) offered with the clinical institution at the time of inquiry and information obtained beforehand And in genuine-time if the required ailments on the insurer to whom the insured is affiliated as well as evaluation and payment organization in cost are happy.
To start with, in FIG. one, the get-togethers linked to the information process with the current invention is going to be clarified. This information system features a medical establishment that prescribes prescribed drugs on the insured, an insurance plan pharmacy that dispenses prescribed drugs depending on a prescription issued from the health-related establishment and delivers them for the insured, an insurance provider that bears clinical insurance plan fees, and An assessment / payment institution that examines professional medical price information from health-related establishments / insurance policy pharmacies is related. Each and every celebration provides the information procedure that has a number of required information for being explained afterwards.In the information technique, (one) information on possibilities and prescriptions from the insurance company for drugs prescribed because of the insurance health-related establishment with the insured Enter / keep wished-for precedence information, (two) Enter / maintain ailments / benchmarks for acceptance of receipt critique by critique / payment Group, (three) Inquire about availability of insurance plan for prescription drugs from clinical establishments for each medical observe Based upon particular information for example acceptance, insured's symptom, health-related history, age, and many others.
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Instead, notify the clinical establishment, and motivate the medical institution to reselect prescription content, Pharmaceutical prescription information inquiry / distribution process characterised by comprising
The present invention pertains to transactions related to prescription and purchase of moral drugs amongst suppliers and prescribers including health-related institutions and insurance policies pharmacies and consumers for instance examination payers, insurers and insured folks during the pharmaceutical distribution market. It turns into possible to make clear if There may be agreement amongst the get-togethers in genuine time. Due to this fact, the examination / payment institution / insurer will likely have an opportunity to proficiently Categorical their intentions concerning the variety of drugs, which enables them to develop their selections for drug prescriptions they desire and enhance their fulfillment and cost efficiency.
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。
The prescription have to be signed via the prescriber by his / her hand. His/her tackle and registration range actually need to be prepared in the situation of perilous and behavior-forming medicines.
【解決手段】保険医療機関が処方する医薬品について、代替品情報、保険者の処方希望優先順位情報を入力・保持する手段、審査支払機関によるレセプト審査承認のための条件・基準を入力・保持する手段、医療機関から診療行為毎に、処方医薬品の保険適用可否に関する照会を受付け、被保険者の症状等の個人情報に基づき、照会内容が保険者・審査支払機関の指定条件に合致しているか否かを判定する手段、上記照会内容が指定条件に合致していない場合は、保険者が指定する医薬品の中から、症状等の被保険者の情報に基づき指定条件を満たす他の医薬品を検索し代替品として医療機関に通知、医療機関にて処方内容の再選択を促す手段を有するシステム。
hold the likely of remaining abused, and that can lead to effectively remaining threats from Damaging effects if taken incorrectly,
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指定条件を満たしていると判定した場合には、次に、医療機関・保険者の住所から近くに存在する複数の保険薬局に対して、処方対象医薬品の取扱状況・在庫状況を確認、結果をあわせて医療機関へ配信する。一方、指定条件を満たしていないと判定した場合には、審査支払機関及び保険者の指定条件に合致する範囲内で医療機関が提示した被保険者情報をもとに導出される処方推奨対象となる医薬品のリストを医療機関に配信、医療機関にて再選択を促す。医療機関にて処方推奨医薬品が選択されると、近隣の保険薬局での取扱状況・在庫状況を確認、結果を通知する。
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Up coming, the circulation through which the suggests from the existing invention is executed are going to be described in time sequence with reference to FIG.
Investigate has proven that The proportion of patients with several medications is growing. So has the requirement for varied caregivers and/or Specialist healthcare aid personnel for your equipped specific.