JP6712196B2 - Payment request processing system with improved fraud prevention function - Google Patents

Description

The present invention relates to a payment request processing system such as a medical treatment fee for visiting medical care, a medical fee for visiting nursing, a medical fee for visiting dental care, a medical treatment fee for visiting medical care, a nursing care fee for visiting care, or a nursing care fee for visiting rehabilitation. ..
The present invention guarantees that a visitor such as a doctor visits the user's home as scheduled to claim the medical treatment fee or the nursing care fee, thereby improving the fraudulent billing prevention function such as the camouflaged visit. System.
Here, visitors are doctors, nurses, dentists, dental hygienists, Anma massage shiatsu, Judo reduction, acupuncturists, care workers, care helpers, physical therapists, occupational therapists, etc. A person who visits, etc., provides various services to the user at his/her home and receives a reward.

In recent years, due to the effects of an aging society, etc., not only visiting medical care and visiting nursing, but also visiting dental care, visiting medical treatment, visiting care, visiting rehabilitation, etc. The number of so-called "visiting services" that provide various services to the market is increasing.

Here, the home-visit medical treatment is a general term for the home-visit and the home-visit medical treatment, and the home-visit medical treatment is a medical treatment form in which a medical examination is performed each time the patient requests such as when the patient suddenly changes. It is said to refer to a medical care form in which the patient's home is regularly visited to provide medical treatment and guidance.
Home-visit nursing refers to nursing or assistance accompanying medical treatment or medical treatment performed by a nurse or the like visiting a user's home or the like for a person who is continuously receiving medical treatment at home due to illness or injury. Has been done.

Visiting dentistry is a general term for visiting dentistry and visiting dentistry, and visiting is a form of medical care in which a dental examination is performed each time a request such as a sudden toothache of a patient is made. It is said to mean a medical practice in which dentists and dental hygienists regularly visit patients' homes for dental and oral care.

For home-visit medical treatment, for those who continue to receive medical treatment at home due to illness or injury, those who have national qualifications such as Anma massage Shiatsu, Judo rehabilitation, and acupuncturist visit the home of the user. It is said that it refers to the treatment to be performed. For example, a person who has a national qualification of an anma massage shiatsu massage visits a user's home for a user who is difficult to go to the hospital alone due to paralysis or contracture, and the purpose is to maintain or improve physical function. Provide a medical service by giving a massage.

Home-visit care allows care workers and home helpers to visit the user's home, etc., so that the user can lead an independent daily life at home as much as possible, and provide care (body, excretion, bathing, etc.) It is said that it refers to life support such as nursing care) and cleaning, laundry, shopping, cooking, etc.
Home visit rehabilitation is a service for patients who the doctor recognizes as "need to use the home visit rehabilitation service", and nurses and physiotherapists etc. visit their homes according to the instructions of the attending doctor to perform functional recovery training and medical care, It is said to mean providing medical assistance.

In the present specification, these may be collectively referred to as “service”, and the entity that performs the service may be referred to as “service provider” or “visitor”.
In the above-mentioned visit-type services, menus covered by insurance such as medical insurance and long-term care insurance are paid by the insurer except for the patient's share of expenses, and payment is made through paperwork with insurance payment request. Be seen. In addition, although it is a visit type service, for menus that are not covered by insurance such as health insurance and long-term care insurance, all expenses are borne by the patient as so-called "free medical treatment".
Under the health insurance system and national health insurance system, medical fees are determined for each medical treatment content, nursing content, dental treatment content, and medical treatment content for users, and the claimant creates a receipt according to the rules of medical treatment compensation. Ask the insurer to which the user belongs to pay the cost using.
Medical treatment-type institutions that continue medical treatment for a long period of time, such as bone grafting clinics, acupuncture and moxibustion clinics, and massage massage institutions, have medical treatment costs determined for each type of medical treatment. In accordance with the above, use the created medical treatment payment application form to ask the insurer to whom the medical care provider belongs to pay the medical treatment cost.
In addition, under the long-term care insurance system, long-term care fees are set for each type of care provided to the user, and the claimant pays the insurer to whom the user belongs by using the receipt created in accordance with the rules for long-term care fees. Ask for payment.

Here, in the insurance claim from the visitor to the insurer, regarding medical treatment fee and long-term care fee, a receipt is prepared according to a predetermined rule according to the service provision content, and the insurer (municipal public health, mutual aid association, health insurance association) , Long-term care insurance, Wide-Aged Medical Association, etc.), the insurer examines the legitimacy of the receipt, and if it is legitimate, pays the medical treatment fee and long-term care fee to the insured person.
On the other hand, the medical treatment claim is originally a reimbursement payment, so once the user pays all the expenses, he/she will apply for the medical treatment payment to the health insurance association and receive the benefit later. Also, under certain conditions, proxy requests are allowed, and the service provider Anma Massage Shiatsu creates a receipt according to predetermined rules according to the service provision content, submits it to the insurer, and insurance The person examines the legitimacy of the receipt, and if it is legitimate, pays medical expenses to the claimant.
In this way, the service provider himself/herself creates a receipt and claims the insurer for all of the medical treatment fee, the nursing care fee, and the medical treatment fee.

However, in the past, the service provider had to make the receipt and handle the insurance claim, and thus inappropriate insurance claims had become a problem. Inappropriate insurance claims can be false claims due to negligence or intentional fraudulent claims. If it is an error request due to negligence, it is easy to prevent it by devising a check method such as checking the compatibility of medical care contents and insurance points, recalculation check of insurance points calculation.
However, if a fraudulent request is made intentionally, it is difficult to detect the fraud. In other words, it is difficult for an insurer who is not there to completely check whether the service provided to the user matches the contents actually provided, and the service provider's self-reported belief is taken as it is. Since it is necessary to calculate the amount of money, it is difficult to detect malicious fraudulent charges.
Furthermore, in the visit-type service that the service provider visits at the user's home, the service provider increases the number of visits, and it is falsely said that the service provider visited the service even on days when he/she was not actually visiting. There is a risk that a so-called "visit to Kara" will be made.
Since the receipt payment examination organization conducts a large amount of receipt examination, it is difficult to sufficiently check the above-mentioned fraudulent claims.

FIG. 18 is a flow of a system for charging a medical treatment fee and a nursing care fee using the service provider system B having a conventional receipt creation support function.
After the service provider visits the user's home A to provide the service, and then returns to the place of business of the service provider, the service provider system B summarizes the service contents provided at the user's home A. After inputting, the receipt was manually completed while using the receipt making support function, and the receipt examination system C was billed. It is also difficult for the receipt reviewing organization to examine a large amount of receipts, and if fraud cannot be detected, the receipt reviewing is completed and medical fee data is sent to the insurer system D, and the insurer services the amount of medical fee billing. The current situation is to pay the provider.

Here, there are cases where correct payment of medical fees and nursing care fees cannot be processed due to intentional or misunderstanding.
First, for example, it is possible that after the service provider returns to the office, all of the service contents performed at the user's home cannot be correctly input to the service provider system B. There is a possibility of padding due to intentional or misunderstanding, and there is a possibility of misunderstanding and underreporting due to omission of input.
Next, the receipt examination organization needs to complete a huge amount of receipt examinations within a certain period of time, and in some cases, physically elaborate examinations may not be possible.

