JP6818397B2 - Collective management request processing device, batch management request processing method and batch management request processing program - Google Patents

Description

The present invention collectively manages medical bills for home medical care in addition to community-based comprehensive care costs, prescription drug costs, prescription drug costs, food costs, and diaper costs, which are incurred when a placement drug supplier or the like performs community-based comprehensive care. It relates to a centralized management request processing device for billing a care recipient and a patient, a collective management request processing method, and a collective management request processing program.

While the baby boomer generation in Japan will be over 75 years old in 2025, which is becoming a social problem in an aging society, the Ministry of Health, Labor and Welfare seems to be in a familiar area even if it is in a severe need for long-term care. The goal is to build a comprehensive community care system that provides housing, medical care, long-term care, prevention, and life support in an integrated manner so that people can continue their lives to the end of their lives.

For this reason, the number of long-term care workers has more than doubled in the last few years, and the number of industries that support them has also increased. In the future, the medical / long-term care-related business is expected to intensify competition in each field as new services and industries diversify based on their own fields of expertise.

Service recipients who enjoy medical / long-term care services repeatedly meet with doctors and care managers who formulate long-term care plans so that the best services for them will be provided as they age, while comparing services that are diversifying. , It is assumed that they will be exposed to the complicated mechanism that they are required to select and combine each of them.

Looking at the current medical / long-term care market, it is said that more than half of them are recognized as having cognitive impairment, and complicated processing is required to enjoy the above-mentioned complicated services.

In fact, even now, payments for various services are distributed for each service, and transfer procedures and automatic payment procedures are also difficult and difficult tasks for the elderly.

Therefore, when considering measures to improve the quality of life in Japan, which is facing an aging society, that is, quality of life measures, it is necessary to build a contractor who undertakes all of these complicated procedures and a unified processing system. ing.

On the other hand, apart from a series of home medical care, community-based comprehensive care, and home medical care frameworks, there are placement drug dealers that originate from "Toyama's drug dealer."

The placement chemicals company mainly has a business system that visits at home, installs a first-aid kit, and provides daily necessities including medicines and adhesive plasters at "pre-emptive after-sales", but the sales person who visited at the time of the visit Since he does not have medical qualifications in particular, he is engaged in replenishment work for general medicine and confirmation of survival.

Service providers such as medical institutions, long-term care facilities, pharmacies, and long-term care product stores, which are necessary to build a comprehensive community care system, directly bill the patient and the service recipient who is the long-term care recipient. As a result, the number of billing destinations increases and the procedure becomes very complicated.
Even now, many people who enjoy medical or long-term care services are people with dementia or the elderly, so it is difficult to understand the details of the billing, the payment of the billing cost is delayed, and the service provider pays the billing cost. There are also troubles such as not being able to receive the service, and troubles such as not paying the compensation billing fee when the memory of whether or not the service has been enjoyed is ambiguous.

Furthermore, as a payment method for service recipients, even if an automatic withdrawal contract is made, there is a problem that the balance of the withdrawal account is insufficient after the service provider provides the service.

The present invention has been made in view of the above points, and an object of the present invention is to unify the billing for service provision, reduce the complexity of the billing procedure, and reliably withdraw the billing cost.

In order to solve the above problem, the invention according to claim 1 provides a calculation means for treating a unique My Number possessed by each service user who enjoys the service as a number and performing a fixed calculation, and the service. A receiving means for receiving data associated with the content of the service and the billing cost for the service, to which the service provider ID assigned to the service provider and the service beneficiary ID assigned by the calculation means are added. Certification rank changing means for receiving certification rank data from an administrative agency and rewriting the certification rank of the service beneficiary, the service provider ID, the service beneficiary ID, the content of the service, and the compensation billing cost for the service. There Referring to the recorded database, and aggregation means to combine consideration request cost for each of the service receiver ID, a presentation means for indicating the summed amount of consideration claims costs grouped by the service receiver ID, the presentation It is characterized by being provided with a security sending means for sending the data presented by the means while having a security function .

According to the present invention, a service provider such as a medical institution, a long-term care facility, a pharmacy, or a long-term care product store can use a server managed by a placed drug supplier or the like to pay a compensation bill and enjoy the service of a patient or a care recipient. It is possible to make a batch management request processing device having the above-mentioned characteristics possessed by a placed drug supplier or the like who is visiting at home without directly requesting each person.
In addition, by handing the aggregated invoices to the service recipients, it is possible to grasp the invoice contents in a list even for those suffering from dementia and the elderly.

Furthermore, an ID to be used is generated from the unique number given to each citizen, and this ID is also a unique ID depending on the fixed calculation method, so medical institutions, nursing care facilities, pharmacies, nursing care products Even when receiving compensation requests from various service providers such as retailers, ID duplication does not occur, and the batch management request processing device can be operated without trouble.

In addition, by receiving accredited rank data from government agencies, it is possible to enhance various services by using accredited rank changes and present invoices, etc. to service recipients while protecting personal information. Become.

The invention according to claim 2 is the collective management request processing device according to claim 1, and the service beneficiary's pension transfer account, salary transfer account, or insurance claim receiving account is used before the service is enjoyed. From the application form data, the total amount of the pre-confirmation means for confirming in advance whether or not the consideration billing cost can be withdrawn from the service beneficiary and the consideration billing cost organized for each service beneficiary ID is calculated in the service beneficiary's account. Therefore, a withdrawal means that automatically withdraws money at intervals of once every two months, and a beneficiary use restriction means that writes usage restriction data to service beneficiary data when the withdrawal cannot be made by the withdrawal means. , When the certified rank of the service beneficiary is rewritten by the certified rank changing means, the withdrawal means at the time of changing the certified rank that immediately withdraws the service, and the database is referred to, and the consideration is charged for each service provider ID. It is characterized by including a second aggregation means for collecting costs and a transfer means for automatically transferring the total amount of consideration billing costs collected for each service provider ID to the service provider's account.

According to the present invention, the delay in payment of the billing cost from the service beneficiary is reduced, and the billing cost can be paid to the service provider without omission.

In addition, it is possible to identify the pension transfer account, salary transfer account, or insurance claim receiving account of the service recipient who regularly receives payment, and the service provider such as a medical institution, a nursing facility, a pharmacy, or a nursing care product store provides the service. It is possible to avoid troubles such as no balance in the withdrawal account even though the service is provided.

