KR20210135830A - System for providing intergrated payment service of medical institutions - Google Patents

Abstract

The present invention relates to a system for providing an integrated payment service of medical institutions. The objective of the present invention is to perform various payment processing regardless of the type of a payment method of a medical service user and automatically request an insurance company for the amount of insurance payment that can be provided to the medical service users as a proxy to increase convenience of insurance claims as well as payment for medical expenses. As one example, the system comprises: a payment service processing unit using a payment means of a medical service user to process at least one payment service of card payment, mobile simple payment, simple account payment, cash payment, and loan payment; and an insurance claim service processing unit generating insurance claim data on the basis of the medical service user's personal information, insurance company information, and medical record information and transmitting the generated insurance claim data to an insurance company to request payment processing for medical service expenses.

Description

System for providing integrated payment service for medical institutions

An embodiment of the present invention relates to a system for providing an integrated payment service of a medical institution.

As the quality of life has improved, the national health insurance system is being implemented as part of the social security system. In the conventional national medical insurance system, when a customer who subscribes to the national health insurance has a medical insurance card and visits a hospital or clinic to receive medical services, the National Medical Insurance Corporation pays a portion of the medical service cost, and the rest is The point is that the customer pays.

However, the number of diseases covered by the national medical insurance is limited, and diseases such as cancer, which have high medical service costs, are excluded from the national medical insurance.

Accordingly, the majority of citizens subscribe to at least one private medical insurance in addition to the national medical insurance to receive insurance services for diseases that are not covered by the national medical insurance, or to receive better health insurance for diseases included in the national medical insurance. I would like to receive insurance services.

However, unlike the national medical insurance system, which requires only having a medical insurance card, private medical insurance has multiple insurance companies and the service method is not standardized. contains problems.

Registered Patent Publication No. 10-1741960 (Registration Date: May 24, 2017) Laid-Open Patent Publication No. 10-2018-0122506 (published date: November 13, 2018)

According to an embodiment of the present invention, various payment processing is possible irrespective of the type of payment method possessed by the medical service user, and by automatically billing the insurance company for the insurance payment that the medical service user can receive on behalf of the medical service user and processing the medical expenses payment, , provides an integrated payment service provision system for medical institutions that can further improve the convenience of insurance claims as well as payment for medical expenses.

The system for providing an integrated payment service of a medical institution according to an embodiment of the present invention uses a payment means of a medical service user to process at least one payment service of card payment, mobile simple payment, simple account payment, cash payment, and loan payment payment service processing unit; and an insurance claim service processing unit that generates insurance claim data based on the medical service user's personal information, insurance company information, and medical record information, and sends the generated insurance claim data to the insurance company to request payment processing for medical service fees do.

In addition, the payment service processing unit acquires the card payment method information of the medical service user through the card payment terminal, receives the payment amount information, and provides interest-free and interest-free payments based on the obtained card payment method information and the input payment amount information. a card payment service processing unit for selectively processing interest payments; and a non-face-to-face payment service processing unit that receives the card payment method information and payment amount information of the medical service user, respectively, and processes non-face-to-face remote payment based on the input card payment method information and payment amount information.

In addition, the payment service processing unit transmits a message including medical service payment information to the mobile simple payment platform of the medical service user so that payment is processed through the mobile simple payment platform, or an identification code including medical service payment information a first mobile simple payment service processing unit for providing the mobile simple payment platform to be recognized through the mobile terminal of the medical service user, and for processing the payment on the mobile simple payment platform based on the recognized medical service payment information; and a second mobile simple payment service processing unit that generates an identification code including medical service payment information, and provides the generated identification code for the medical service user's mobile simple payment platform to recognize so that the payment is processed on the mobile simple payment platform may include.

In addition, the payment service processing unit may include a simple account payment service processing unit for transmitting medical service payment information to the medical service user's mobile terminal in the form of a message and receiving payment processing from the medical service user's previously registered account. .

In addition, the payment service processing unit processes the cash payment including the taxable amount and the tax-free amount for the medical service payment amount, and selects the issuance method of at least one cash receipt among income deduction, expense proof, voluntary issuance and receipt. It may include a cash settlement service processing unit that is issued.

In addition, the payment service processing unit receives the loan amount, personal information, and interest rate and limit inquiry processing method selection information of the medical service user, applies for a loan from an affiliated card financial company, and processes the payment with the applied loan It may include a service processing unit.