Therefore, in the related art, a technique for preventing illegal billing of a visit type service has been developed. For example, there is a payment request office work proxy system described in Japanese Patent Laid-Open No. 2009-032129. This is a system that executes a receipt creation process and a submission process to an insurer while mediating between a user, a service provider, and an insurer, and enables an insurance payment request that cannot be fraudulently claimed.
FIG. 19 is a diagram showing a payment request office work proxy system described in Japanese Patent Laid-Open No. 2009-032129. As shown in FIG. 19, an installation object 50 in which a special code that can be read by the visitor mobile terminal 200 is displayed is installed in advance in the user's house, and the installation object read by the reader unit 21 at the time of visiting home care. The special code of 50 and the latitude and longitude information of the current location acquired by the GPS unit 220 are transmitted. The center system analyzes the special code information of the installation 50 and the latitude and longitude information acquired by GPS, confirms the visit to the user's house and the execution of the massage treatment, and confirms that there is no fraudulent claim and accepts the receipt. It is created automatically.
The payment request office work agent system described in Japanese Patent Laid-Open No. 2009-032129 is an excellent system, and so-called "color visit" in which the user is disguised as if he/she visited the user's house even though he/she has not actually visited the house. It can be said that this is a technology that effectively prevents unauthorized billing.

JP, 2009-032129, A

Although the payment request office work proxy system of Japanese Patent Application Laid-Open No. 2009-032129 mentioned above is an excellent system, the present invention is a further development of the technology for preventing fraudulent claims, and intentionally makes fraudulent claims. It is an object of the present invention to provide a payment invoice business processing system having an improved function of preventing fraudulent claims by further improving the level of preventing fraudulent claims from persons.

In order to achieve the above object, the payment request processing system with improved fraudulent claim prevention function of the present invention is a medical treatment fee for home medical care, a medical fee for home nursing, a medical fee for home dentistry, a medical fee for home medical treatment, and at home. A payment request processing system for processing payment requests for nursing care fees or nursing care fees for home rehabilitation, including a center system, doctors, nurses, dentists, dental hygienists, massage massage shiatsu, judo A visitor mobile terminal held by a remediator, acupuncturist, care worker, care helper, physical therapist, or occupational therapist, a user terminal installed in the user's home in advance, and the user from the center system. The first dynamic code is dynamically transmitted to the terminal only for a certain time from the scheduled visit time and displayed on the user terminal, and the visitor portable terminal reads the first dynamic code. Start confirmation means for transmitting to the center system, and the center system for dynamically transmitting the second dynamic code to the user terminal only for a fixed time from the scheduled end time for display on the user terminal. And a termination confirmation means for causing the visitor mobile terminal to read the second dynamic code and transmitting the second dynamic code to the center system, wherein the first dynamic code and the second dynamic code are different data, In the center system, a billing clerical work processing having an improved fraudulent bill prevention function for guaranteeing that the visitor stays at the user's home based on the first dynamic code and the second dynamic code System.
With the above configuration, the first dynamic code is dynamically transmitted/displayed directly to the user terminal only for a certain time from the scheduled visit time, and the first dynamic code is displayed after a certain time (for example, 10 minutes) has elapsed. If the operation is stopped, the service provider cannot send the first dynamic code to the center system unless it visits the user's home. Similarly, the second dynamic code is dynamically transmitted/displayed directly to the user terminal only for a fixed time from the scheduled end time, and after the fixed time (for example, 10 minutes) has passed, the second dynamic code is not displayed. In operation, the service provider cannot send the second dynamic code to the center system unless it stays at the user's home until the scheduled end time.

Although the first dynamic code is displayed only for a fixed time from the scheduled visit time, it may be displayed for a fixed time from a predetermined time before the scheduled visit time. That is, it may be displayed before and after the scheduled visit time, such as 5 minutes before the scheduled visit time to 10 minutes after the scheduled visit time.
Similarly, although the second dynamic code is displayed only for a fixed time from the scheduled end time, it may be displayed for a fixed time from a predetermined time before the scheduled end time. That is, the display may be performed before and after the scheduled end time, such as from 5 minutes before the scheduled end time to 10 minutes after the scheduled end time.
In other words, it is possible to operate considering that there are cases where the vehicle arrives a little early and cases where it takes a long time to move and arrives a little late.

Here, the dynamic code is different from the fixed static code, and is a mechanism in which a different code is dynamically created and transmitted every time. Therefore, the service provider who is going to make a fraudulent bill does not actually visit after the second visit, but reuses the first dynamic code and the second dynamic code obtained at the first visit and makes an illegal visit. Even if an attempt is made to make a request, a different code is assigned in the center system in each operation, so that the past dynamic code cannot be reused. It is guaranteed that the service provider will actually visit the user's house each time to get the correct dynamic code.

Further, since the first dynamic code and the second dynamic code are different data, it is guaranteed that the user stays at the scheduled time. For example, as a fraudulent pattern, after visiting the scheduled visit time properly and getting the first dynamic code, the service provision is cut off and terminated halfway, and it is withdrawn from the user's house and the scheduled end time is reached. Then, even if the same first dynamic code is sent again from the outside and an attempt is made to misrepresent it, the first dynamic code and the second dynamic code do not match, so leave the user's home. It turns out that there is.
As a matter of course, the "first dynamic code" at the time of visit and the "second dynamic code" at the time of termination can be changed rotationally every time. In other words, the “first dynamic code” given at every rotation and the “second dynamic code” at the end are respectively the “first dynamic code” at the time of visit allocated in the past and the “end”. It goes without saying that it is different from the “second dynamic code of time”.
As described above, in the present system, based on the first dynamic code and the second dynamic code, it is possible to confirm that the service provider stayed at the user's home at both the scheduled visit time and the scheduled end time. Can be guaranteed.

Here, the dynamic code is not limited, but preferably has a certain amount of information that can be carried so that a large number of patterns can be generated, and examples thereof include a two-dimensional dot code.
The information carried by the dynamic code may be entirely random numbers, or may be information obtained by calculation from user information such as user ID information and user address information and random numbers.

Next, as a further device of the above configuration, there is a device for accurately specifying the time.
The start confirmation means divides the fixed time into a plurality of time zones, transmits a different code as the first dynamic code for each divided time zone, and the end confirmation means also divides the fixed time into a plurality of time zones. This is a device to divide into time zones and to transmit a different code as the second dynamic code for each divided time zone.
With this device, in the center system, by analyzing the first dynamic code, it is possible to identify in which time zone the visitor portable terminal has read the first dynamic code by analyzing the first dynamic code. In addition, by analyzing the second dynamic code, it is possible to specify in which time zone the visitor portable terminal has read the second dynamic code within a certain period of time. In other words, it is possible to guarantee what time the service provider actually visited and the end time when the service provision was actually ended. It should be noted that such an idea of changing the dynamic code depending on the time zone has an effect of improving security for preventing illegal charges. If the system that uses the clock function of the visitor mobile terminal to identify the time, the clock time of the visitor mobile terminal may be changed. That is, generally, a mobile terminal has a time adjustment function, and there is a possibility that the time adjustment function is abused and the time setting is changed. Further, if the system uses the clock function of the user terminal, the clock time of the user terminal may be changed. That is, generally, the user terminal has a time adjustment function, and there is a possibility that the time adjustment function is misused and the time setting is changed. In addition, the idea of inserting the time information in the information carried by the dynamic code is that the time in the first dynamic code and the second dynamic code is fixed, and the service provider It is not possible to grasp the visit time and the end time of each of them in detail.
However, as described above, if the dynamic code is changed by dividing it into time zones, for example, if the dynamic code is changed every one minute, the center system will change the time zone from the visitor mobile terminal. By analyzing whether the target code was transmitted, it is possible to accurately specify the time even though it is a minute unit.

Next, as a further device of the above configuration, there is a device for preventing the user terminal from being taken out.
The visitor mobile terminal has a GPS information acquisition function, and the start confirmation means is a means for transmitting the first dynamic code and the first GPS data obtained by the GPS information acquisition function from the visitor mobile terminal to the center system. The end confirmation means is a device for transmitting the second dynamic code from the visitor portable terminal and the second GPS data obtained by the GPS information acquisition function to the center system.
Even if the service provider takes out the user terminal itself from the user's house in order to make an illegal bill and tries to make an illegal bill at hand, the center system transmits the first GPS data and the second GPS data. Based on the above, it is possible to confirm the location information of the service provider at the visit time when the first dynamic code is read and the end time when the second dynamic code is read. Both of them can guarantee that they stayed at the user's house.