In addition, withdrawals will be made at intervals of once every two months in line with the pension payment, which will enable more reliable withdrawals in an aging society.

The invention according to claim 3 is the collective management request processing device according to claim 1 or 2, and is a usage ticket required for the beneficiary of the service to receive the next service after enjoying the service. The first confirmation means for confirming the record of the service beneficiary enjoying the service from the service provider from the ticketing means for issuing the ticket and the data of the ticket issued by the ticketing means when the request is made. It is characterized by being prepared.

According to the present invention, did the service recipient himself / herself enjoy the service at his / her next ticket request to prove the fact that the patient or the care recipient who enjoyed the service actually enjoyed the service? Whether or not, it is possible to avoid troubles when paying the compensation billing cost, which occurs when the memory of the service beneficiary is ambiguous.

The invention according to claim 4 treats the unique My Number of each service beneficiary who enjoys the service as a number, performs a fixed calculation, and provides a service assigned to the service provider who provides the service. Receive the reception step to receive the data related to the content of the service and the billing cost of the service to which the person ID and the service beneficiary ID assigned by the calculation step are added, and receive the certification rank data from the administrative agency. Refer to the certification rank change step for rewriting the certification rank of the service beneficiary, and the database in which the service provider ID, the service beneficiary ID, the content of the service, and the billing cost for the service are recorded. , An aggregation step that summarizes the consideration billing costs for each service beneficiary ID, a presentation step that shows the total amount of the consideration billing costs that are summarized for each service beneficiary ID, and security of the data presented by the presentation means. It is characterized by including a security sending step of sending while having a function.

The invention according to claim 5 provides the service, which is a calculation means for treating a computer managed by a placement drug supplier as a number and performing a fixed calculation by treating a unique My Number possessed by each service recipient who enjoys the service as a number. Receiving means and administration that receive data associated with the content of the service and the billing cost of the service, to which the service provider ID assigned to the service provider and the service beneficiary ID assigned by the calculation means are added. The certification rank changing means for receiving the certification rank data from the institution and rewriting the certification rank of the service beneficiary, the service provider ID, the service beneficiary ID, the content of the service, and the billing cost for the service are recorded. With reference to the provided database, the aggregation means for summarizing the consideration billing costs for each service beneficiary ID, the presenting means for showing the total amount of the billing costs summarized for each service beneficiary ID, and the presenting means are presented. It is a program characterized in that it functions as a security sending means for sending such data while having a security function.

According to the present invention, service providers such as medical institutions, long-term care facilities, pharmacies, and long-term care product stores can centralize the billing for service provision and make it to the centralized management bill processing device, and patients who enjoy the service. , It is possible to reliably withdraw the consideration billing cost from the care recipient.

It is a schematic block diagram using the community-based comprehensive care collective management request processing device by one embodiment. It is a figure which shows the process from the use registration of the management request processing apparatus to the consideration expense request. (A) shows the structure of DB102b and DB102c in the storage unit 102 of the community-based comprehensive care collective management request processing device 10, and (b) is a diagram showing a query or view structure after batch processing. It is a figure which shows an example of the invoice for a service user. It is a block diagram which shows an example of the outline structure of the management request processing apparatus 10 which concerns on embodiment. (A) is a diagram showing an example of the content registered in the service provider DB102a, (b) is a diagram showing an example of the content registered in the service user DB102b, and (c) is a diagram showing an example of the content registered in the service user DB102b. It is a figure which shows an example of the content registered in the provision record DB 102c. It is a flowchart which showed the example of the method which oneself proves that the service beneficiary actually enjoyed the service. It is a flowchart which shows an example of the step of the service beneficiary initial registration. (A) is a flowchart showing an example of processing when the service enjoyer 1 receives the service, and (b) is the processing when the service providers 3 to 6 such as a hospital make a request. (A) An example of processing for starting batch processing, (b) is an example of batch processing when aggregating service beneficiary consideration billing costs, and (c) is a batch when aggregating service provider consideration billing costs. It is a flowchart which shows an example of a process. It is a flowchart which shows an example of the method of sending an invoice to a service beneficiary. It is a flowchart diagram of the processing example at the time of automatically debiting from the beneficiary's account. It is a flowchart of the processing example at the time of the automatic transfer to the account of a provider. It is a flowchart of the process example which changes the service enjoyment rank of a service beneficiary.

Hereinafter, embodiments of the present invention will be described with reference to the attached drawings. The following description does not limit the technical scope and meaning of terms described in the claims.

[1. Configuration and function overview of the management request processing device]
First, the configuration and functional outline of the management request processing system S according to the present embodiment will be described with reference to FIG. FIG. 1 is a diagram showing an example of an outline configuration of the management request processing system S according to the present embodiment.

As shown in FIG. 1, the management request processing system S includes a community-based comprehensive care collective management request processing device 10 (hereinafter abbreviated as a management request processing device), terminals 20 of a plurality of assigned drug providers and the like, and a plurality of services. It is configured to include terminals 30 of persons 3 to 6, a plurality of servers such as banks 70, and terminals 80 of a plurality of administrative agencies. Then, the management request processing device 10, the terminal 20 of the arranged drug supplier, the terminal 30 of the service providers 3 to 6, the server 70 such as a bank, and the terminal 80 of the administrative agency are connected to, for example, a communication protocol via the network NW. It is possible to send and receive data to and from each other using TCP / IP and the like. The network NW is constructed by, for example, the Internet, a dedicated communication line (for example, a CATV (Community Antenna Television) line), a mobile communication network (including a base station, etc.), a gateway, and the like.

The management request processing device 10 is a device managed or contracted by the placement drug supplier, etc. 2, and has a database, a processing program, etc. for managing payment requests in an internal storage unit, and each service provider. It is a device that receives a compensation request from and processes payment.

The terminal 20 is a general-purpose terminal for a communication device owned or contracted by the arranged chemicals company 2, etc., and may be a personal computer, a tablet, or the like. A service that has a WEB browser application inside, or has a dedicated application, and uses them to connect to the management request processing device 10 via the network NW, and is a patient or a care recipient. Register the beneficiary 1 (hereinafter referred to as the service beneficiary 1), check the service enjoyment, and request the issuance of a coupon code.

