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医療機関による医薬品の処方に際しては、被保険者（患者）が保健医療機関で医師の診察を受け、その診断結果をもとに医師が処方箋を発行、同処方箋に基づき保険薬局にて医薬品が調剤、提供される、という流れになっている。保険が適用される医薬品の費用請求については、被保険者による一部費用負担を除くと、医療機関・保険薬局などが、レセプトと呼ばれる診療報酬明細書に、診療、検査、投薬、手術など医療行為の内容を記入し、月ごとに審査支払機関に提出、医療費を請求する。審査は、社会保険診療報酬支払基金と都道府県支部、国民健康保険中央会と各都道府県の国民健康保険団体連合会にて実施され、かかった医療費をそのまま医療保険から支払う「出来高払い制」を採用されている。
In primary phrases, the prescription is a little bit of paper which is penned in the registered health treatment practitioner (RMP) depending on the shopper's ailment dilemma.
請求項１に記載の医薬品処方情報照会・配信システムにおいて、医療機関が発行した処方箋に記されている医薬品の保険適用につき、保険薬局からの照会を受付け、処方箋発行医療機関との照会履歴の有無、結果について配信することを特徴とする医薬品処方情報照会・配信システム。
At the moment, an information method that replaces the creation and software of the above mentioned-described receipt having an electronic strategy from a conventional prepared process has presently been place into simple use. On the other hand, in The us, Pharmacy Gain Administration (“PBM”) is a company that manages dispensing expenses for policyholders.
従って、本発明の課題は、わが国の医療保険制度の中で、医療サービス受給の公平性を維持しつつ、被保険者・保険者もしくは審査支払機関が、代替品の中から最も強く処方を希望する医薬品を、医療機関・保険薬局が、他の代替品の中から優先的に採用する機会を提供することを可能にさせる、医療用医薬品処方情報照会・配信システムを提供することにある。
The prescription information inquiry / distribution method Based on declare one, accepting inquiries from insurance coverage pharmacies for insurance coverage protection of pharmaceuticals described in prescriptions issued by health-related institutions, and existence of inquiry historical past with prescription issuing healthcare establishments Pharmaceutical prescription information inquiry and distribution process characterised by distributing success.
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Now, There may be an illustration that aims to Enhance the work performance by digitizing the health care payment assessment request instead of composing, but This is certainly aimed toward labor saving of Office environment function with the health care institution.
次に、図２を用いて本発明の手段が実行されるフローを時系列で説明する。本発明の手段の実行は情報システムを通じて行われるが、この実行は大別して、システムの準備段階及び運用段階の二段階に分けられる。
If it is set that the specified problems are achieved, upcoming, Check out the managing standing / stock position of prescription drugs in opposition to numerous coverage pharmacies near website the handle from the professional medical institution / insurer, and procure the results. Also supply to professional medical institutions. Conversely, if it is determined that the required circumstances will not be fulfilled, the prescription suggestion subject matter derived dependant on the insured person's information presented by the medical establishment inside of a array that matches the desired problems in the examination payer and the insurance provider Distribute an index of medicines to professional medical institutions and inspire them to reselect.
The present creation for solving the above mentioned-talked about problems is made up of the subsequent areas. (one) Enter and hold information on substitutes and prescription priority information of insurers for prescription drugs prescribed by insurance policy medical establishments for insured individuals (two) Enter and retain the circumstances and requirements for receipt critique acceptance via the examination and payment Group (three) Accepting inquiries from health care establishments with regards to The provision of insurance for prescription drugs for each medical follow, and producing inquiries according to personal information like the insured's symptoms, health-related historical past, age, and so forth., and information on (1) and (two) higher than Judgment is built in actual time to determine whether the material meets the circumstances specified from the insurance provider / evaluation and payment institution (four) If the above inquiries do not meet the required problems, hunt for other drugs that fulfill the desired conditions dependant on the insured's information for example symptoms, and many others. Notify clinical institutions and persuade them to reselect prescription information.
This A A part of the prescription contains Instructions for that pharmacist, while in the party of the drug if it should be compounded within the pharmacy.
contain the probable of remaining abused, and that can result in properly being threats from Negative effects if taken incorrectly,
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