Next, as a further device, there is a device for preventing the impersonation of the service provider.
The visitor mobile terminal has an ID information acquisition function, and the start confirmation means obtains from the visitor mobile terminal the first dynamic code, the first GPS data obtained by the GPS information acquisition function, and the ID information acquisition function. Is a means for transmitting the first ID information to the center system, and the end confirmation means is the second mobile code from the visitor portable terminal, the second GPS data obtained by the GPS information acquisition function, and the ID information. This is a device for transmitting the second ID information obtained by the acquisition function to the center system.
Even if the service provider makes a fraudulent claim and the person concerned, not the service provider himself, visits and provides the service, he or she tries to perform the so-called “spoofing and impersonation” fraud. Based on the code, the first GPS data, the first ID information, the second dynamic code, the second GPS data, and the second ID information, the service provider at both the visit time and the end time This guarantees that the person stayed at the user's house.

For example, the ID information is card ID information stored in the IC card carried by the visitor, and the ID information acquisition function is an IC card reader function of reading the card ID information stored in the IC card. .. For example, if the service provider himself/herself is included in the IC card and the card ID information is read by the IC card reader function after being presented to the user, "spoofing impersonation" can be prevented.
Further, there is a device in which the ID information is the biometrics information of the service provider and the ID information acquisition function is the biometrics reader function for reading the biometrics information.
For example, if biometrics such as fingerprint pattern of finger, vein pattern of finger, iris pattern of eye, voiceprint pattern of voice, etc. are input, it is possible to provide reliable identification by matching biometrics information that is difficult to tamper with. It is possible to prevent “spoofing and impersonation”.

A payment request processing method with improved fraudulent bill prevention function according to the present invention is a medical treatment fee for home medical care, a medical fee for home nursing, a medical fee for home dental care, a medical fee for home medical treatment, a nursing care fee for home care, or , A payment request processing method for processing payment requests for home-based rehabilitation nursing care, using a center system, including doctors, nurses, dentists, dental hygienists, anma massage shiatsu practitioners, judo reduction practitioners, acupuncture and moxibustion A nurse, a care worker, a care helper, a physical therapist, or an occupational therapist holds a visitor mobile terminal, installs the user terminal in the user's home in advance, and visits the user terminal from the center system. The first dynamic code is dynamically transmitted and displayed on the user terminal only for a fixed time from a predetermined time before the scheduled time, and the visitor portable terminal reads the first dynamic code to cause the visitor mobile terminal to read the first dynamic code. The start confirmation transmitted to the center system, and the second dynamic code is dynamically transmitted from the center system to the user terminal only for a predetermined time from a predetermined time before the scheduled end time, and is transmitted to the user terminal. The display is displayed, and the visitor mobile terminal reads the second dynamic code and confirms the end of transmission to the center system, and sets the first dynamic code and the second dynamic code as different data. In the center system, based on the first dynamic code and the second dynamic code, the visitor stays at the user's home at any of the scheduled visit time and the scheduled end time. This is a way to guarantee that you have done it.
Although the payment request processing system with improved fraudulent claim prevention function has been described focusing on the fraudulent claim prevention function, it does not include a receipt creation support function and an insurer payment request processing function. It goes without saying that it is also good.

According to the payment request processing system and method with improved fraudulent bill prevention function of the present invention, it is possible to confirm/guarantee that the service provider surely visited the user's house as scheduled and provided the service, and thus fraudulent billing. It is possible to process payment requests without payment.

It is a figure which shows briefly the whole image of the payment request office processing system of this invention. It is a figure which shows in detail centering on the structure of the center system 100 and the visitor portable terminal 200 among the payment request office processing system of this invention. It is a figure (the 1) which shows the flow of the data processing of a payment request office work processing system. It is a figure (the 2) which shows the flow of the data processing of a payment request office work processing system. It is a figure (the 3) which shows the flow of data processing of a payment request office work processing system. It is a figure (the 4) which shows the flow of data processing of a payment request office work processing system. It is a figure (the 5) which shows the flow of the data processing of a payment request office work processing system. It is a figure (the 6) which shows the flow of the data processing of a payment request office work processing system. It is a flowchart (the 1) which shows the flow of the data processing of a payment request processing system. It is a flowchart (the 2) which shows the flow of the data processing of a payment request office work processing system. It is the figure which showed the 1st dynamic code and the 2nd dynamic code which were transmitted for every time zone managed by schedule management part 130 as a list easily. It is the figure which showed in detail centering on the structure of the center system 100 and the visitor portable terminal 200 among the payment request office processing systems concerning Example 3 of this invention. It is a figure (the 1) which shows the flow of the data processing of the payment bill office processing system when reading the ID information of an IC card as ID information. It is a figure (the 2) which shows the flow of the data processing of the payment claim office work processing system at the time of reading the ID information of an IC card as ID information. It is a figure (the 1) which shows the flow of the data processing of the payment claim office work processing system at the time of reading biometrics information as ID information as ID information. It is the figure which simply showed the concept which inputs the biometrics information of a visitor. It is a figure (the 2) which shows the flow of the data processing of the payment claim office work processing system at the time of reading biometrics information as ID information as ID information. It is a figure which shows the flow of the system which charges the medical treatment fee and the nursing care fee using the service provider system B with the conventional receipt preparation support function. It is a figure which shows the payment request clerical agency system described in Unexamined-Japanese-Patent No. 2009-032129.

Hereinafter, the best mode for carrying out the present invention will be specifically described with reference to Examples. The present invention is not limited to these examples.

A configuration example of the payment invoice processing system 100 having an improved fraudulent invoice prevention function according to the present invention will be described with reference to the drawings.
In the following description, the medical treatment fees targeted by the payment request processing system 100 of the present invention include medical treatment fees for visiting medical care, medical fees for visiting nursing, medical fees for visiting dentistry, medical fees for visiting medical treatment, and the like. , There are nursing care rewards for home-visit nursing care, nursing care rewards for home-visit rehabilitation, etc., which can process payment requests, but, for example, a comprehensive system that can handle all cases is also possible. A computerized system is also possible. In other words, if the system is tuned for a medical institution, it will be the system that mainly handles the medical fee for visiting medical care and the medical fee for visiting nursing. It will be a system to handle. Similarly, if the system is tuned for massage and acupuncture, it will be the system that mainly deals with medical fees for visiting medical treatment, and if the system is tuned for nursing care stations and rehabilitation stations, it will be for nursing care for visiting care and visiting rehabilitation. It may be a system that mainly deals with the nursing care reward.
Hereinafter, the service provider and the institution to which the service provider belongs are not particularly limited, and the insurer is also not particularly limited. Further, the operator of the center system will be described by taking the payment and billing agency as an example, but it is also possible that the receipt inspection agency or the insurer itself is the operator of the center system.

FIG. 1 is a diagram simply showing an overview of a payment request processing system according to the present invention.
FIG. 2 shows the details of the center system 100 and the visitor portable terminal 200 of the payment request processing system according to the present invention.
As shown in FIG. 1, in this overall image, a center system 100 installed by a payment and billing agency, a visitor mobile terminal 200 carried by a service provider, a service provider system 300 installed by a service provider, A user terminal 400 installed at the user's home, a receipt screening system 500 installed and managed by a receipt screening and payment organization such as a payment fund and the National Health Insurance Federation, and an insurer system installed and managed by an insurer. There are 600.
The center system 100 intervenes between a service provider who is an insurance claimer, a receipt inspection agency, and an insurer, and executes receipt data creation processing on behalf of the two and billing processing for medical fees and nursing care fees. It is the one that executes on behalf of.
Although the entity that installs/manages the center system 100 is described as an independent entity that acts as a billing clerical agent, it is also possible that the receipt inspection organization and the insurer themselves are operators of the center system. ..