The management request processing device 10 and the terminal 20 are premised on being managed, owned, or contracted by a placed chemicals company or the like. We visit home-based chemical companies, set up first-aid kits, and provide daily necessities including chemicals and adhesive plasters. Since the person in charge of the assigned medicine sales visits the home regularly for the purpose of replenishing general medicines and confirming the survival, it is easy to have a close relationship with the service recipient 1 and as the manager of the management request processing system S. It is appropriate, but it may be done by a long-term care facility operator who provides home-visit care or a medical company.

The terminal 30 is a general-purpose terminal for a communication device owned or contracted by a service provider such as a hospital 3, a nursing facility 4, a pharmacy 5, and a nursing care product supplier 6, and may be a personal computer or a tablet. Etc. may be used. It has a WEB browser application inside, or it has a dedicated application, and by using them, it connects to the management request processing device 10 via the network NW, and the registration of the provided service and the service provision consideration Make a bill for expenses.

The bank server 70 is a bank server of a bank account contracted by the service recipient 1 and the service providers 3 to 6. It is a server operating for online transactions, and is connected to the management request processing device 10 via the network NW to withdraw or transfer the consideration charge cost.

The terminal 80 is a general-purpose terminal for a communication device owned or contracted by an administrative agency 8 which is a municipality, and may be a personal computer, a tablet, or the like. It has a WEB browser application inside, or it has a dedicated application, and by using them, it connects to the management request processing device 10 via the network NW, and the service beneficiary 1 is certified as requiring nursing care. Designate the certification rank of.

[2. From registration of use of management request processing device to billing of consideration costs]
Next, with reference to FIG. 2, the process from registration of use of the management request processing device to billing of consideration costs will be described.
In order to enjoy medical and long-term care services at home, the service recipient 1 makes an application to the placement drug supplier, etc. 2 who visited the home to use the management request processing system S.

Regarding the application for using this management request processing system S, in addition to the name, address and My Number for issuing ID, in order to smoothly withdraw the consideration billing fee, a bank account, credit card number, etc. Is added.

The placement drug supplier 2 who received the application connects to the management request processing device 10 via the network NW using the terminal 20, inputs necessary items, and is a patient or a service recipient 1 who is a long-term care recipient. Register for use.
At the time of application, the service beneficiary 1 is issued an ID generated so that there is no duplication even if there are a plurality of service providers.

Similarly, the hospital 3 of the medical provider, which is a service provider, has made an application in advance for using the management request processing device 10 of the present invention, and has been issued a service provider ID by the management request processing device 10. Since this ID only needs to be managed in the management request processing device 10, the issuing logic may be provided independently.

When the service provider, the hospital 3, receives a request from the service recipient 1 to provide the service, the hospital 3 uses the terminal 30 to connect to the management request processing device 10 via the network NW.

Here, in addition to FIG. 2, a description will be given with reference to FIG. FIG. 3A shows the service beneficiary DB102b and the service provision record DB102c structure in the storage unit 102 of the community-based comprehensive care collective management request processing device 10, and FIG. 3B shows a query after batch processing. , Or, is a diagram showing a view structure.
The ID for the connected hospital 3 is used to log in to the management request processing device 10, and the service beneficiary DB 102b of the service beneficiary 1 managed by the hospital 3 stored in the storage unit 102 is accessed. The WEB browser application or the dedicated application in the terminal 30 may be linked with the original management request system in the hospital to improve efficiency.

The hospital staff who has accessed the service beneficiary DB102b of the service beneficiary 1 managed by the hospital 3 inputs the ID of the service beneficiary 1 on the screen for confirming the ID of the service beneficiary 1. The management request processing device 10 displays the service beneficiary ID and the registration information such as the name, address, or date of birth of the service beneficiary 1 on the WEB browser application or the dedicated application in the terminal 30 held by the hospital 3.

If the contents of the service provision request application and the displayed contents match, the hospital staff has proved that the usage registration of the management request processing device 10 of the service recipient 1 has been performed correctly. The hospital 3 can provide services such as home medical care to the beneficiary 1.

After providing the service to the service beneficiary 1, the hospital 3 may perform the process of issuing the coupon code for the next use to the management request processing device 10 and deliver the coupon code to the service beneficiary 1. The coupon code issuance process is performed by the service providers 3 to 6 to the management request processing device 10, and the coupon code obtained by the service providers 3 to 6 is passed to the service beneficiary 1 after the service is provided to provide the service. By presenting the coupon code when the beneficiary 1 applies for the service next time, it is also a proof that the beneficiary 1 has actually enjoyed the service.

After providing the service, the hospital 3 processes the compensation request for the service to the management request processing device 10.
The hospital 3 connects to the management request processing device 10 via the network NW by using the WEB browser application or the dedicated application in the terminal 30 owned by the hospital 3.
The hospital staff logs in to the management request processing device 10 with the connected ID for the hospital 3, and from the terminal 30, the ID for the hospital 3, the patient ID that provided the service, the medical treatment, the treatment, the medicine, etc. Enter the billing cost for the service content and services such as medical treatment fee, treatment fee, and medicine fee.

If there is no error in the entered contents, the final transmission process is performed. When the definitive transmission process is performed, the terminal 30 adds the ID for the hospital 3 and the patient ID that enjoyed the service, and transmits the data associated with the content of the service and the charge for the service to the management request processing device 10. To do.

The management request processing device 10 writes the received service provider ID and the data of the consideration billing cost with the service beneficiary ID in the service provision record DB 102c in the storage unit 102. At this point, the proof of service enjoyment has not yet been obtained, so the billing cost does not have to be fixed.

Similarly, the long-term care facility 4, the pharmacy 5, or the long-term care product supplier 6 of the long-term care provider, which is the service provider, also applies in advance for using the management request processing device 10 of the present invention, and the management request processing device 10 gives an ID. Is issued, and the same processing as in Hospital 3 is performed as described above.

The management request processing device 10 refers to the service provision record DB 102c every month or on a fixed date within a fixed period, and aggregates the consideration billing costs for each service provider ID and each service beneficiary ID. I do.

The billing cost aggregation process for each ID of service providers 3 to 6 such as medical institutions, nursing care facilities, pharmacies, and nursing care product stores is to aggregate the billing costs for providing services and transfer the billing costs to the service providers. Do.
The management request processing device 10 refers to the service provision record DB 102c in the storage unit 102, sets the service provider IDdF1 as the aggregation key, creates a query (Query) or a view (View), and charges for the data. Are all added. The total billing cost for that period is held in the storage unit 102 as the total billing cost within the fixed period of the service provider ID.