In addition, the insurance claim service processing unit, receiving the personal information and initial treatment information of the medical service user, the medical treatment history inquiry unit for inquiring the medical treatment details of the user; An insurance claim data generating unit that provides checkboxes for each item of the treatment details provided through the treatment history inquiry unit to correct and refine the treatment details, and selectively creates additional items for the treatment details to generate insurance claim data ; and an insurance claim data transmission unit that receives the insurance company information of the medical service user and transmits the insurance claim data generated through the insurance claim data generation unit to the selected insurance company.

In addition, payment transaction information for medical service users by card payment, mobile simple payment, simple account payment, cash payment, and loan payment of a medical institution through the payment service processing unit and the insurance claim service processing unit are collected, and the collected payment transaction information Calculates sales information based on It may further include a transaction sales information management unit to provide.

According to the present invention, various payment processing is possible regardless of the type of payment method possessed by the medical service user, and by automatically claiming the insurance payment amount that the medical service user can receive from the insurance company on behalf of the medical service user and processing the medical expenses payment, medical expenses In addition to payment, it is possible to provide an integrated payment service providing system for medical institutions that can further improve convenience for insurance claims.

1 is a schematic diagram illustrating a relationship between the overall configurations of a system for providing an integrated payment service of a medical institution according to an embodiment of the present invention.
2 is a block diagram showing the overall configuration of a system for providing an integrated payment service of a medical institution according to an embodiment of the present invention.
3 is a block diagram illustrating a detailed configuration of a payment service processing unit according to an embodiment of the present invention.
4 is a block diagram illustrating a detailed configuration of an insurance claim service processing unit according to an embodiment of the present invention.
5 to 7 are diagrams showing captured execution screens of the card payment service processing unit according to an embodiment of the present invention.
8 is a diagram illustrating a screen capture of an execution screen of a non-face-to-face payment service processing unit according to an embodiment of the present invention.
9 is a view showing a screen capture of the execution of the first mobile simple payment service processing unit according to an embodiment of the present invention.
10 is a view showing a captured execution screen of the second mobile simple payment service processing unit according to an embodiment of the present invention.
11 is a diagram illustrating a screen capture of an execution screen of a simple account payment service processing unit according to an embodiment of the present invention.
12 is a diagram illustrating a screen capture of an execution screen of a cash payment service processing unit according to an embodiment of the present invention.
13 is a view showing the captured execution screen of the loan payment service processing unit according to an embodiment of the present invention.
14 to 16 are diagrams illustrating additional explanations on the execution screen capture of the treatment history inquiry unit according to an embodiment of the present invention.
17 to 19 are views showing additional explanations on the execution screen capture of the insurance claim data generating unit according to an embodiment of the present invention.
20 is a view showing an additional explanation on an execution screen capture of the insurance claim data transmission unit according to an embodiment of the present invention.
21 to 25 are views showing captured execution screens of the transaction sales information management unit according to an embodiment of the present invention.

Terms used in this specification will be briefly described, and the present invention will be described in detail.

The terms used in the present invention have been selected as currently widely used general terms as possible while considering the functions in the present invention, but these may vary depending on the intention or precedent of a person skilled in the art, the emergence of new technology, and the like. In addition, in a specific case, there is a term arbitrarily selected by the applicant, and in this case, the meaning will be described in detail in the description of the corresponding invention. Therefore, the term used in the present invention should be defined based on the meaning of the term and the overall content of the present invention, rather than the name of a simple term.

When a part "includes" a certain element throughout the specification, this means that other elements may be further included, rather than excluding other elements, unless otherwise stated. In addition, terms such as "...unit" and "module" described in the specification mean a unit that processes at least one function or operation, which may be implemented as hardware or software, or a combination of hardware and software. .

Hereinafter, with reference to the accompanying drawings, embodiments of the present invention will be described in detail so that those of ordinary skill in the art can easily carry out the embodiments of the present invention. However, the present invention may be embodied in several different forms and is not limited to the embodiments described herein. And in order to clearly explain the present invention in the drawings, parts irrelevant to the description are omitted, and similar reference numerals are attached to similar parts throughout the specification.

