そして個々の診療行為毎に医療機関から医薬品処方につき照会を受けると、照会時に医療機関から提示される被保険者情報（医療保険関連情報、傷病・症状等の情報等）と、予め取得した情報とを照合し、被保険者が加入している保険者並びに担当の審査支払機関の指定条件を満たしているか否かをリアルタイムで判定する。
The existing invention relates to transactions linked to prescription and purchase of moral drugs involving suppliers and prescribers for instance health care institutions and insurance coverage pharmacies and consumers which include evaluation payers, insurers and insured individuals inside the pharmaceutical distribution marketplace. It becomes doable to clarify whether or not There exists agreement among the parties in authentic time. As a result, the evaluation / payment establishment / insurer will likely have an opportunity to correctly Specific their intentions concerning the collection of drugs, which enables them to broaden their selections for drug prescriptions they wish and make improvements to their satisfaction and cost performance.
The prescription must be signed by means of the prescriber by his / her hand. His/her deal with and registration range actually must be geared up in the situation of perilous and conduct-forming medicines.
At this time, an information program that replaces the development and software of the above-pointed out receipt by having an Digital technique from a standard published process has presently been set into sensible use. Then again, in The usa, Pharmacy Profit Administration (“PBM”) is a company that manages dispensing prices for policyholders.
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The central method features a calculation unit, a Display screen and output unit, an enter unit, and an information storage device. An example of a knowledge file for being referred to at some time of calculation is proven in FIG.
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、個々の診療行為毎に医療機関から医薬品処方につき照会を受付け、照会時に医療機関から提示される被保険者情報（医療保険関連情報、傷病・症状等の情報等）と、予め取得した情報とを照合し、被保険者が加入している保険者並びに担当の審査支払機関の指定条件を満たしているか否かをリアルタイムで判定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。
The healthcare prescription information inquiry / distribution process In accordance with declare one, whereby the health care prescription is received from a health-related institution for each health care observe, and insured information (medical insurance policy relevant information, harm and ailment) offered with the clinical establishment at some time of inquiry.
) offered from the professional medical establishment at time of inquiry and information acquired upfront And in real-time if the desired problems in the insurer to whom the insured is affiliated as well as evaluation and payment Corporation in cost are happy.
At the same time, for prescription drugs that satisfy the required conditions, entry the insurance coverage pharmacy databases and Verify the dealing with and inventory information on the pharmaceuticals at several insurance plan pharmacies near the deal with of your health-related establishment or maybe the insured. . Additionally, when an coverage pharmacy makes an inquiry about the insurance plan software of the medicine described in the prescription issued by a medical institution, the presence or absence of an inquiry background Together with the prescription issuing clinical establishment and the result are dispersed.
The present invention for fixing the above mentioned-talked about issues is made up of the subsequent components. (1) Enter and maintain information on substitutes and prescription precedence information of insurers for prescription drugs prescribed by insurance health-related institutions for insured individuals (2) Enter and keep the disorders and conditions for receipt evaluation approval through the evaluation and payment Firm (three) Accepting inquiries from healthcare institutions concerning the availability of insurance coverage for prescription drugs for every medical observe, and earning inquiries dependant on personalized information like the insured's signs, healthcare history, age, and many others., and information on (1) and (two) earlier mentioned Judgment is created in true time to determine whether or not the articles satisfies the ailments specified through the insurance provider / examination and payment establishment (4) If the above mentioned inquiries tend not to meet the desired disorders, seek out other drugs that fulfill the specified problems based on the insured's information which include symptoms, and many others. Notify health-related establishments and motivate them to reselect prescription content.
To start with, in FIG. one, the functions connected to the information program in the present invention is going to be clarified. This information program includes a medical establishment that prescribes prescribed drugs towards the insured, an insurance coverage pharmacy that dispenses prescription drugs based upon a prescription issued with the clinical institution and presents them on the insured, an insurer that bears professional medical insurance policies expenses, and An evaluation / payment establishment that examines health care rate information from healthcare institutions / insurance pharmacies is connected. Just about every celebration supplies the information procedure using a series of needed information to generally be explained afterwards.Within the information technique, (1) information on solutions and prescriptions of your insurer for drugs prescribed from the coverage healthcare establishment for that insured Enter / maintain ideal precedence information, (2) Enter / hold circumstances / specifications for approval of receipt review by evaluation / payment organization, (three) Inquire about availability of coverage for prescription drugs from professional medical establishments for each professional medical exercise Determined by private information for instance acceptance, insured's symptom, health care background, age, etcetera.
Every time a health care institution prescribes medicines, the insured (patient) is examined by a doctor at the health medical establishment, the health practitioner troubles a prescription determined by the prognosis outcome, and the drugs is dispensed on the insurance coverage pharmacy based on the prescription , Furnished. With regard to saying the price of medicines covered by insurance plan, health-related establishments and insurance coverage pharmacies, etcetera.
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