The current creation relates to a pharmaceutical prescription information inquiry / distribution product, a pharmaceutical prescription information inquiry / distribution program, and a pharmaceutical prescription information inquiry / distribution strategy.
結果として、医療サービス受給の公平性を保ちつつ、代替品が存在する医薬品の中で、被保険者・保険者や審査支払機関が、効果・価格等の観点から望ましいと考える医薬品を選択する機会が十分に提供されていない。
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Hereinafter, a flowchart of an illustration of an information inquiry / determination procedure are going to be explained with reference to FIG. Initially, the required information is acquired in the examination payer / insurance provider / insurance plan clinical institution / insurance coverage pharmacy. The information and selected ailments for being obtained with the examination payer as well as insurance company are as explained previously mentioned.
The current invention pertains to transactions connected with prescription and purchase of ethical drugs concerning suppliers and prescribers for instance health-related institutions and insurance plan pharmacies and people including assessment payers, insurers and insured individuals during the pharmaceutical distribution market place. It becomes attainable to clarify whether or not There exists settlement in between the functions in serious time. Because of this, the assessment / payment establishment / insurer can have a chance to correctly express their intentions regarding the variety of drugs, which will permit them to extend their selections for drug prescriptions they desire and boost their fulfillment and value efficiency.
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。
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、本システムを介して為された一連の照会履歴を審査支払機関及び保険者に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。
【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。
【選択図】図３[Issues] To deliver a technique for delivering an opportunity for just a clinical institution / coverage pharmacy to preferentially undertake a medicine that an insured / insurance company or evaluation / payment institution would like to prescribe inside the professional medical insurance policies method. Furnished. [Indicates FOR Fixing PROBLEMS] Getting into / Keeping information on alternatives, prescription priority order information of the insurance company, and ailments / requirements for approval of a receipt evaluation by an examination / payment institution for a medicine prescribed by an insurance plan medical institution Inquiries relating to no matter if coverage for prescription drugs is obtainable for Each and every health-related click here follow from your signifies and health care institution, and whether the inquiries match the required ailments on the insurance company / assessment and payment organization based on own information for instance indicators in the insured Means to ascertain whether or not the above mentioned inquiry material would not match the desired conditions, seek for other drugs that meet the desired conditions with the drugs specified from the insurance company based on the insured's information for example indications A program acquiring means for notifying a health care institution as an alternative and prompting the health-related institution to reselect prescription contents. [Collection] Determine three Description
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In the conventional payment examination technique, a healthcare establishment troubles a prescription and prescribes and pays to the drug for the patient at an insurance policy pharmacy, and so forth., after which the examination ask for for your medical observe is manufactured towards the assessment payment institution. However, it can be not possible to evaluate the suitability of the appliance contents beforehand for professional medical establishments. On top of that, the insured / insurance provider (health insurance Affiliation, and many others.) that bears the price of prescribed drugs just isn't completely informed about information on drugs such as efficacy and rate, and is particularly entirely informed concerning the existence of multiple possibilities. It is frequently not completed. For this reason, the selection of medicines is entirely left for the judgment of the health-related institution, and it really is tough to exercising the right to choose medicines as a cost bearer and a purchaser.
Precedence day (The priority date is an assumption and isn't a lawful summary. Google has not carried out a lawful Assessment and can make no illustration as to the accuracy of your day detailed.)
Future, the movement in which the suggests with the present creation is executed will probably be explained in time sequence with reference to FIG.
Each time a prescription proposed medicine is selected by a professional medical institution, the managing standing / stock position at a nearby insurance pharmacy is confirmed and the result is notified.