The consideration billing cost aggregation process for each service beneficiary ID is a bank that aggregates the consideration for enjoying the service, creates an invoice for the service beneficiary 1 as the consideration billing cost, and has a bank account specified in advance. Etc. It means connecting to the server 70 and performing the withdrawal processing of the consideration billing cost.
The management request processing device 10 refers to the storage unit 102, sets the service beneficiary IDdF2 as the aggregation key, creates a query (Query) or a view (View), and adds all the data billing costs. The total billing cost for that period is held in the storage unit 102 as the total billing cost within the fixed period of the service beneficiary ID.

The management request processing device 10 aggregates the total amount of billing costs held in the storage unit 102 as the total billing cost within a fixed period of the service beneficiary ID, using the service beneficiary ID as in the example of FIG. 4 as a key. It can be printed as a book.
The placement chemicals company 2 that owns the management request processing device 10 sends the printed matter as an invoice to the service beneficiary 1 by mail, so that the service beneficiary 1 confirms the service enjoyment contents and the compensation billing cost in a list. It becomes possible to do.

The placement drug dealer, etc. 2, which owns the management request processing device 10, sends the invoice as electronic data by attaching it to an e-mail, or attaches it to an SNS (Social Networking Service) service (hereinafter referred to as SNS) such as LINE or Messenger. It is also possible to distribute it. The management request processing device 10 may be provided with a function of automatically transmitting.

The management request processing device 10 connects the total amount of the consideration request cost printed on the invoice to the server 70 of a bank or the like having a bank account or the like designated in advance, and performs the withdrawal process of the consideration charge cost.
If the service beneficiary 1 has designated a withdrawal account such as a pension transfer account or salary transfer account, the consideration claim cost cannot be withdrawn by withdrawing the consideration claim cost immediately after the pension transfer date or payday. It is possible to avoid the risk of becoming.

The management request processing device 10 from which the consideration billing cost is deducted from the service beneficiary 1 is the total billing cost written in the storage unit 102 as the total billing cost within the determined period for each ID of the service providers 3 to 6. With reference to the amount of money, the service provider connects to a bank or the like server 70 that has a bank account or the like designated in advance, and transfers the total compensation billing cost.
Here, money is exchanged, and a human being may be involved in order to reduce the risk, and the management request processing device 10 may wait for the confirmation process by the human before the automatic transfer, and then perform the transfer.

In addition, the administrative agency 8 such as a municipality receives information that the service recipient 1 is certified as requiring long-term care / support, is not certified, suffers from an illness, becomes a patient, recovers, or dies. Receive from a doctor or care manager who is person 1 or service provider 3-6. Since this information is related to the application of insurance and is greatly related to the compensation claim, the care manager and the administrative agency 8 are the information to be actively exchanged.

When the rank of certification changes, the administrative agency 8 such as a municipality connects to the management request processing device 10 via the network NW using the terminal 80. The person in charge of the administrative agency logs in to the management request processing device 10 with the ID for the connected administrative agency 8, and inputs from the terminal 80 that the service beneficiary ID and the rank have been changed. The management request processing device 10 rewrites the column of the certification rank dFr in the service beneficiary DB 102b in the storage unit 102.

[3. Configuration of management request processing device]
Next, the configuration of the management request processing device 10 will be described with reference to FIGS. 5 and 6.

FIG. 5 is a block diagram showing an example of an outline configuration of the management requesting device 10 according to the present embodiment. As shown in FIG. 5, the management request processing device 10 includes a communication unit 101, a storage unit 102, an input / output interface 103, and a system control unit 104. The system control unit 104 and the input / output interface 103 are connected to each other via the system bus 105.

The communication unit 101 is connected to the network NW to control the communication state with the terminal 20 of the arranged chemical supplier and the terminal 30 of the service provider.

The storage unit 102 is composed of, for example, a hard disk drive, an SSD, or the like. A database such as a service provider DB 102a, a service beneficiary DB 102b, a service provision record DB 102c, and a bank account DB 102d is constructed in the storage unit 102. "DB" is an abbreviation for database. The storage unit 102 is an example of the storage means and the confirmation date storage means in the present invention.

FIG. 6A is a diagram showing an example of the contents registered in the service provider DB 102a. In the service provider DB 102a, service beneficiary information regarding service providers 3 to 6 registered as service providers in the management request processing system S is registered. Specifically, the service provider DB102a contains the service provider ID, password, service provider name, postal code, location, telephone number, person in charge e-mail address, service provider transfer account information, and the like. It is registered in association with each of 3 to 6. The service provider ID is the identification information of the service provider. The service provider transfer account information is information on the bank transfer account registered by the service provider. For the service provider transfer account information, for example, information such as bank information (bank code number), branch information (branch code), ordinary / current, name of holder, account number, etc. is set. Bank information is information that identifies a bank. By registering the service provider transfer account information in advance, the service provider does not have to enter the service provider transfer account information each time the service is provided.

FIG. 6B is a diagram showing an example of the contents registered in the service beneficiary DB 102b. In the service beneficiary DB 102b, service beneficiary information regarding the service beneficiary 1 registered as a service beneficiary in the management request processing system S is registered. Specifically, the service beneficiary DB 102b includes the service beneficiary ID, the service beneficiary name, the service enjoyment rank, (rank of support for nursing care, etc.), date of birth, zip code, address, telephone number, e-mail address, etc. The service beneficiary withdrawal account information and the like are registered in association with each service beneficiary 1. The service beneficiary ID is identification information of the service beneficiary 1. The service beneficiary withdrawal account information is the information of the bank withdrawal account registered by the service beneficiary 1. For the service beneficiary withdrawal account information, for example, information such as bank information (bank code number), branch information (branch code), ordinary / current, name of holder, account number, etc. is set. Bank information is information that identifies a bank. The service beneficiary ID may be generated from My Number, which will be described later, in order to prevent duplication.