Each component of the center system 100 will be described.
The configuration example of the center system 100 of FIG. 2 includes a service provider information database 110, a user information database 120, a schedule management unit 130, a visit confirmation unit 140, a receipt data creation unit 150, an insurance information database 160, and a communication unit 170. ing.

The service provider information database 110 is a database that stores various information of service providers who provide services such as medical treatment, medical treatment, and nursing care at home, and includes name, qualification information, service provider ID information, and the like. It also stores the name, address, service content, and service information of the schedule of the user who the service provider plans to visit. When the service provider ID information is biometrics information, biometrics information of the service provider, for example, finger vein pattern information, fingerprint information, palm vein pattern information, iris pattern information, voiceprint pattern information, etc. are stored. ..

The user information database 120 is a database that stores various information for each user who wants to provide services such as medical treatment, medical treatment, and nursing care at home, and uses the user's name, address, age, insurance number, and the like. In addition to various information that indicates the attributes of the user, user status information that indicates the user's condition such as the disease name and symptoms of the user, and the degree of nursing care required, the service content scheduled for the user and its schedule, etc. The service information of is also stored.

The schedule management unit 130 manages a visit schedule for each service provider, issues a dynamic code according to the schedule, and manages the schedule information and the dynamic code in association with each other.
The dynamic code is preferably a two-dimensional code having a relatively large information capacity per area. There are various types of two-dimensional codes such as QR code, DataMatrix, and PDF417.
The dynamic code information may be completely random numbers, but may also be information obtained by calculating from user information such as user ID information and user address information and random numbers. If the random number part is changed every time, the dynamic code will be changed every day, and it is extremely difficult for the service provider to make illegal or fictitious charges, and security can be improved.
The issued first dynamic code and second issued dynamic code are used to confirm the start and end of service provision.
In order to confirm the start, the schedule management unit 130 dynamically transmits the first dynamic code to the user terminal 400 only for a certain time from the scheduled visit time and displays it on the signage unit 410 of the user terminal 400 to visit. The person portable terminal 200 is made to read.
For confirmation of completion, the schedule management unit 130 dynamically transmits the second dynamic code to the user terminal 400 only for a fixed time from the scheduled end time and displays it on the signage unit 410 of the user terminal 400. , And makes the visitor mobile terminal 200 read it.

The visit confirmation unit 140 analyzes the data received from the visitor mobile terminal 200 via the communication unit 170, the service provider visits the user's home, and stays at the user's home for a predetermined time. This is a part for confirming whether the service provision has been executed. As will be described later, based on various data such as the first dynamic code, the first GPS data, the first ID information, the second dynamic code, the second GPS data, and the second ID information. Analyze and confirm. This confirmation processing will be described later.
The payment request processing system of the present invention ensures the confirmation of the start of the service provision and the confirmation of the end of the service provision by interlocking the schedule management unit 130 and the visit confirmation unit 140.
The start confirmation means and the end confirmation means will be described later.

The receipt data creation unit 150 receives the medical care data input from the input unit 230 of the visitor mobile terminal 200, creates a receipt data based on the medical care data, and transmits the created receipt data to the receipt examination system 500. It has a function to do.
In the home-visit type service, an appropriate operation is performed on the visited user, but the applied contents are collected by the center system 100 to create a receipt. The receipt data is transmitted to the receipt examination system 500 described later.

The insurance information database 160 includes basic information (information on the insured, etc.) of each company such as local governments, basic information on medical institutions/dispensing pharmacies such as hospitals (information on approval applications), and the Ministry of Health and Welfare at the time of revision of the law. Stores information necessary for calculating medical fees, and the receipt data creation unit 150 accesses the insurance information database 160 when converting medical care contents into insurance points, and assigns points for converting medical care contents into insurance points. It is possible to obtain necessary information such as and calculation formulas.
The medical fee will be finally charged to the insurer, but before that, the receipt will be examined by the receipt inspection agency.

The communication unit 170 has a data communication function. A configuration having a voice communication function in addition to the data communication function is also possible. Here, the first dynamic code and the second dynamic code read by the dynamic code reader unit 210 of the visitor mobile terminal 200, which will be described later, the GPS latitude/longitude information acquired by the GPS unit 220, and the ID information input. The ID information and the like input by the unit 230 is received.

Next, the visitor mobile terminal 200 will be described. The visitor mobile terminal 200 is carried by the service provider, and the visitor mobile terminal 200 is a doctor, a nurse, a dentist, a dental hygienist, an anma massage shiatsu, a judo reduction doctor, an acupuncturist, a care worker, and a care helper. , A physical therapist, or an occupational therapist, which is a terminal carried by a service provider having a predetermined qualification.
For example, a smartphone equipped with an application for functioning as the visitor mobile terminal 200 of the present invention or the like. In addition to the basic functions of smartphones, it is equipped with a dynamic code reading function for cameras, a GPS function, and other ID information reading functions. As will be described later in detail, the first dynamic code and the second dynamic code displayed on the signage unit 410 of the user terminal by the dynamic code reading function are obtained by photographing, and in combination with the GPS function, Guaranteeing that the holder of the visitor mobile terminal 200 stayed at the user's home according to the visit schedule, and that the person who carried the visitor mobile terminal 200 by the ID information reading function is the registered service provider. Can be guaranteed.
The visitor mobile terminal 200 includes a dynamic code reader unit 210, a GPS unit 220, an input unit 230, a display unit 240, and a communication unit 250. The visitor portable terminal 200 can be configured by using a smartphone in which an application is installed so as to exhibit the functions of the present invention as having these respective elements.

The dynamic code reader unit 210 is a unit that reads a dynamic code that is dynamically displayed on the signage unit 410 of the user terminal 400 installed at a home-visit destination as described later. For example, there is a configuration including a camera function and an application that decodes a captured dynamic code.

The GPS unit 220 obtains latitude/longitude information of the current location through data transmission/reception with GPS satellites. It is said that the accuracy of the latitude/longitude information obtained by the current GPS is 10 m or more, but the accuracy will improve if a highly accurate GPS can be used in the future.

The input unit 230 is an input interface that enables a practitioner to operate to input data. The input method is not particularly limited, and for example, an input button, a cross key, a touch panel, etc. are not particularly limited. Voice recognition input can also be adopted. For example, the content of the treatment performed on the day is input from the input unit 230.

The display unit 240 is an output interface that enables data output to the operating operator. The display system is not particularly limited, and examples thereof include a liquid crystal display panel. When the practitioner is a visually handicapped person, it is preferable to have a voice output function.
For example, after transmitting the dynamic code to the center system 100, it is possible to receive the data of the treatment content from the center system 100 to confirm the treatment content of the day and display the data on the display unit 240.

The communication unit 250 has a data communication function. A configuration having a voice communication function in addition to the data communication function is also possible.

Next, the service provider system 300 will be described.
The service provider system 300 is a system managed and operated by a service provider. There can be various forms depending on the service provided.
For home visits and nursing visits, the operating entity of the medical institution will operate. If it is a visiting dental practice, the management entity such as a dental clinic operates it. For home-visit medical treatment, management entities such as massage and acupuncture centers operate it. In the case of home-visit nursing care, the operating entity such as the home-visit care provider or home-care support company operates it. For home visit rehabilitation, the management entity of the medical institution operates it.
It has a function to support the work that the service provider should perform when providing the service, for example, to support the work to get the approval of the insurer by setting the schedule of the service contents to be provided to the user and the center system. The schedule is notified to 100 to support schedule management in the center system 100.
Note that smartphones in recent years have improved in capacity as computer resources, and the visitor portable terminal 200 may also serve as the service provider system 300.