1 is a schematic diagram showing the relationship between the overall configuration of the integrated payment service providing system of a medical institution according to an embodiment of the present invention, and FIG. 2 is a block showing the overall configuration of the integrated payment service providing system of a medical institution according to an embodiment of the present invention 3 is a block diagram showing a detailed configuration of a payment service processing unit according to an embodiment of the present invention, FIG. 4 is a block diagram showing a detailed configuration of an insurance claim service processing unit according to an embodiment of the present invention, and FIG. 5 7 to 7 are diagrams showing the captured execution screen of the card payment service processing unit according to an embodiment of the present invention, and Figure 8 is a view showing the captured execution screen of the non-face-to-face payment service processing unit according to the embodiment of the present invention, Figure 9 is a view showing the capture of the execution screen of the first mobile simple payment service processing unit according to an embodiment of the present invention, Figure 10 is a view by capturing the execution screen of the second mobile simple payment service processing unit according to the embodiment of the present invention 11 is a view showing a captured execution screen of the simple account payment service processing unit according to an embodiment of the present invention, and FIG. 13 is a view showing the captured execution screen of the loan payment service processing unit according to an embodiment of the present invention, and FIGS. 14 to 16 are added on the execution screen capture of the medical treatment history inquiry unit according to the embodiment of the present invention 17 to 19 are views showing additional explanations on the execution screen capture of the insurance claim data generation unit according to an embodiment of the present invention, and FIG. It is a view showing additional explanation on the execution screen capture of the insurance claim data transmission unit, and FIGS. 21 to 25 are diagrams showing the captured execution screen of the transaction sales information management unit according to an embodiment of the present invention.

In order to use the integrated payment service providing system 1000 of a medical institution according to an embodiment of the present invention, first, a medical institution must have a platform for using the service installed and connected to a management server, and the management server is a card financial institution server (30), the mobile simple payment platform server 40, the bank server 50, and the insurance company server 60 must be connected, and the scanner 12 necessary for medical service users to use the mobile simple payment platform is provided. desirable.

On the other hand, it is preferable that the user of the medical service has a mobile simple payment platform (application) installed according to the mobile terminal connected to the network and the payment method.

1 to 4 , the integrated payment service providing system 1000 of a medical institution according to an embodiment of the present invention includes a payment service processing unit 100 , an insurance claim service processing unit 200 , and a transaction sales information management unit 300 . include

The payment service processing unit 100 uses various payment methods such as credit card, cash IC card, UnionPay card, mobile simple payment platform, and account of the medical service user to make card payment, mobile simple payment, simple account payment, cash payment and At least one payment service among loan payments may be processed.

To this end, the payment service processing unit 100 includes a card payment service processing unit 110 , a non-face-to-face payment service processing unit 120 , a first mobile simple payment service processing unit 130 , and a second mobile simple payment service as shown in FIG. 3 . It may include a processing unit 140 , a simple account settlement service processing unit 150 , a cash payment service processing unit 160 , and a loan settlement service processing unit 170 .

The card payment service processing unit 110 obtains the card payment method information of the medical service user through the card payment terminal 11, receives the medical service use payment amount information, and receives the obtained card payment method information and the entered payment Based on the amount information, interest-free and interest-free payment can be selectively processed.

For example, as shown in FIG. 5 , if the card payment method of the medical service user is a UnionPay card, the card information is read using the card payment terminal 11, and then the amount of the taxable portion and the tax-free portion of the payment amount You can enter your information and select the installment period to proceed with the payment. In addition, as shown in FIG. 6 , even when the card payment method of the medical service user is a general credit card, after reading the card information using the card payment terminal 11, the taxable portion and the tax-free portion of the payment amount You can enter the amount information and select the installment period to proceed with the payment. When you select an installment period, you can check the interest-free information for each installment period of each card company, and select an installment payment according to the medical service user's choice.

In addition, as shown in FIG. 7 , if there is an event promotion benefit of each medical institution, discount benefit information is calculated and provided, and the calculated discount benefit can be applied to the installment payment, and at this time, in each installment month By providing comparative information on the monthly payment amount, it is possible to select the appropriate number of installment months.

The non-face-to-face payment service processing unit 120 may receive each input of card payment method information and payment amount information of a medical service user, and process non-face-to-face remote payment based on the input card payment method information and payment amount information. .