FIG. 6C is a diagram showing an example of the contents registered in the service provision record DB 102c. In the service provision record DB 102c, what is transmitted as a record of service provision by service providers 3 to 6 after service provision is registered in the management request processing system S. Specifically, the service provision record DB102c is associated with the provision date, provision time, provision content, provision service provider ID, service beneficiary ID, consideration billing cost, service enjoyment check, etc. for each service provision record. Is registered. The content provided is the content of the service provided by the service providers 3 to 6 to the service recipient 1. For example, "medical treatment" for hospital 3 and "helper provision" for long-term care facilities are registered. To.

Next, other information stored in the storage unit 102 will be described. Various data such as HTML (HyperText Markup Language) documents, XML (Extensible Markup Language) documents, image data, text data, and electronic documents for displaying WEB pages are stored in the storage unit 102.

Further, various programs such as an operating system, a WWW (World Wide WEB) server program, a DBMS (Database Management System), a service provision processing program, and an n-ary conversion program are stored in the storage unit 102. The service provision processing program is service content and expense reception processing, consideration expense billing aggregation processing, service total amount presentation processing, account automatic withdrawal processing, account automatic transfer processing, coupon code generation processing and confirmation processing, withdrawal possibility certification processing, My It is a program for executing a process of generating an ID from a number.
The service provision processing program is an example of the information processing program in the present invention. The various programs may be acquired from another server device or the like via the network NW, or may be recorded on a recording medium such as a DVD (Digital Versatile Disc) and read via the drive device. You may do so.

The input / output interface 103 is configured to perform interface processing between the communication unit 101 and the storage unit 102 and the system control unit 104.

The system control unit 104 includes a CPU 104a, a ROM (Read Only Memory) 104b, and a RAM (
Random Access Memory) 104c and the like. Then, the system control unit 104 reads and executes various programs by the CPU 104a, so that the receiving means, the collecting means, the presenting means, the withdrawal means, the transfer means, the first confirmation means, the second confirmation means, and the calculation means in the present invention. , Converting means and storing means.

The management request processing device 10 may be composed of a plurality of server devices. For example, a service content receiving server device, a server device that performs bank account management processing, a server device that transmits a WEB page in response to a request from a terminal 20 and a terminal 30, a server device that manages a database, and the like are connected to each other via a LAN or the like. May be connected.

[4. Management billing system operation]
Subsequently, with reference to FIG. 5, a method of generating a unique service beneficiary ID in Japan will be described.

The patient or the long-term care service recipient 1 receives an application for receiving medical services and long-term care services, and the placement drug dealer, etc. 2 receives a message from the terminal 20 or the My Number reader connected to the terminal 20. The number is read, connected to the management request processing device 10 via the network NW, and the applied My Number is input to the input / output interface 103 in the management request processing device 10. My number is a number assigned to all citizens who have a resident's card without duplication, so if you can generate a number starting from this number, you can create a unique ID in Japan.

The CPU 104a in the system control unit 104 calculates a fixed value programmed in advance from the input My Number. For example, after adding a fixed value to My Number, the number may be multiplied by an integer. By setting one fixed operation in the management request processing system S according to the present invention, it is possible to uniquely perform number conversion. In addition, there is an advantage that the My Number cannot be inferred from the service beneficiary ID even if the service beneficiary ID is leaked to the outside by performing an unknown calculation to the outside.

The CPU 104a in the system control unit 104 reads the n-ary conversion program and converts the fixedly calculated My Number into an n-ary number. The n-ary number can be set up to 36-ary by adding 26 alphabetic characters that can be input with a standard keyboard in addition to the decimal number from 0 to 9. By setting one n-ary number in one system according to the present invention, it is possible to uniquely perform number conversion. Further, the larger the value of n in the n-ary number, the smaller the number of digits, and there is an advantage that the user ID can be easily handled.

The RAM 104c in the system control unit 104 stores the service beneficiary ID generated above. The generated service beneficiary ID is registered in the service beneficiary DB 102b from the input / output interface 103 to the storage unit 102 via the system bus 105. By this registration, the service beneficiary ID is confirmed, and after registering other information associated with this ID, the service beneficiary 1 can enjoy the service.

Next, with reference to FIG. 7, an example of a method for certifying that the service beneficiary 1 actually enjoyed the service will be described.
There are few service recipients 1 who clearly remember the services they received in their daily lives after the service providers 3 to 6 such as medical institutions, nursing care facilities, pharmacies, and nursing care product stores actually provided the services. .. Therefore, prove that you enjoyed the service by your own processing according to the following flow.

Before the hospital 3 which is the service provider provides the medical service, the terminal 30 is used to connect to the management request processing device 10 via the network NW and register to provide the service. In response to this, the management request processing device 10 generates a coupon code (step S11), and the hospital 3 obtains the coupon code in advance.
For example, the coupon code may be generated by performing a fixed operation using the number of the date and time of provision and the ID of the service user 1 as keys so that the date on which the service is provided can be known.

After the service provider, the hospital 3, provides the medical service, the hospital 3 presents the service beneficiary 1 with a coupon code for receiving the next service. As the presentation method, what is printed on a paper medium may be handed over directly, or may be notified by e-mail or SNS.

The service beneficiary 1 who enjoyed the service adds the coupon code by the determined date, and applies for the next service enjoyment voucher to the placement drug dealer, etc. 2 who visited at home. The placement drug supplier 2 connects to the management request processing device 10 via the network NW using the terminal 20, and transmits the service enjoyment application data with the coupon code to the management request processing device 10 ( Step S12). At this time, the management request processing device 10 confirms whether the coupon code is attached (step S13), and the management request processing device 10 cannot accept the application not added. In that case, the placement drug supplier 2 can accept the usage application again after confirming the previous service enjoyment contents and date by having the service beneficiary 1 enter the contents and date in the application form.

By following the above steps, the service recipient 1 cannot enjoy the next service unless he / she proves that he / she has enjoyed the service. Therefore, for elderly people and dementia patients who do not know whether or not they have enjoyed the service. You can continue to provide services with peace of mind.

Similar to the hospital 3, the nursing care facility 4, the pharmacy 5, the nursing care product supplier 6, and the like of the nursing care provider, which is the service provider, can also perform the steps in the above steps.

Next, with reference to FIG. 8, an example of the initial registration step performed by the service beneficiary 1 in order to use the management request processing device 10 for the arranged drug supplier and the like 2 will be described.
When the service beneficiary 1 wants to use the management request processing device 10 of the assigned drug supplier 2 etc., he / she visits the arranged drug supplier 2 who visited his / her home or the service beneficiary 1 himself / herself and applies for the service. ..