The user terminal 400 is a terminal installed in the user's home in advance.
The user terminal 400 includes a signage unit 410 and a communication unit 420.
The signage unit 410 displays the dynamic code transmitted from the center system. The resolution of the signage unit 410 needs to be such that the two-dimensional code can be displayed accurately. Note that recent liquid crystal monitors and the like have sufficient resolution.
The communication unit 420 has a communication function of receiving data from the center system 100.
The user terminal 400 receives the dynamic code transmitted from the schedule management unit 130 of the center system 100 at a predetermined time and displays it on the signage unit 410. When the predetermined time has elapsed, the dynamic code displayed on the signage unit 410 is erased from the signage unit 410.

The user terminal 400 can be equipped with other added value in addition to the dynamic code display function. For example, it is possible to receive advertisement data or public relations data via the communication unit 420 and display the advertisement or public relations on the signage unit 410. By displaying the advertisement, the advertisement fee income from the sponsor can be used for the installation cost of the user terminal 400. Public relations that are regularly issued by administrative organizations are usually distributed in paper media, but if they can be displayed on the user terminal 400, the cost of issuing public relations can be reduced. It can contribute to the improvement of services.

Next, the receipt examination system 500 will be described. The receipt examination system 500 is a system established and managed by a receipt examination and payment organization such as a payment fund and the National Health Insurance Federation. It receives information such as the receipt data necessary for the receipt examination and receives information about the results of the receipt examination (return notice). Information etc.) In the present invention, since the center system 100 is interposed between the medical institution system 20 and the examination system 500, the information such as the receipt data is received and the result information of the receipt examination is returned to the center system 100.

The insurer system 600 is a system installed and managed by insurers such as local governments (national health insurance, etc.) and companies (health insurance associations, etc.). It has information on the insured and is approved by the receipt examination agency. According to the received receipt data, insurance payment processing and the like are performed according to the medical fee claim.

The above is an example of the configuration of the payment request processing system.
Next, the visit confirmation process to the user's house, the visit termination process after the service is provided, and the receipt process, which are executed in the payment request office processing system, will be described.
3 to 8 are diagrams showing the flow of data processing in the configuration example of the payment request processing system shown in FIG. 2, and FIGS. 9 to 10 are flowcharts showing the flow of the processing.

As a premise, the user's home is equipped with a user terminal 400, and the user information database 120 of the center system 100 has a registration procedure for user information such as name, address, and insurance number necessary for insurance processing. It is assumed to be completed.
In addition, it is assumed that a schedule for the service provider to visit the user's home is set in advance. Further, in the case of visiting medical treatment, it is assumed that a medical treatment plan and a medical treatment payment application are prepared, and that necessary paperwork such as signature of the required medical treatment payment application is completed.

First, according to the visit schedule, the schedule management unit 130 of the center system 100 transmits the first dynamic code at the scheduled visit time (FIG. 3, FIG. 9 step S1), and the signage unit 410 of the visitor portable terminal 200. The first dynamic code is displayed on the screen (FIG. 3, FIG. 9, step S2).

Here, the display time of the first dynamic code is a fixed time from a predetermined time before the scheduled visit time. In this example, the operation is displayed from 10 minutes before the scheduled visit time to 10 minutes after the scheduled visit time before and after the scheduled visit time. That is, the first dynamic code is not displayed after 10 minutes from the scheduled visit time, and the service provider does not always visit the user's home before and after the scheduled visit time to the user's home. The physical code cannot be transmitted to the center system 100 side.

In addition, here, the first dynamic code is a QR code generated by encoding data obtained by calculating from user information such as user ID information and user address information and a random number.
In addition, the idea of transmitting the first dynamic code different for each time zone and displaying it on the signage unit 410 of the user terminal 400 will be described in the second embodiment.
In addition, here, it is assumed that the first dynamic code continues to display the same first dynamic code from 10 minutes before the scheduled visit time to 10 minutes after the scheduled visit time.

At the scheduled visit time, the service provider visits a place where the service is provided by home visit such as the user's home. Here, the service provider carries the visitor mobile terminal 200 while visiting.
The service provider operates the application of the visitor mobile terminal 200 and taps the “start” button.
The service provider operates the dynamic code reader unit 210 of the visitor mobile terminal 200 to read the first dynamic code displayed on the signage unit 410 of the user terminal 400, with the user's consent. An image is taken and read (step S3 in FIG. 3 and FIG. 9).

The application of the visitor portable terminal 200 activates the GPS unit 220 to acquire the first GPS data composed of the latitude and longitude data of the current location (FIG. 4, FIG. 9 step S4), and via the dynamic code reader unit 210. The captured first dynamic code, the first GPS data obtained via the GPS unit 220, and the terminal ID information of the visitor portable terminal 200 are transmitted to the center system 100 (FIG. 4, step S5 in FIG. 9). ).

Although the first dynamic code, the GPS data, and the terminal ID information of the visitor portable terminal 200 are transmitted here, other information, for example, an example in which the visitor ID information is also input and transmitted. Will be described in Example 3.
In the center system 100, the first dynamic code, the first GPS data, and the terminal ID information of the visitor portable terminal 200 are received by the analysis unit 140 (FIG. 4, step S6 in FIG. 9).

Subsequently, the visitor provides the user with a predetermined service for a predetermined time.
According to the visit schedule, it is about a predetermined time when the predetermined service is completed for a predetermined time.
The second dynamic code is transmitted from the schedule management unit 130 of the center system 100 in accordance with the scheduled end time (FIG. 5, step S7), and is displayed on the signage unit 410 of the visitor portable terminal 200 (FIG. 5). , Step S8 in FIG. 9).

Here, the display time of the second dynamic code is a fixed time from a predetermined time before the scheduled end time. In this example, the operation is performed from 10 minutes before the scheduled visit time to 10 minutes after the scheduled visit time before and after the scheduled visit time. The second dynamic code will not be displayed 10 minutes after the scheduled end time, and the second dynamic code will not be displayed unless the service provider visits the user home before or after the scheduled end time at the user home. Cannot be transmitted to the center system 100 side.
Further, here, the second dynamic code is also a QR code generated by encoding data obtained by calculating from user information such as user ID information and user address information and a random number.

In addition, the idea of transmitting the second dynamic code different for each time zone and displaying it on the signage unit 410 of the user terminal 400 will be described in the second embodiment. That is, here, it is assumed that the second dynamic code continues to display the same second dynamic code from 10 minutes before the scheduled end time to 10 minutes after the scheduled end time.

The service provider operates the application of the visitor mobile terminal 200 and taps the “End” button.
The visitor operates the dynamic code reader unit 210 of the visitor mobile terminal 200 to capture the second dynamic code displayed on the signage unit 410 of the user terminal 400 with the user's consent. And read (step S9 in FIGS. 5 and 9).

The application of the visitor portable terminal 200 activates the GPS unit 220 to obtain the second GPS data composed of the latitude and longitude data of the current location (FIG. 6, FIG. 9 step S10), and via the dynamic code reader unit 210. The captured second dynamic code, the second GPS data obtained via the GPS unit 220, and the terminal ID information of the visitor portable terminal 200 are transmitted to the center system 100 (FIG. 6, step S11 in FIG. 9). ).
Although the second dynamic code, the second GPS data, and the terminal ID information of the visitor portable terminal 200 are transmitted here, other information, for example, the visitor ID information is also input. An example of transmitting will be described in the third embodiment.

In the center system 100, the second dynamic code, the second GPS data, and the terminal ID information of the visitor portable terminal 200 are received by the analysis unit 140 and an analysis process is performed (FIG. 6, step S12 in FIG. 10). ).

The analysis unit 140 is managed by the schedule management unit 130 based on the first dynamic code, the first GPS data, the second dynamic code, and the second GPS data transmitted from the visitor mobile terminal 200. The combination of the scheduled visit time and the first dynamic code and the scheduled end time and the second dynamic code, which are further managed, and the terminal ID information of the visitor portable terminal 200 managed by the service provider information database 110, Furthermore, by collating the GPS data of the user's house managed in the user information database 120 and confirming that all the data match and no abnormality is recognized (FIG. 6, step S13: Yes). ), it guarantees that the visitor stayed at the user's home at both the visit time and the end time (step S14 in FIGS. 6 and 10).

