GRANT APPLICATION SYSTEM, GRANT APPLICATION SERVICE PROVIDING METHOD, PROGRAM FOR GRANT APPLICATION SYSTEM, AND COMPUTER-READABLE RECORDING MEDIUM RECORDING PROGRAM

• Main Authors: SATO SATOMI, NAGANO TOSHIHIKO
• Format: Patent
• Language: English; Japanese
• Published: 23.04.2020
• Subjects: CALCULATING; COMPUTING; COUNTING; DATA PROCESSING SYSTEMS OR METHODS, SPECIALLY ADAPTED FORADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORYOR FORECASTING PURPOSES; PHYSICS; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE,COMMERCIAL, FINANCIAL, MANAGERIAL, SUPERVISORY OR FORECASTINGPURPOSES, NOT OTHERWISE PROVIDED FOR

To provide a grant application system capable of easily performing application for grants to the government according to differences in the operation in each municipality as an insurer while suppressing the occurrence of receipts that require human inspection.SOLUTION: A grant application system A includes: an extraction condition recording unit 1 that sets extraction conditions for specific receipt information from a reception group; a data shaping unit 2 that shapes the data of the receipt information; a collation unit 3 that collates the receipt information with a disease name master; a calculation unit 4 that calculates points for specific medical treatment and medicines; a determination unit 5 that determines whether it is an application object; an extraction unit 6 that separately extracts a piece of receipt information for the application object, non-application object, and inspection object; an application receipt confirmation unit 7 that collates the application object receipt information with additional information such as retirement transfer information and unfair gain information to determine the final application amount; and a grant application amount determination part 8 that determines the application amount related to the grant of all confirmed application receipts.SELECTED DRAWING: Figure 1 【課題】人による点検が必要なレセプトの発生を抑制し、国への交付金の申請を、保険者である各自治体の運用の違いに対応して容易に行うことができる、交付金申請システムを提供する。【解決手段】交付金申請システムＡは、レセプト群から特定のレセプト情報の抽出条件を設定する抽出条件記録部１と、レセプト情報のデータ整形を行うデータ整形部２と、レセプト情報と傷病名マスタ等を照合する照合部３と、特定の診療行為、医薬品の点数計算を行う計算部４と、申請対象かを判定する判定部５と、申請対象、申請対象外、点検対象のレセプト情報を分けて抽出する抽出部６と、申請対象レセプト情報を退職振替情報及び不当利得情報等の付加情報と照合し、最終的な申請金額を確定する申請対象レセプト確定部７と、確定された全ての申請対象レセプトの交付金に関する申請額を決定する交付金申請額決定部８とを備える。【選択図】図１