Naturally, the address, name, age, occupation, etc. will be stated on the usage application form, but if there is a certain age or history at that time, conditions will be set for the consideration billing fee deduction account.
The conditions are that the withdrawal account has money transfers at regular intervals, and that a certain amount of balance has been deposited for a certain period of time. The account is assumed to be a salary transfer account, a pension transfer account, or a long-term care insurance transfer account.

After connecting to the management request processing device 10 via the network NW using the terminal 20, the placement drug supplier 2 who received the application is transmitted the data of the application contents to the management request processing device 10 ( Step S21). The management request processing device 10 that has received the data determines whether or not there is a certain age or a certain age or a medical history (step S22).

By following the above steps, it is possible to avoid the risk that the balance of the account is insufficient and the withdrawal cannot be made when the consideration billing cost is automatically withdrawn.

As a means of confirming the conditions of the withdrawal account, you can attach a copy of the passbook containing the history of the account for one year or more to this usage application form, or attach a copy of the application form of the pension transfer account. , Etc. can be considered. The management processing server determines whether or not the attachment is attached (step S23), and if these are not attached, the application for use can be rejected (step S24).

By following the above steps, even though service providers 3 to 6 such as medical institutions, nursing care facilities, pharmacies, and nursing care product stores have provided services, there is no balance in the withdrawal account of service recipient 1. It can be avoided.

Next, a billing cost management processing method by the management request processing device 10 according to the present embodiment will be described.
FIG. 9 is a flowchart showing a processing example when the service recipient 1 receives the service and the service providers 3 to 6 such as a hospital make a request by the management request processing device 10 according to the embodiment. FIG. 9A is a diagram when the service recipient 1 receives the service, and FIG. 9B is a diagram when the service providers 3 to 6 such as a hospital make a request.
When the service beneficiary 1 receives a service such as receiving medical treatment or purchasing a product or the like, the service beneficiary ID is shown to the hospital 3 which is the service provider. The hospital staff who has been shown the service beneficiary ID connects to the management request processing device 10 via the network NW using the WEB browser application or the dedicated application in the terminal 30, and displays the service beneficiary ID input screen. Open and enter the service beneficiary ID and name, date of birth, etc. A card or the like in which the service beneficiary ID is written on the card surface or the ID information is magnetically written may be indicated.
Through the above processing, the management request processing device 10 receives the ID and additional information of the service user 1 (step S31).

In the management request processing device 10 in which the service beneficiary ID, the name, the date of birth, etc. are input, the service beneficiary ID stored in the service beneficiary DB 102b in the storage unit 102 and other input information match. It is determined whether or not (step S32). If they match, it is proved that the payment means has been secured, and the management request processing device 10 notifies the WEB browser application or the dedicated application in the terminal 30 owned by the hospital 3 that the service can be enjoyed ( Step S33). If they do not match, the service of the management request processing system S cannot be enjoyed until the payment means is secured (step S34).

When the service provider, the hospital 3, applies for and obtains the coupon code in advance after providing the medical service, and the management request processing device 10 issues the coupon code (step S35), the service beneficiary 1 is notified. In response, present the coupon code to receive the next service. The hospital 3 may keep a copy of the service beneficiary 1's signature or check on the paper-based usage certificate. When the check or sign is performed (step S36), the hospital 3 uses the WEB browser application or the dedicated application in the terminal 30, and the management request processing device 10 sends the service recipient 1 to the service provision record DB 102c in the storage unit 102. Records that he / she enjoyed the service (step S37).

Next, an example will be described when the service provider performs the cost claim processing on the management request processing device 10.
The hospital 3 that provided the service connects to the management request processing device 10 via the network NW using the WEB browser application or the dedicated application in the terminal 30 in order to charge the compensation cost, and provides the service. Enter the cost, which is the consideration, together with the service beneficiary ID and the provided service.
Through the above processing, the management request processing device 10 receives the ID of the hospital 3, the consideration cost, and the service name provided (step S41).

The management request processing device 10 that has received the request determines whether or not the service provision record DB 102c in the storage unit 102 contains a record that the service user 1 has received the service content as a service ( Step S42). When receiving the service, the billing amount is described in the billing field of the service provision record DB 102c in the storage unit 102 (step S43). If the service is not received, the coupon code input waiting state is set, and a message indicating that the billing is awaiting confirmation is displayed on the WEB browser application or the dedicated application in the terminal 30 (step S44).

When the service beneficiary 1 directly applies to the assigned drug supplier 2 or the hospital 3 that provides the service, if there is a coupon code presented by the hospital 3 when the service was enjoyed last time, apply for the code. Fill out the form. The placement drug supplier 2 that received the application, or the hospital 3 that provides the service, connects to the management request processing device 10 via the network NW using the WEB browser application or the dedicated application in the terminal 30 to provide the service. The ticket issuance process is performed, and the management request processing device 10 receives the enjoyment application to which the coupon code is attached (step S45).

After the above step, the management request processing device 10 checks whether the coupon code is generated by the management request processing device 10 (step S46). If the coupon code is not entered or the code is not generated by the management request processing device 10, no particular processing is performed (step S47). If it is presumed that there is an operation error by a human such as the number of digits of the code does not match, the management request processing device 10 may notify to that effect.
When the coupon code is generated by the management request processing device 10, the same processing as when checking that the service associated with the coupon code has been enjoyed is performed.

In the above step, the request for which it is confirmed that the service has been enjoyed becomes a finalized request, and the confirmation column of the consideration billing cost is checked, and the consideration billing cost for each service provider ID and each service beneficiary ID is set. It will be added to the list to be aggregated (step S49).

Next, a method of aggregating billing costs by the management billing processing device 10 according to the present embodiment will be described.
FIG. 10 is a flowchart showing a processing example in which the management request processing device 10 according to the embodiment automatically aggregates the consideration request costs for a certain period and when a certain date is reached. (A) is an outline of batch processing, (b) is an aggregation for transfer for service providers, and (c) is an aggregation for withdrawal for service users 1.
Here, the fixed period is generally processed monthly, but since it is considered that elderly people often pay the compensation claim cost from the pension, the period of pension transfer is set to two months here. It will be a fixed period, and the fixed date will be explained as the pension transfer date.

