Following the inquiry within the health care establishment, the final prescription information is transmitted from the clinical establishment for the information process when the prescription drug is determined. When an coverage pharmacy inquires about the availability of insurance policy for prescription drugs explained in prescriptions, the presence / absence on the inquiry history Using the health-related institution and the outcomes are distributed. Last but not least, a number of inquiry histories is distributed to your examination and payment establishment as well as the insurance company, as well as information inquiry / judgment procedure is completed.
Initial, in FIG. 1, the functions linked to the information procedure with the existing invention will probably be clarified. This information program features a clinical institution that prescribes prescription drugs to the insured, an insurance policies pharmacy that dispenses prescribed drugs based on a prescription issued by the medical establishment and delivers them on the insured, an insurer that bears medical coverage charges, and An examination / payment establishment that examines healthcare rate specifics from clinical institutions / insurance plan pharmacies is connected. Every single party supplies the information system by using a number of necessary information for being explained later.From the information system, (1) information on alternate options and prescriptions with the insurance provider for drugs prescribed from the insurance policy clinical establishment for that insured Enter / maintain wished-for precedence information, (2) Enter / hold situations / expectations for approval of receipt evaluation by evaluation / payment organization, (three) Inquire about availability of coverage for prescription drugs from medical establishments for each health-related apply According to personal information which include acceptance, insured's symptom, health care background, age, etc.
Concurrently, for prescribed drugs that meet the desired circumstances, obtain the insurance policies pharmacy databases and Examine the managing and inventory information on the pharmaceuticals at many insurance coverage pharmacies close to the address in the professional medical institution or even the insured. . Moreover, when an insurance pharmacy will make an inquiry about the insurance plan application of a medication explained within a prescription issued by a medical institution, the presence or absence of an inquiry heritage Together with the prescription issuing professional medical establishment and The end result are dispersed.
It is made up of assumed healthcare rate factors calculated for every damage and symptom categorised As outlined by case, drug selling check here price regular of applied drugs, coverage points, other knowledge needed for evaluation of professional medical charge information, etcetera. Pharmaceutical prescription information inquiry and distribution program.
And when you get an inquiry about professional medical prescriptions from a professional medical institution for every person clinical observe, insured person information (health-related coverage related information, information on sickness / signs and symptoms, and so forth.
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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。
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possess the possible of remaining abused, and that can bring about perfectly getting threats from Detrimental effects if taken improperly,
At the moment, an information procedure that replaces the creation and software of the above-outlined receipt with the electronic strategy from a standard written process has already been put into useful use. On the flip side, in America, Pharmacy Benefit Management (“PBM”) is a company that manages dispensing costs for policyholders.
If it is decided that the specified problems are fulfilled, future, Verify the dealing with standing / inventory position of prescription drugs versus a number of insurance pharmacies close to the deal with of the healthcare institution / insurance provider, and acquire the effects. Also produce to professional medical institutions. Then again, if it is determined that the specified disorders are usually not fulfilled, the prescription recommendation subject derived based on the insured human being's information offered through the clinical institution inside of a array that matches the specified disorders in the assessment payer along with the insurer Distribute a summary of medicines to medical institutions and persuade them to reselect.
Drug Look for by Illness/Symptom - Find out what a drug is useful for, or if an adverse reaction may be caused by a certain drug.
最後に、一連の照会履歴を審査支払機関及び保険者に配信し、情報照会・判定の手順を終了する。
Examine has established that The proportion of patients with various medications is expanding. So has the necessity for varied caregivers and/or Qualified professional medical support staff to your provided person.