For example, as shown in FIG. 8, after entering the amount information for the taxation and duty-free parts, manually input information such as a card number and expiration date, and selecting a payment method such as a lump sum payment or installment payment, You can proceed with the payment.

The first mobile simple payment service processing unit 130 transmits a message including medical service payment information to the mobile simple payment platform of the medical service user so that payment is processed through the mobile simple payment platform or receives medical service payment information The identification code included may be provided so that the mobile simple payment platform can recognize it through the mobile terminal of the medical service user, and based on the recognized medical service payment information, the payment can be processed by the mobile simple payment platform.

For example, as shown in FIG. 9 , an alert message including payment information is transmitted to the mobile terminal of the corresponding medical service user, so that the payment is processed on a mobile simple payment platform such as 'Kakao Pay', and the corresponding payment is approved Or check the cancellation history or generate a QR code or barcode including payment information to scan through the mobile terminal of the medical service user, and allow the payment to be processed on the mobile simple payment platform that recognizes this to approve or You can check the cancellation history.

The second mobile simple payment service processing unit 140 generates an identification code including medical service payment information, and provides the generated identification code so that the mobile simple payment platform of the medical service user recognizes the mobile simple payment platform. Allow payment to be processed.

For example, as shown in FIG. 10, using a mobile simple payment platform such as 'Alipay' or 'WeChat Pay', payment is made through recognition of barcode and QR code containing payment information through linking with the corresponding application. can make it go away

The simple account payment service processing unit 150 may transmit medical service payment information to the mobile terminal of the medical service user in the form of a message, and receive payment processing from the medical service user's previously registered account.

For example, as shown in FIG. 11 , payment information in the form of a URL may be transmitted to the mobile phone number of the medical service user through SMS, and the medical service user may directly proceed with payment using the URL.

In addition, the payment menu can be configured with the hospital name (ex. St. Mary's PAY). In this case, the payment URL can be transmitted to the mobile phone of the medical service user to provide a simple payment service that allows payment to the user's account. In this case, after registering the payment account for the first time, if you register and input a PIN number (6 digits of password), payment can be made immediately. may provide.

The cash payment service processing unit 160 processes a cash payment including a taxable amount and a tax-free amount for the medical service payment amount, and the issuance method of at least one cash receipt among income deduction, expense proof, voluntary issuance and receipt You can choose to publish.

For example, as shown in Fig. 12, after inputting payment amount information including taxable amount and tax-free amount, select which one of income deduction, expense proof, voluntary issuance and receipt for the cash settlement method. You can proceed with payment.

The loan payment service processing unit 170 receives the loan amount, personal information, and interest rate and limit inquiry process selection information of the medical service user, applies for a loan from an affiliated card financial company, and processes the payment with the applied loan. can

For example, as shown in FIG. 13 , the loan amount, customer name (medical service user name), and mobile phone number are input, respectively, and the interest rate and limit inquiry is performed on the customer's mobile phone or PC. By selecting the method, you can check the limit/interest rate, and after borrowing an appropriate amount according to the provided limit and interest rate, you can process the loan payment by deducting the required payment amount from the loan amount.

The insurance claim service processing unit 200 generates insurance claim data based on the medical service user's personal information, insurance company information and medical record information, and transmits the generated insurance claim data to the insurance company to process payment for medical service usage fees In addition, the medical service user himself/herself may pay a prescribed fee and direct the insurance company to submit an insurance claim.

To this end, the insurance claim service processing unit 200 may include a medical treatment history inquiry unit 210 , an insurance claim data generation unit 220 , and an insurance claim data transmission unit 230 as shown in FIG. 4 . As shown in FIG. 14, prior to providing the claim service, if the mobile phone number of the medical service user (customer) who will receive the link for creating an insurance claim is entered and transmitted, the request for insurance claim processing, that is, the request for an insurance claim, is sent to the hospital or the hospital. It can be transmitted to the POS terminal of the legislator.

The medical treatment history inquiry unit 210 may receive the personal information and initial medical information of the medical service user and inquire about the medical service history of the user.