Once every two months, batch processing of aggregation processing runs on the 14th day before the 15th, which is the transfer date of the pension transfer month (15th is Saturday, and if it is a holiday, the day before that) (step S51). This process refers to the service provision record DB 102c in the storage unit 102 in the management request processing device 10, and aggregates each service provider ID and each service beneficiary ID shown in FIG. ..

First, the aggregation for each service provider ID will be described with reference to the service provision record DB 102c in the storage unit 102 shown in FIG. 3A.
Using the service provider ID column dF1 of the service provision record DB102c as a key, the consideration billing cost data dF3 having the same ID is aggregated to create a query (Query) or a view (View) (step S52). A billing list is created based on the created query or view (step S53). This query, or view, aggregates only the data that contains the checked dFc whose service enjoyment has been confirmed by the service beneficiary 1.
All the amounts in the consideration billing cost column dF3 in the billing list are added (step S54), and the total billing for two months of this service provider ID is a new transfer table shown in FIG. 3 (b). Create Qr1 (step S55) and record the service provider ID and consideration billing total cost column (step S56).

Similarly, the aggregation for each service beneficiary ID will be described with reference to the service provision record DB 102c shown in FIG. 3 (a).
Using the service beneficiary ID column dF2 of the service provision record DB102c as a key, the consideration billing cost column dF3 having the same ID is aggregated to create a query or a view (step S57). A billing list is created based on the created query or view (step S58). This query, or view, aggregates only the data that contains the checked dFc whose service enjoyment has been confirmed by the service beneficiary 1.
All the amounts in the consideration billing cost column dF3 in the billing list are added (step S59), and the withdrawal table Qr2 shown in FIG. 3B is used as the total billing for two months of this service beneficiary ID. Create (step S60) and record the service beneficiary ID and the total cost of billing (step S61).

Next, a method of sending an invoice to the service beneficiary 1 by the management request processing device 10 according to the present embodiment will be described.
FIG. 11 is a flowchart showing a processing example in which the management request processing device 10 according to one embodiment sends the aggregated consideration billing cost for each service beneficiary as an invoice when a certain period and a certain date are reached. Is.
In the same manner as above, the pension transfer period of two months is set as a fixed period, and the fixed date is explained as the pension transfer date.

On the 14th day before the 15th, which is the transfer date of the pension transfer month (15th is Saturday, and the day before that if it is a holiday), the withdrawal table Qr2 of FIG. 3 created above was created. Based on the above, the total amount is entered in the prepared invoice table (which may be electronic data or paper media) for each ID of the service user 1 (step S71). As the details of the invoice as in the example of FIG. 4, the service provision name, service provision date, and consideration billing cost on the query or view created by aggregating the consideration billing cost data based on the service beneficiary ID. Are listed in the invoice table (step S72).

After the details are listed, the name and address (or e-mail address, SNS ID) of the service beneficiary 1 are entered in the invoice table based on the service beneficiary ID (step S73).
Since the invoice is completed in the above steps, the invoice is sent by mail in an envelope in which only the name and address can be seen from the outside, or by e-mail with the invoice data with a password attached, or via SNS (step S74).

Next, a method of withdrawing the billing cost by the management billing processing device 10 according to the present embodiment will be described.
FIG. 12 shows an example of processing when the management request processing device 10 according to one embodiment automatically deducts the consideration billing cost from the account of the service beneficiary 1 at a certain date for a certain period of time. It is a flowchart which shows.
In the same way as above, the period of pension transfer is set to two months as a fixed period, and the fixed date is described as the pension transfer date.

For withdrawal of Fig. 2 created above on the 15th (Saturday, 15th is Saturday, the day before if it is a holiday), which is the payment date of the pension payment month, the day after the above batch processing and the invoice is created or sent. Based on the table Qr2, the withdrawal amount for each service beneficiary ID is checked (step S81). A query or view is generated for each withdrawal bank account described in the withdrawal table Qr2 (step S82), and a list is created by grouping the service beneficiaries 1 who specify bank A, for example. Withdrawal processing is performed for bank A based on the created list (step S83). Similarly, withdrawal processing will be carried out with Bank B and Bank C.

It is confirmed whether or not the withdrawal is possible (step S84), and if the withdrawal is successful, no particular processing is performed. If the withdrawal is not possible, check the non-withdrawal column dF7 in the table of the service beneficiary ID that could not be withdrawn (step S85). If this is checked, you may set restrictions on future use, or you may use it for processing such as stopping the enjoyment of the service itself.
In that case, the management request processing device 10 notifies the service recipient 1 that the withdrawal was not possible by mailing it in an envelope in which only the name and address can be seen from the outside, or a document notifying that the withdrawal was not possible via e-mail or SNS. Is sent (step S86).
After that, a process of reducing the transfer amount of the service providers 3 to 6 described in the transfer table Qr1 is performed (step S87). After that, a process is performed to notify the service providers 3 to 6 by e-mail or the like together with the service beneficiary ID and other information that could not be withdrawn (step S88).

Next, a method of transferring the billing cost by the management billing processing device 10 according to the present embodiment will be described.
FIG. 13 shows the processing when the management request processing device 10 according to the embodiment automatically transfers the consideration billing cost to the service provider's account at a certain date for a certain period of time. It is a flowchart.

The next day after the withdrawal is made, the transfer amount for each service provider ID is checked based on the transfer table Qr1 of FIG. 3 created above (step S91). Among them, create a query or view for each transfer bank account listed in the transfer table Qr1, and create a list of service providers who specify bank A, for example. Transfer processing is performed to bank A based on the created list (step S92). Similarly, transfer processing is performed with Bank B and Bank C.

After performing the transfer, the management request processing device 10 sends a message stating that the transfer has been performed by e-mail or the like and the amount of the transfer to the service providers 3 to 6 (step S93).

Next, the service certification rank (rank of care-requiring support, etc.) setting change work of the service beneficiary 1 by the management request processing device 10 according to the present embodiment will be described.
FIG. 14 is a flowchart showing a process of changing the service enjoyment rank of the service enjoyer 1 by the management request processing device 10 according to the embodiment.

If the administrative agency 8 such as a municipality changes the certification rank of the service recipient 1, the burden of insurance premiums will change. Therefore, the network NW can be used by using the WEB browser application or the dedicated application in the terminal 80 owned by the municipality. Through this, the management request processing device 10 is connected and the rank change application screen is opened (step S101).