If any of the data fails to match and an abnormality is recognized (FIG. 6, FIG. 10, step S13: No), the visitor stayed at the user's house as scheduled at either the visit time or the end time. If this cannot be guaranteed, an alarm is raised (FIG. 6, step S22 in FIG. 10).

Although not described here in detail, if it cannot be guaranteed that the visitor stayed at the user's home as scheduled, it is determined that there is a risk of fraudulent billing, and processing is performed according to the determined operation.
Here, the description will be continued assuming that the analysis unit 140 guarantees that the visitor stayed at the user's home at both the visit time and the end time.

The service provider operates the application of the visitor portable terminal 200 and taps the button of "the operated service menu".
The service provider inputs the service content provided to the user at the user's house via the input unit 230 of the visitor mobile terminal 200 (FIG. 7, step S15 in FIG. 10). There may be various input methods, but here, a scheduled service menu is displayed on the display unit 240, and by tapping a service that can be provided as scheduled in the menu, the service content that can be provided can be displayed. input.
The data indicating the service content input from the visitor through the input unit 230 is transmitted to the center system 100 (FIG. 7, step S16 in FIG. 10) and passed to the receipt data creation unit 150 of the center system 100.

The receipt data creation unit 150 of the center system 100 receives the data of the service content that was applied on the day transmitted from the visitor, accesses the insurance information database 160, and creates the receipt data while confirming the insurance points (FIG. 7, 10 step S17), the receipt data is transmitted to the receipt examination system 500 (FIG. 7, step S18 in FIG. 10). It goes without saying that it is possible to change the receipt data to be transmitted on a daily basis, weekly basis, or monthly basis, depending on the operation.

After that, the receipt is examined by the receipt examination system 500 (FIG. 8, step S19 in FIG. 8), and if the examination is passed, the receipt data is sent to each insurer (FIG. 8, step S20), and the medical fee is charged. Is done.
The medical fee or long-term care fee is paid to the service provider system 300 managed by the service provider (step S21 in FIG. 8 and FIG. 10).

The above is the outline of the flow of the visit confirmation process to the user's house, the visit end process after the service provision, and the receipt process, which are executed in the payment request processing system.

What is important here is that both the acquisition of GPS data by the GPS function and the reading of the dynamic code displayed on the signage unit 410 of the user terminal 400 in the user's house are performed simultaneously. If you use a terminal with GPS function to trace the latitude and longitude information acquired by GPS, you can see the rough movement status of the practitioner, but it is said that the current GPS has an error and its accuracy is tens to hundreds of meters. It is being appreciated. On the other hand, there are many cases where apartment houses and high-rise condominiums are increasing, and it is often the case that the service providers go around to the user's home. Therefore, the visit to the user's house cannot be surely proved only by the latitude and longitude information by GPS. On the other hand, even if the service provider takes out the user terminal 400 from the user's house by reading the dynamic code displayed on the signage unit 410 of the user's house 400 in the user's house, it is necessary to bring the user's house to the user's house. Even if the user does not visit, a fictitious visit service will be possible if he/she reads the dynamic code displayed on the signage unit 410 of the user terminal 400 at another place, for example, his/her office.

However, the present invention realizes a reliable proof of visit by combining GPS information and dynamic code reading simultaneously. When a visitor attempts to make an illegal bill, the reader unit 210 reads the dynamic code displayed on the signage unit 410 of the user terminal 400 taken out of the user's home while traveling around the user's home by car or the like. You have to take the step of sending. There is almost no merit in making illegal charges even after taking such a procedure, and the visit to the user's home can be proved.

In addition, it is important to note that the first dynamic code and the second dynamic code are different data, so that the user can be guaranteed to stay at the scheduled time. Even if the first dynamic code is obtained after properly visiting at the scheduled visit time, the second dynamic code transmitted at the scheduled end time is different from the first dynamic code. It cannot be reused and must always stay at the user's home at the scheduled end time. Even if the same first dynamic code is transmitted in the end confirmation process, the first dynamic code and the second dynamic code do not match, so it is found that the user has left the home. I will end up.
As described above, in this system, based on the first dynamic code, the first GPS data, the second dynamic code, and the second GPS data, at any of the scheduled visit time and the scheduled end time, It can be guaranteed that the service provider stayed at the user's house.

As a payment request office processing system according to the second embodiment of the present invention, a configuration example in which a time is accurately specified will be shown.
The basic configuration is the same as that of the first embodiment, but regarding the dynamic code used in the start confirmation means and the end confirmation means, the display time is divided into a plurality of time zones, and a different code is transmitted for each divided time zone. It has been given.

In the above-described first embodiment, the dynamic code transmitted from the schedule management unit 130 in the start confirming unit and the end confirming unit is the same for a certain period of time. For example, the start confirmation means starts displaying 10 minutes before the scheduled visit time, and displays the same first dynamic code for 10 minutes after the scheduled visit time, that is, for 20 minutes between the scheduled visit times. However, in the second embodiment, the time is divided into a plurality of time zones and a different code is transmitted for each of the divided time zones. For example, it is devised to divide 20 minutes into 1 minute intervals and switch to a different dynamic code for each minute for display. The same measure is applied to the end confirmation means.

The list displayed on the front side of FIG. 11 is a diagram showing a simple list of the first dynamic codes transmitted by each time slot, which are managed by the schedule management unit 130.
In the list displayed on the front side of FIG. 11, 20 dynamic codes are shown. The first dynamic code transmitted at 9:50 is "dynamic code A1", the first dynamic code transmitted at 9:51 is "dynamic code A2", transmitted at 9:52 The first dynamic code to be transmitted is “dynamic code A3”,..., The first dynamic code transmitted at 10:00 is “dynamic code A11”,. The first dynamic code transmitted to the device is “dynamic code A20”, and 20 dynamic codes having different patterns are transmitted as the first code every minute.

In this way, by devising to transmit different dynamic codes by dividing into time zones, the first dynamic code read by the dynamic code reader unit 210 of the visitor portable terminal 200 is in any time zone. It is possible to identify which time zone the dynamic code is by analyzing the dynamic code. In other words, if the first dynamic code captured by the visitor portable terminal 200 and transmitted to the center system 100 is collated with the data shown in FIG. 11 managed by the schedule management unit 130 in the analysis unit 140 and analyzed. , It is possible to specify in which time zone the first dynamic code is transmitted. In this example, the dynamic code is changed every 1 minute, so if the first dynamic code transmitted from the visitor mobile terminal 200 is analyzed, the visitor will see the user terminal The time when 400 is accessed can be accurately specified.

For example, when the dynamic code information returned from the visitor portable terminal 200 is code information corresponding to the first dynamic code A8 transmitted from 9:57 to 9:58, the center system 100 The analysis unit 140 can confirm that the actual visit time is 9:58.
Similarly, for the end time, similarly, the time to be displayed for the second dynamic code is divided for each time zone and a different dynamic code is transmitted as the second dynamic code.

The list on the rear side of FIG. 11 is a diagram simply showing a list of the second dynamic codes transmitted from the schedule management unit 130 for each of the divided time zones.
20 minutes from 10 minutes before 11:00 to 10 minutes after the scheduled end time is divided every minute and is switched to a different dynamic code every minute for transmission. That is, the second dynamic code transmitted at 10:50 is “dynamic code B1”, the second dynamic code transmitted at 10:51 is “dynamic code B2”,... The second dynamic code transmitted at 11:00 is “dynamic code B11”,..., The second dynamic code transmitted at 11:09 is “dynamic code B20”. In this example, 20 dynamic codes having different patterns are transmitted as the second code every minute.

If the analysis unit 140 matches and analyzes the data managed by the schedule management unit 130 shown in FIG. 11, it is possible to identify in which time zone the second dynamic code is transmitted. For example, when the dynamic code information returned from the visitor portable terminal 200 is code information corresponding to the second dynamic code B17 transmitted from 11:06 to 11:07, the center system 100 The analysis unit 140 can confirm that the actual end time is 11:06.