For example, if the inquiry button is pressed after setting the patient name (medical service user name) and inquiry period as shown in FIG. 15, as shown in FIG. 16, the request date, patient name, resident number, status, and transmission Detailed information such as work may be retrieved and displayed. After selecting a patient name to be input, as shown in FIG. 17 , information about the patient is switched to a state in which input is possible, and information on the patient name, the date of the first visit, and the cause of the invention may be displayed. For example, in the case of dental treatment, after checking the initial defect site, you can save (checked by the hospital staff, not selected if there is no), and add treatment details (select each item after pressing the Add button to select each item) Items (treatment classification, type, code, etc.) can be output After completing the input of treatment details, saving and selecting the send button, the details can be transmitted to the insurance company selected by the patient (customer). have.

The insurance claim data generation unit 220 provides a check box for each item of the treatment details provided through the treatment history inquiry unit 210 to correct and refine the treatment details, and select additional items for the treatment details can be created to generate insurance claim data.

For example, as shown in FIG. 18, treatment classification (scaling, periodontal disease, direct filling, indirect filling, pulp treatment, other, alveolar bone graft) information, treatment type (salary, periodontal repair, root planing, amalgam, resin) , Other, Grainomer, Gold/Apprentice, Inlay, Onlay, Guitar, Crown, Pulp (neurotherapy), Extraction, Implant, Bridge, Denture, Bone Grafting, Osteogenic Regeneration, Maxillary sinus lift, Osteotomy, Bone kidney Alcohol, etc.) and treatment classification codes (K05, K02, K04) can be displayed in detail. In addition, by selecting the treatment category and treatment type combo box, new treatment details can be added, and a treatment category code for the selected content can be automatically entered. At this time, as shown in Fig. 19, when the tooth number combo box is selected (duplicate selection is possible), the tooth number set is exposed, and when scaling is selected, the full jaw is automatically displayed, and when the specific combo box is selected, the selected tooth number is transmitted. can be

The insurance claim data transmission unit 230 may receive the selected insurance company information of the medical service user and transmit the insurance claim data generated through the insurance claim data generation unit 220 to the selected insurance company. As shown, in the case of general card payment, a fee for transmission of insurance claim data may be charged as card payment details, and an insurance claim may be directly submitted to the relevant insurance company at the request of a medical service user at a site such as a hospital or clinic. In this case, when transmitting the insurance claim to the insurance company, the G&Net module may be used, but this embodiment is not limited thereto.

The transaction sales information management unit 300 is, through the payment service processing unit 100 and the insurance claim service processing unit 200, for medical service users by card payment, mobile simple payment, simple account payment, cash payment and loan payment of a medical institution. Collect payment transaction information, calculate sales information based on the collected payment transaction information, and provide the calculated sales information according to at least one classification period of daily, weekly, and monthly units, weekly and monthly It may be provided after processing into statistical information according to at least one classification criterion.

For example, as shown in FIG. 21, if you input and set the distance date, transaction type, transaction classification, card company, card classification, payment type, approval number, and card/identification number, respectively, the total number of transactions that meet the conditions, Detailed information on the number of approvals, the number of cancellations, the total transaction amount, the approval amount, and the cancellation amount can be provided in the form of a table, and can be printed out for each number.

In addition, as shown in FIG. 22, comprehensive information on the total number of cases, the number of approvals, and the number of cancellations by date, transaction time, classification (cancellation/approval), card company, card classification, card/identification number, approval number, transaction Detailed information on amount, installment period, transaction type, payment type, cancellation processing, and receipt printing may be provided in the form of a table.

In addition, as shown in FIG. 23 , detailed information on monthly sales may be provided in the form of a table, or in the form of a calendar as shown in FIG. 24 . In this case, the amount may be calculated and provided for each payment method, such as card payment (interest-free installment installment, interest installment installment, manual payment), SMS payment, and cash payment.

In addition, if a certain period is set as shown in FIG. 25, the amount of sales increase or decrease compared to the previous week can be calculated and provided for the period compared to before and after, and a graph comparing the sales by week can be generated and provided have. In addition, it is possible to provide information on sales and the number of cases in the form of a table by calculating statistics on the transaction share for each day of the week.

According to this embodiment, various payment processing is possible regardless of the type of payment method possessed by the medical service user, and by automatically claiming the insurance payment amount that the medical service user can receive from the insurance company on behalf of the medical service user, In addition to paying for medical expenses, the convenience of claiming insurance can be further improved.