If the service beneficiary 1 dies (step S102), if it dies, enter that fact, but since the bank account etc. may be frozen, the management request processing device 10 has no withdrawal money. Is immediately examined (step S103). If there is an undebited amount, the aggregation process is immediately performed before the account is frozen, and the withdrawal process is performed (step S104).

After the withdrawal process is successfully completed, or when there is no undeducted money, the management request processing device 10 deletes the data of the corresponding beneficiary from the service beneficiary management DB 102b (step S105).

If the change in the certification rank is not "death processing", the certification rank application is input and it is confirmed whether the certification rank has increased or decreased (step S106). Increasing the rank means that care is required, support is required, and the patient becomes more severe, and in general, insurance claims and subsidies often increase. Therefore, the management claim processing device 10 enjoys the service of changing the certified rank dFr. It is a process of only writing to the DB 102b for personal management (step S107).

When the change in certification rank goes down, it means that care is required, support is required, and the severity of the patient becomes less severe. In general, insurance claims and subsidies are often reduced, so immediately check for undeducted money. (Step S108). If there is an undeducted amount, the aggregation process is immediately performed before the certification rank is changed, and the withdrawal process is performed (step S109).

After the withdrawal process is successfully completed, or when there is no undeducted money, the management request processing device 10 writes the change of the certification rank dFr to the service beneficiary management DB 102b. (Step S107).

1 Service recipients who enjoy services 2 Placed pharmacists, long-term care facility establishments, or medical-related businesses 3 Hospitals that provide medical services, such as doctors and nurses, and provide medical care and treatment 4 Long-term care services 5 Nursing-care facility founders who mainly provide home-based nursing care 5 Pharmacists who provide drug sales services and have pharmacists, etc. and who are engaged in the sales of long-term care products 6 Mainly for long-term care products (nursing diapers, etc.) Long-term care product distributors engaged in sales 8 Administrative agencies such as municipalities 10 Community-based comprehensive care collective management request processing device 20 General-purpose terminals (computers, tablets, etc.) owned by the placement pharmacist 2
30 General-purpose terminals (PCs, tablets, etc.) owned by service providers such as hospitals and long-term care facilities
70 A server that manages and exchanges money held by financial institutions such as banks 80 General-purpose terminals (PCs, tablets, etc.) owned by government agencies 8
101 Communication unit 102 Storage unit 102a Service provider DB
102b Service beneficiary DB
102c Service provision record DB
103 Input / output interface 104 System control unit 104a CPU
104b ROM
104c RAM
105 System Bus NW Network Qr1 Transfer Table Qr2 Withdrawal Table S Management Request Processing System

Claims (5)

A calculation means that treats the unique My Number of each service recipient who enjoys the service as a number and performs fixed calculation.
Data in which the service provider ID assigned to the service provider who provides the service and the service beneficiary ID assigned by the calculation means are added, and the content of the service and the billing cost for the service are associated with each other. Receiving means to receive
A means of changing the certification rank that receives the certification rank data from the government agency and rewrites the certification rank of the service user,
With reference to a database in which the service provider ID, the service beneficiary ID, the content of the service, and the billing cost of the service are recorded, and an aggregation means for summarizing the billing cost for each service beneficiary ID. ,
Presenting means showing the total amount of consideration billing costs organized for each service beneficiary ID, and
A security sending means for sending the data presented by the presenting means while having a security function,
Collective management request processing device characterized by being equipped with. The collective management request processing device according to claim 1.
Prior confirmation means for confirming in advance whether or not the compensation claim cost can be withdrawn from the service beneficiary from the application data of the service beneficiary's pension transfer account, salary transfer account, or insurance claim receiving account before the service is enjoyed. When,
Withdrawal means that automatically withdraws the total amount of consideration billing costs collected for each service beneficiary ID from the service beneficiary's account at intervals of once every two months .
When the withdrawal cannot be made by the withdrawal means, the beneficiary use restriction means for writing the usage restriction data in the service beneficiary data and the beneficiary use restriction means.
When the certification rank of the service beneficiary is rewritten by the certification rank changing means, the withdrawal means at the time of changing the certification rank, which immediately withdraws,
With reference to the database, a second aggregation means for summarizing the billing costs for each service provider ID, and
A transfer means for automatically transferring the total amount of consideration billing costs collected for each service provider ID to the service provider's account, and
Collective management request processing device characterized by being equipped with. The collective management request processing device according to claim 1 or 2.
The service is based on the ticketing means for issuing a ticket and the data of the ticket issued by the ticketing means when the beneficiary of the service requests a usage ticket necessary for receiving the next service after enjoying the service. The first confirmation means for confirming the record of the beneficiary enjoying the service from the service provider, and
Collective management request processing device characterized by being equipped with. It is a collective management request processing method managed by the placement drug supplier.
A calculation step that treats the unique My Number of each service recipient who enjoys the service as a number and performs a fixed calculation,
Data in which the service provider ID assigned to the service provider who provides the service and the service beneficiary ID assigned by the calculation step are added, and the content of the service and the billing cost for the service are associated with each other. To receive the receiving step and
The certification rank change step that receives the certification rank data from the government agency and rewrites the certification rank of the service beneficiary,
With reference to a database in which the service provider ID, the service beneficiary ID, the content of the service, and the billing cost of the service are recorded, and the aggregation step of summarizing the billing cost for each service beneficiary ID. ,
A presentation step showing the total amount of consideration billing costs organized for each service beneficiary ID, and
A security sending step that sends the data presented in the presentation step while having a security function,
Collective management request processing method characterized by including
Computers managed by placement chemicals
An arithmetic means that treats the unique My Number of each service recipient who enjoys the service as a number and performs fixed operations.
Data in which the service provider ID assigned to the service provider who provides the service and the service beneficiary ID assigned by the calculation means are added, and the content of the service and the billing cost for the service are associated with each other. Receiving means,
A means of changing the certification rank, which receives certification rank data from an administrative agency and rewrites the certification rank of the service recipient.
An aggregation means for summarizing the billing costs for each service user ID by referring to a database in which the service provider ID, the service beneficiary ID, the contents of the service, and the billing costs for the services are recorded.
Presenting means showing the total amount of consideration billing costs organized for each service beneficiary ID,
A security sending means that sends the data presented by the presenting means while having a security function.
Collective management request processing program characterized by functioning as

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