Display control unit 70 for controlling display to 72, keyboard 74 having keys and switches for setting various parameters, mouse 76 as means for performing various operations on the screen of CRT 72, and data input / output A storage device 78 as a means for performing, a printer 80, and a network I / F unit 82 that performs communication via the LAN 90 and the Internet 400 are connected. The display control unit 70 is connected to a CRT 72 that displays processing results and the like.
[0060]
As the storage device 78, a device such as a CD-ROM drive, a magneto-optical disk (MO) drive, a DVD drive or the like can be used, and a receipt can be received via a storage medium that can be inserted into and removed from these devices. Data input / output and backup can be performed.
[0061]
The administrator of the receipt check system 12 uses the system management terminal 60 to acquire master creation data from the external organization 4 to create and update the check master data, and to input / output receipt data via the storage device 78. Maintenance and management of check database and receipt database.
[0062]
Next, the operation of the above embodiment will be described.
[0063]
FIG. 3 shows the flow of the receipt data check process. The receipt data check is performed by the user terminal device (here, the server 200 of the medical institution 1), the receipt check server 20, and the receipt database server 40.
[0064]
The server 200 activates a web browser installed in the server 200 in response to an instruction input from the user (step S100), and requests activation of a receipt check program (step S102). As a result, a receipt check program activation request and user identification information are transmitted to the receipt check server 20. This user identification information is used by the receipt check system 12 for user identification, and includes the user ID and password.
[0065]
When receiving the receipt check program activation request and the user identification information, the receipt check server 20 activates the receipt check program (step S200), and displays the screen on the server 200 of the medical institution 1 specified by the user identification information. Send data and files.
[0066]
The server 200 displays a start screen of the receipt check program based on the data and file (step S104), and selects the receipt data to be checked by the user's instruction input (step S106).
[0067]
Note that the format of the receipt data selected in step S106 may be a receipt computer processing format or a format customized by the user. Even for such different formats, it is possible to check the receipt data by preparing corresponding format data in the receipt database.
[0068]
When the server 200 requests a receipt check (step S108), the receipt check request and the receipt data to be checked are transmitted to the receipt check server 20. Upon receipt of the data, the receipt check server 20 transmits a check data extraction request to the receipt database server 40 (step S202).
[0069]
Upon receipt of the check data extraction request, the receipt database server 40 activates the database management program to extract the check data (past receipt data, medical data, user custom data) (step S300), and the receipt check server. 20 to send.
[0070]
The receipt check server 20 collates the receipt data input from the server 200 with the check data and the data stored in the check database (check master data and user master data) to check the accuracy of the receipt data. Check (step S202).
[0071]
In this way, the receipt check system 12 refers to the master data customized by the user in the receipt check and the past receipt data, so that the accurate receipt data can be obtained in consideration of different conditions and length of the medical treatment period for each user. Gender can be checked appropriately.
[0072]
The receipt check server 20 transmits the check result of the receipt data to the server 200 and the receipt database server 40 of the medical institution 1 (Step S204). Upon receiving the receipt check result, the receipt database server 40 updates the receipt data check history (step S302).
[0073]
The server 200 displays the check result received from the receipt check server 20 (step S110), and prints, outputs, and stores the check result based on the instruction input from the user (step S112). A screen display example of the check result is shown in FIG.
[0074]
If the check result is not correct, the user can correct the receipt data based on the check result and check again.
[0075]
The server 200 transmits a receipt data storage request to the receipt check server 20 based on an instruction input from the user (step S114).
[0076]
Upon receipt of the receipt data storage request, the reception check server 20 transmits a reception data storage request to the reception database server 40 (step S206), and the reception database server 40 stores the reception data in the reception database based on the request (step S206). Step S304).
[0077]
In this manner, in the receipt check system 12, the user can request storage according to the check result of the receipt data, so that only correct receipt data can be stored in the receipt database.
[0078]
Next, the server 200 transmits a receipt data transmission request to a predetermined billing institution 3 to the receipt check server 20 based on an instruction input from the user (step S116). When receiving the request, the receipt check server 20 transmits a receipt data transmission request to the billing institution 3 to the receipt database server 40 (step S208). Based on the request, the receipt database server 40 transmits receipt data to a predetermined billing institution 3 (step S306). As described above, the receipt database server 40 transmits the receipt data to the predetermined billing institution 3, thereby preventing a user such as the medical institution 1 from transmitting the receipt data by mistake.