As described above, in the payment request processing system according to the second embodiment, the visit confirming unit and the end confirming unit guarantee what time the visitor actually visited and the end time when the service was actually finished. can do.

What is important here is that the clock function of the user terminal 400, the clock function of the visitor portable terminal 200, and the like are not used in specifying the time. Generally, the digital clock function has a time adjustment function, and a visitor who tries to make a mistake may tamper with the time of the clock function. However, in the second embodiment, the clock of the user terminal 400 is held. The time is grasped by changing the patterns of the first dynamic code and the second dynamic code transmitted from the center system side without changing the function and the clock function of the visitor portable terminal 200. To do.

Furthermore, it is important that the first dynamic code and the second dynamic code themselves are not encoded with time information. When the first dynamic code and the second dynamic code themselves are encoded with time information, when decoded, if the IT technology is good, the digit of the code information is the time information. There is a possibility that some people will analyze it when pointing to, but in the example of the second embodiment, since the first dynamic code and the second dynamic code themselves do not include time information, Even if a person who is good at IT technology decodes and tries to falsify the time information part of the code information, the time information itself is not included, and therefore the falsification cannot be performed. It is also impossible to predict and create the dynamic code yourself, because different patterns are sent every minute every time.

In the third embodiment, in addition to the configurations described in the first and second embodiments, in order to strengthen the confirmation process that the visitor is the qualified person himself/herself as scheduled, the ID information is acquired and the ID information is acquired. It is a combination of the start confirmation process and the end confirmation process.

FIG. 12 is a block diagram of a medical treatment fee billing office work proxy system according to the third embodiment of the present invention. The parts that are not particularly described may be the same as those described in the first embodiment.
As shown in FIG. 12, the visitor mobile terminal 200a is different from the visitor mobile terminal 200 of the first embodiment in that an ID information acquisition unit 260a is added. The other components are the same as the components of the visitor portable terminal 200 according to the first embodiment, and thus the description thereof is omitted here.
The ID information acquisition unit 260a is a device equipped with a function of reading specified ID information.
For example, there is an example in which ID information is stored in an IC card for personal authentication that is issued to each qualified person and carried, and the ID information of the IC card is read. In this case, the ID information acquisition unit of the visitor portable terminal 200a serves as an IC card reader that communicates with the IC card and reads the ID information.

FIG. 13 is a diagram showing a configuration example of reading the ID information of the IC card as the ID information.
In the first embodiment, if the application of the visitor portable terminal 200a is operated as the confirmation start means and the “start” button is tapped to activate the start confirmation means, the first dynamic code of the first dynamic code shown in FIG. From reading (FIG. 3, step S3 in FIG. 9), acquisition of GPS data of the GPS unit 220a shown in FIG. 4, transmission of the first dynamic code, GPS data, and terminal ID information to the center system 100a (FIG. 4, FIG. Although a series of processing of 9 steps S4 and S5) is performed, in this example, FIG. 4 is the flow of FIG. That is, the application of the visitor mobile terminal 200a activates the GPS unit 220a to acquire the first GPS data composed of the latitude and longitude data of the current location (FIG. 13, S4-1), and the display unit 240a of the visitor mobile terminal 200a. A guidance "read IC card" is issued to the user, and the IC card carried by the visitor is held over the ID information acquisition unit 260a to input the ID information in the IC card as shown in FIG. 13 (S4- in FIG. 13). 2). Here, it is assumed that the ID information input by the start confirmation means is "first ID information". Then, in the transmission process to the center system 100a (FIG. 13, S5-1), in addition to the first dynamic code, the first GPS data, and the terminal ID information, the first information acquired by the ID information acquisition unit 260a. The ID information is also transmitted to the center system 100a.
The analysis unit 140a receives the first ID information in addition to the first dynamic code, the GPS data, and the terminal ID information (FIG. 13, S6-1).

Similarly, in the first embodiment, as the end confirmation means, if the application of the visitor portable terminal 200a is operated and the "end" button is tapped to activate the end confirmation means, the second operation shown in FIG. From the reading of the dynamic code (FIG. 5, step S9 in FIG. 9), the GPS data of the GPS unit 220a shown in FIG. 6 is acquired, and the second dynamic code, the GPS data, and the terminal ID information are transmitted to the center system 100a (FIG. 6, FIG. 9 steps S10 and S11) are performed, but in the third embodiment, FIG. 6 is the flow of FIG. That is, the application of the visitor mobile terminal 200a activates the GPS unit 220a to acquire the second GPS data including the latitude and longitude data of the current location (FIG. 14, S10-1), and the display unit 240a of the visitor mobile terminal 200a. A guidance "read IC card" is issued to the user, and as shown in FIG. 14, hold the IC card carried by the visitor over the ID information acquisition unit 260a to input the ID information in the IC card (S10- in FIG. 14). 2). Here, the ID information input by the end confirmation means is "second ID information". Then, in the transmission process to the center system 100a (FIG. 14, S11-1), in addition to the second dynamic code, the second GPS data, and the terminal ID information, the second dynamic code acquired by the ID information acquisition unit 260a. The ID information is also transmitted to the center system 100a.
The analysis unit 140a receives the first ID information in addition to the first dynamic code, the GPS data, and the terminal ID information, and performs the analysis process (FIG. 14, S12-1).

The analysis unit 140a uses a combination of the scheduled visit time and the first dynamic code and the scheduled end time and the second dynamic code managed by the schedule management unit 130a, and the users managed by the user information database 120a. All the data is matched by matching the home GPS data, the terminal ID information of the visitor portable terminal 200 managed by the service provider information database 110a, the first ID information, the second ID information, and the like, By confirming that no abnormality is recognized, it is guaranteed that the visitor stayed at the user's home at both the visit time and the end time (S12-1 in FIG. 14: Yes).
If any data fails to match and an abnormality is recognized, an alarm is raised if it cannot be guaranteed that the visitor stayed at the user's home as scheduled at either the visit time or the end time (Fig. 14). S12-1: No).

Next, an example of using the biometrics information of the visitor as the ID information will be described.
The ID information acquisition unit 260b is a device equipped with a function of reading specified ID information. In this example, as biometrics information, for example, vein authentication for reading a vein pattern of a palm or finger, finger authentication There are fingerprint authentication that reads a fingerprint, iris authentication that reads an iris pattern, and voiceprint authentication that recognizes a voiceprint pattern of a voice. In this case, the ID information acquisition unit 260b of the visitor portable terminal 200 is a device having a biometrics reading capability. Although the visitor portable terminal 200b is assumed to be a smartphone, if the device having biometrics reading capability is not included in the basic equipment of the smartphone, an external device connectable by USB may be used. There are a fingerprint authentication device, a scan-type vein authentication device for reading a finger vein, and a scan-type iris authentication device for reading an iris of an eye.

FIG. 15 is a diagram showing a configuration example of reading biometrics information of a visitor.
FIG. 16 is a diagram simply showing the concept of inputting biometrics information of a visitor.
As shown in FIG. 15, the biometrics information of the visitor is stored in the service provider information database 110b.

The flow shown in FIG. 4 is the flow shown in FIG. That is, the application of the visitor mobile terminal 200b activates the GPS unit 220b to acquire the first GPS data including the latitude and longitude data of the current location (FIG. 15, S4-1), and the display unit 240b of the visitor mobile terminal 200b. The guidance "Read biometrics" is issued to, for example, the guidance "Please scan your fingerprint" is issued, and as shown in Fig. 16, put your finger on the fingerprint authentication device to scan the fingerprint and scan the fingerprint data. Is input (FIG. 15, S4-2). Here, the biometrics information input by the start confirmation means is "first ID information". Then, in the transmission process to the center system 100b (S5-1 in FIG. 15), in addition to the first dynamic code, the first GPS data, and the terminal ID information, the first information acquired by the ID information acquisition unit 260b. The biometrics information, which is ID information, is also transmitted to the center system 100b.