What has been described above is only one embodiment for implementing the system for providing an integrated payment service for a medical institution according to the present invention, and the present invention is not limited to the above embodiment, and as claimed in the claims below, the present invention Without departing from the gist of the present invention, it will be said that the technical spirit of the present invention exists to the extent that various modifications can be made by anyone with ordinary knowledge in the field to which the invention belongs.

1000: system for providing integrated payment service for medical institutions
100: payment service processing unit
110: card payment service processing unit
120: Non-face-to-face payment service processing unit
130: first mobile simple payment service processing unit
140: second mobile simple payment service processing unit
150: simple account payment service processing unit
160: cash payment service processing unit
200: claim service processing department
210: medical history inquiry unit
220: insurance claim data generation unit
230: insurance claim data transmission unit
300: transaction sales information management unit
1: Card
2: Mobile simple payment platform
3: Cash
11: Card payment terminal
12: Scanner
30: card financial company server
40: Mobile simple payment platform server
50: bank server
60: insurance company server

Claims (8)

a payment service processing unit for processing at least one payment service of card payment, mobile simple payment, simple account payment, cash payment, and loan payment using a payment method of a medical service user; and
Including an insurance claim service processing unit that generates insurance claim data based on the medical service user's personal information, insurance company information, and medical record information, and sends the generated insurance claim data to the insurance company to request payment processing for medical service fees An integrated payment service providing system for a medical institution, characterized in that.
According to claim 1,
The payment service processing unit,
A card that obtains card payment method information of a medical service user through a card payment terminal, receives payment amount information, and selectively processes interest-free and interest-free payment based on the obtained card payment method information and input payment amount information payment service processing unit; and
A medical institution comprising a non-face-to-face payment service processing unit that receives the card payment method information and payment amount information of the medical service user, respectively, and processes non-face-to-face remote payment based on the input card payment method information and payment amount information of integrated payment service provision system.
According to claim 1,
The payment service processing unit,
A message containing medical service payment information is sent to the medical service user's mobile simple payment platform and payment is processed through the mobile simple payment platform, or an identification code containing medical service payment information is sent to the mobile simple payment platform for medical service. a first mobile simple payment service processing unit that provides recognition through the user's mobile terminal and allows payment to be processed on the corresponding mobile simple payment platform based on the recognized medical service payment information; and
A second mobile simple payment service processing unit that generates an identification code including medical service payment information and provides the generated identification code so that the mobile simple payment platform of the medical service user can process the payment on the mobile simple payment platform An integrated payment service providing system of a medical institution, characterized in that it comprises.
According to claim 1,
The payment service processing unit,
An integrated payment service for a medical institution, comprising a simple account payment service processing unit for transmitting medical service payment information to the medical service user's mobile terminal in the form of a message and receiving payment processing from the medical service user's pre-registered account system.
According to claim 1,
The payment service processing unit,
Includes a cash settlement service processing unit that processes cash settlement including taxable amount and tax-free amount for medical service payment, and selects the issuance method of at least one of income deduction, expense proof, voluntary issuance, and receipt An integrated payment service providing system of a medical institution, characterized in that.
According to claim 1,
The payment service processing unit,
It includes a loan settlement service processing unit that receives the loan amount, personal information, and interest rate and limit inquiry process selection information of the medical service user, applies for a loan from an affiliated card financial company, and processes the payment with the applied loan amount A system for providing integrated payment services for medical institutions.
According to claim 1,
The insurance claim service processing unit,
a medical service history inquiry unit that receives the personal information and initial medical information of the medical service user and inquires the medical service history of the user;
An insurance claim data generating unit that provides checkboxes for each item of the treatment details provided through the treatment history inquiry unit to correct and refine the treatment details, and selectively creates additional items for the treatment details to generate insurance claim data ; and
and an insurance claim data transmission unit for receiving a selection of insurance company information of a medical service user and transmitting the insurance claim data generated through the insurance claim data generating unit to the selected insurance company.
According to claim 1,
Collect payment transaction information for medical service users by card payment, mobile simple payment, simple account payment, cash payment, and loan payment of a medical institution through the payment service processing unit and the insurance claim service processing unit, and based on the collected payment transaction information to calculate sales information, provide the calculated sales information according to at least one classification period among daily, weekly, and monthly units, and process and provide statistical information according to at least one classification criterion among weekly and monthly units The integrated payment service providing system of a medical institution, characterized in that it further comprises a transaction sales information management unit.

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