[0079]
The receipt data may be transmitted to the billing institution 3 every time an instruction is input from the user as described above, or may be performed periodically (for example, every month).
[0080]
The receipt data may be transmitted by outputting the receipt data to a recording medium via the system management terminal 60 and sending the medium to the billing institution 3 at the request of the user.
[0081]
In this way, in the receipt processing system 10, a user such as the medical institution 1 can check the receipt data without relying on the visual inspection of the person in charge or the computer and program dedicated to the receipt data check, and know the result. Receipt data can be transmitted to the billing institution 3. Moreover, it is not necessary to hold the past receipt data by itself.
[0082]
That is, in the receipt processing system 10 according to the present embodiment, it is possible to appropriately check the accuracy of the receipt data and reduce the burden on the user.
[0083]
Next, browsing of the receipt related data by the user will be described.
[0084]
FIG. 4 shows a flow of processing for browsing the receipt related data. Note that the receipt-related data is data extracted in accordance with a user instruction from data stored in the receipt database.
[0085]
The browsing of the receipt related data is performed by the user's terminal device (here, PC 300 of the patient 5), the receipt check server 20, and the receipt database server 40.
[0086]
The PC 300 activates the web browser installed in the PC 300 in response to an instruction input from the user (step S120), and requests activation of the receipt check program (step S122). As a result, a receipt check program activation request and user identification information are transmitted to the receipt check server 20. This user identification information is used by the receipt check system 12 for user identification, and includes the user ID and password.
[0087]
When receiving the receipt check program activation request and the user identification information, the receipt check server 20 activates the receipt check program (step S220), and displays data for screen display on the PC 300 of the patient 5 specified by the user identification information and Send the file.
[0088]
The PC 300 displays a start screen of the receipt check program based on the data and the file (step S124), and sets the browsing condition for the receipt related data by the user's instruction input (step S126).
[0089]
The browsing of the receipt-related data may be limited in browsing conditions according to the user identified by the above-described user identification information. For example, in the case of patient 5, it is limited to data relating to the medical institution that he / she visits, in the case of medical institution 1, limited to data relating to the medical practice performed by himself / herself, and in the case of insurance association 2, data relating to the contents of claims to himself / herself. (In the present embodiment, the case where the patient 5 browses the contents of the medical treatment he / she received) is described.
[0090]
When the PC 300 requests browsing of medical treatment contents (step S128), the medical care content browsing request and the browsing conditions are transmitted to the receipt check server 20. Upon receipt of the data, the receipt check server 20 transmits a medical treatment content extraction request to the receipt database server 40 (step S222).
[0091]
Upon receipt of the medical treatment content extraction request, the receipt database server 40 activates the database management program and extracts browsing data (name of medical institution used by the patient 5, date of medical treatment, medical treatment content, medication content, payment amount, etc.). (Step S320), the data is transmitted to the receipt check server 20, and the database management history is updated (Step S322).
[0092]
The receipt check server 20 transmits the browsing data to the PC 300 of the patient 5 (step S224), and the PC 300 displays the medical treatment contents based on the browsing data (step S130). The displayed medical treatment contents are printed, output, and stored in response to patient 5 instruction input (step S132). FIG. 7 shows a display example of medical treatment contents.
[0093]
In this manner, in the receipt processing system 10, users such as the patient 5 and the medical institution 1 can browse the receipt related data regarding themselves. Moreover, since it becomes possible for a user to discover incorrect data by browsing the receipt related data, the receipt data can be checked more appropriately.
[0094]
【The invention's effect】
As described above, according to the present invention, the accuracy of the receipt data is appropriately checked, and the burden on the user is reduced.
[Brief description of the drawings]
FIG. 1 is a diagram illustrating an overall configuration of a receipt processing system according to an embodiment of the present invention.
FIG. 2 is a diagram illustrating a configuration of a receipt check system according to an embodiment of the present invention.
FIG. 3 is a diagram showing a receipt data check process according to the embodiment of the present invention.
FIG. 4 is a diagram illustrating a medical content browsing process according to an embodiment of the present invention.
FIG. 5 is a diagram illustrating customization by a user of a check master according to an embodiment of the present invention.
FIG. 6 is a diagram illustrating customization by a user of a check master according to one embodiment of the present invention.
FIG. 7 is a diagram illustrating an example of a screen display of a receipt data check result according to the embodiment of the present invention.
FIG. 8 is a diagram illustrating an example of a screen display of medical treatment contents according to the embodiment of the present invention.