The analysis unit 140b also receives the first ID information in addition to the first dynamic code, the GPS data, and the terminal ID information (FIG. 15, S6-1).
Similarly, as the end confirmation means, in this example, FIG. 6 shown in the first embodiment becomes the flow of FIG. That is, the application of the visitor mobile terminal 200b activates the GPS unit 220b to obtain the second GPS data including the latitude and longitude data of the current location (FIG. 17, S10-1), and the display unit 240b of the visitor mobile terminal 200b. Display the guidance "Read biometrics information" in, for example, "Enter the vein pattern of the finger. ], the biometrics information of the vein of the visitor is input via the ID information acquisition unit 260b which is a vein authentication device (FIG. 17, S10-2). Here, the ID information input by the end confirmation means is "second ID information". Then, in the transmission process to the center system 100 (FIG. 17, S11-1), in addition to the second dynamic code, the second GPS data, and the terminal ID information, the vein of the finger acquired by the ID information acquisition unit 260a. The second ID information, which is the biometrics information of the pattern, is also transmitted to the center system 100b.

The analysis unit 140b receives the first ID information in addition to the first dynamic code, the GPS data, and the terminal ID information, and performs the analysis processing (FIG. 17, S12-1).
The analysis unit 140b uses the combination of the scheduled visit time and the first dynamic code and the scheduled end time and the second dynamic code managed by the schedule management unit 130b, and the users managed by the user information database 120b. Home GPS data, the terminal ID information of the visitor portable terminal 200b managed by the service provider information database 110b, the fingerprint biometrics information that is the first ID information, and the finger ID that is the second ID information. By checking the biometrics information of the vein pattern, etc., and confirming that all the data match and there is no abnormality, it can be confirmed that the visitor stayed at the user's home at both the visit time and the end time. It is guaranteed (FIG. 17, S12-1: Yes).
If any data fails to match and an abnormality is recognized, an alarm is raised if it cannot be guaranteed that the visitor stayed at the user's home as scheduled at either the visit time or the end time (Fig. 17). S12-1: No).

According to the payment request processing system according to the third embodiment of the present invention, the identity of the visitor can be authenticated with the ID information added.

Although the preferred embodiment of the configuration example of the medical service fee billing agency system of the present invention has been illustrated and described above, it is understood that various modifications can be made without departing from the technical scope of the present invention. Will.

The payment request processing system of the present invention pays medical fees for visiting medical care, medical fees for visiting nursing, medical fees for visiting dentistry, medical fees for visiting medical treatment, nursing fees for visiting care, or nursing fees for visiting rehabilitation. It can be applied to a billing system.

100 center system 110 service provider information database 120 user information database 130 schedule management unit 140 analysis unit 150 receipt data creation unit 160 insurance information database 160
170 communication unit 200 visitor mobile terminal 210 dynamic code reader unit 220 GPS unit 230 input unit 240 display unit 250 communication unit 300 service provider system 400 user terminal 500 receipt examination system 600 insurer system

Claims (8)

Payment request processing system for processing bills for visiting medical fees, visiting nursing fees, visiting dental fees, visiting medical fees, visiting care fees, or visiting rehabilitation fees. And
Center system,
A visitor mobile terminal held by a doctor, a nurse, a dentist, a dental hygienist, an anma massage shiatsu, a judo reduction, an acupuncturist, a care worker, a care helper, a physical therapist or an occupational therapist,
A user terminal installed in the user's home in advance,
The center system dynamically transmits the first dynamic code to the user terminal only for a fixed time from the scheduled visit time and causes the user terminal to display the first dynamic code. Start confirmation means for causing the center code to be read and transmitted to the center system,
The center system dynamically transmits the second dynamic code to the user terminal only for a fixed time from the scheduled end time to display the second dynamic code on the user terminal, and the visitor portable terminal causes the second dynamic code to be displayed. An end confirmation means for reading the physical code and transmitting it to the center system,
The first dynamic code and the second dynamic code are different, and in the center system, the visitor is scheduled based on the first dynamic code and the second dynamic code. A payment request processing system with an improved fraudulent claim prevention function, which guarantees that the user stayed at the user's house. In the start confirmation means, the fixed time is divided into a plurality of time zones, and a different code is transmitted as the first dynamic code for each of the divided time zones,
In the end confirmation means, the fixed time is divided into a plurality of time zones, and a different code is transmitted as the second dynamic code for each of the divided time zones,
In the center system, the visit time is identified by analyzing the received first dynamic code, and the end time is determined by analyzing the second dynamic code. The billing clerical work processing system with improved fraudulent bill prevention function according to claim 1, characterized in that it is possible to specify which time period of the fixed time is. The visitor mobile terminal has a GPS information acquisition function,
The start confirmation means is a means for transmitting the first dynamic code and the first GPS data obtained by the GPS information acquisition function from the visitor portable terminal to the center system,
The end confirmation means is means for transmitting the second dynamic code and the second GPS data obtained by the GPS information acquisition function from the visitor portable terminal to the center system,
In the center system, based on the first dynamic code, the first GPS data, the second dynamic code, and the second GPS data, at any of the visit time and the end time. The payment request processing system with improved fraud prevention function according to claim 2 , wherein the visitor is guaranteed to stay at the user's house. The visitor mobile terminal has an ID information acquisition function,
The start confirmation means, from the visitor portable terminal, the first dynamic code, the first GPS data obtained by the GPS information acquisition function, and the first ID information obtained by the ID information acquisition function. Is a means for transmitting to the center system,
The end confirmation means, from the visitor mobile terminal, the second dynamic code, the second GPS data obtained by the GPS information acquisition function, and the second ID information obtained by the ID information acquisition function. Is a means for transmitting to the center system,
The center system also includes the first dynamic code, the first GPS data, the first ID information, the second dynamic code, the second GPS data, and the second ID information. The payment request processing system with improved fraudulent claim prevention function according to claim 3, which guarantees that the visitor himself/herself stayed at the user's house at both the visit time and the end time. The ID information is card ID information stored in an IC card carried by the visitor,
The payment claim processing system with improved fraudulent claim prevention function according to claim 4, wherein the ID information acquisition function is an IC card reader function for reading the card ID information stored in the IC card. The ID information is biometrics information of the visitor,
The payment request processing system with improved fraud prevention function according to claim 4, wherein the ID information acquisition function is a biometrics reader function for reading the biometrics information of the visitor. Billing office processing system having an improved unauthorized charges prevention function according to any one of claims 1 to 6, wherein the first dynamic code and the second dynamic code is a two-dimensional dot code .. Payment request processing method for processing payment requests for visiting medical care fees, visiting nursing care fees, visiting dental care fees, visiting medical treatment fees, visiting care nursing fees, or visiting rehabilitation nursing fees And
Using the center system,
Doctors, nurses, dentists, dental hygienists, Anma massage shiatsu, Judo reduction, acupuncturists, care workers, care helpers, physical therapists or occupational therapists hold visitor mobile devices,
Install the user terminal in advance in the user's house,
The center system dynamically transmits the first dynamic code to the user terminal only for a fixed time from the scheduled visit time and causes the user terminal to display the first dynamic code. Confirmation to send the automatic code and send it to the center system,
The center system dynamically transmits the second dynamic code to the user terminal only for a fixed time from the scheduled end time to display the second dynamic code on the user terminal, and the visitor portable terminal causes the second dynamic code to be displayed. Confirm the completion of sending the physical code and sending it to the center system,
The first dynamic code and the second dynamic code are different data, and in the center system, the visitor is scheduled based on the first dynamic code and the second dynamic code. In addition, a payment request processing method with improved fraudulent claim prevention function that guarantees that the user stays at the user's house.