[Explanation of symbols]
DESCRIPTION OF SYMBOLS 1 ... Medical institution, 2 ... Insurance association, 3 ... Claiming institution, 4 ... External organization, 5 ... Patient, 10 ... Receipt processing system, 12 ... Receipt check system, 20 ... Receipt check server, 40 ... Receipt database server, 60 ... System management terminal

Claims (9)

Receiving means for receiving receipt data having different formats transmitted by a user terminal device via a communication line;
A receipt check data corresponding to the previously prepared the different formats have a receipt data received by the receiving unit, a receipt check means for checking the accuracy of receipt the received data by comparing,
First transmission means for transmitting a check result checked by the receipt check means to the terminal device of the user via a communication line;
A data storage means for storing the received receipt data in the database as past received data upon receiving an instruction for storing the checked received data transmitted by the user terminal device after checking the received data;
Including
The receipt check data includes a check master data including a standard value for the number of times of medical practice determined according to at least one of injury and illness name, drug name, equipment name, examination name, hospitalization days, and outpatient days. , Including user master data in which the standard value of the check master data and the name of the disease are customized for each user, and the past receipt data .
The receipt check apparatus characterized by the above-mentioned. Means for storing the user master data in a database;
Before the winding Ekku master data and the user-customized screen that displays side by side and user master data, further including a means for updating the user master data based on an instruction which the user of the terminal device enter,
The receipt check apparatus of Claim 1 characterized by the above-mentioned. The user terminal device includes a patient terminal device,
When receiving an instruction to extract the receipt data output from the patient terminal device, the apparatus further includes second transmission means for extracting the patient receipt data from the database and transmitting it to the patient terminal device.
The receipt check apparatus according to claim 1 or 2, wherein Upon receiving an instruction to send checked receipt data sent by the user terminal device after sending the check result, the device further comprises third sending means for sending the receipt data to a terminal device of a predetermined billing institution. ,
Receipt check device according to any one of claims 1 to 3, characterized in that. A user terminal device communicably connected to the reception check system starts a reception check program stored in a server in the reception check system;
Receiving the receipt data having a different format transmitted by the user's terminal device via a communication line;
The receipt check program compares the received receipt data with the receipt check data corresponding to the different format prepared in advance, and checks the accuracy of the received receipt data;
The receipt check program transmitting the check result in the step of checking the accuracy of the receipt data to the user terminal device via a communication line;
When receiving an instruction for storing checked receipt data transmitted by the terminal device of the user after checking the receipt data, storing the receipt data in the database as past receipt data;
Including
The receipt check data includes a check master data including a standard value for the number of times of medical practice determined according to at least one of injury and illness name, drug name, equipment name, examination name, hospitalization days, and outpatient days. , Including user master data in which the standard value of the check master data and the name of the disease are customized for each user, and the past receipt data.
Features and, Relais concept check method that. The receipt check program storing the user master data in a database;
In user-customized screen that displays side by side and the front Symbol check master data the user master data, on the basis of the instruction by the user of the terminal device is input, the receipt check program, and updating the user master data Further including
The receipt check method according to claim 5 , wherein: The user terminal device includes a patient terminal device,
When the receipt check program receives an instruction to extract the receipt data output from the patient's terminal device, the receipt check program further includes extracting the patient's receipt data from the database and transmitting it to the patient's terminal device.
The receipt check method according to claim 5 or 6, characterized in that. When the receipt check program receives an instruction to transmit the checked receipt data transmitted by the user terminal device after the step of transmitting the check result to the user terminal device via a communication line, the receipt data is received. Further comprising the step of transmitting to a terminal device of a predetermined billing institution,
The receipt check method according to any one of claims 5 to 7 , wherein: Receiving receipt data having different formats transmitted by a user terminal device via a communication line;
Comparing the receipt check data corresponding to the different format prepared in advance with the received receipt data to check the accuracy of the received receipt data;
Transmitting the check result in the step of checking the accuracy of the receipt data to the terminal device of the user via a communication line;
When receiving an instruction for storing checked receipt data transmitted by the terminal device of the user after checking the receipt data, storing the receipt data in the database as past receipt data;
To the computer,
The receipt check data includes a check master data including a standard value for the number of times of medical practice determined according to at least one of injury and illness name, drug name, equipment name, examination name, hospitalization days, and outpatient days. , Including user master data in which the standard value of the check master data and the name of the disease are customized for each user, and the past receipt data.
Receipt check program characterized by that .

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