What is a Medical Billing System in Japan? 

What is a Medical Billing System in Japan? 

Advantages of implementation, how to choose, and differences from Electronic Medical Records 

Advantages of implementation, how to choose, and differences from Electronic Medical Records 

The Medical Billing System is an indispensable system for streamlining the billing of medical fees. In this article, we will explain a detailed overview of receipt computers, their differences from electronic medical records, types, how to choose, and points for implementation.

What is a Receipt Computer?

What is a Receipt Computer?

A receipt computer is a system computer that automatically creates medical claim form. Once a month, medical institutions must issue a receipt to be submitted to the health insurance society to claim medical expenses. By using a receipt computer, the creation of receipts can be automated, and office work can be expected to be more efficient. 

Prevalence of Receipt Computers

Prevalence of Receipt Computers

According to the Social Insurance Medical Fee Payment Fund's "Status of Claims by Claim Form (Reiwa 5)," the receipt penetration rate at hospitals, clinics, and dispensing pharmacies is 96.2%. Large hospitals with 400 or more beds have a penetration rate of 99.3%, and dispensing pharmacies are at 99.1%, which is close to 100%. In addition, small and medium-sized clinics with fewer than 400 beds have a penetration rate of 79.1%, nearly 80%. 

Source: Billing status by claim form (Reiwa 5) 

What can you do with a Receipt Computer? 

What can you do with a Receipt Computer? 

Here's what you can do with a receipt computer:

  • Preparation of medical reimbursement statements
  • Registration of medical treatment details and calculation of points
  • Issuance of prescriptions
  • Management of reception/billing operations
  • Cooperation with electronic medical records

By introducing a receipt computer, it is expected to reduce the burden of medical office work and work errors.

Advantages of implementing a Medical Billing System 

Advantages of implementing a Medical Billing System 

The advantages of implementing a medical Billing System in Japan are as follows.

Accurate calculation of medical fees 

Accurate calculation of medical fees 

With the latest medical fee data integrated into the receipt system, medical fees can be calculated automatically and accurately, preventing human errors such as omissions and miscalculations. In addition, the system is updated every two years to reflect revisions in the medical fee structure, ensuring that medical claim is always generated according to the latest standards.

Operational efficiency  

Operational efficiency  

It streamlines the creation of complex and time-consuming receipts, reducing staff man-hours and allowing time for other tasks to improve patient service. This reduction in overtime hours lowers labor costs. In addition, automating receipt creation minimizes mistakes and decreases the mental load on staff. 

Increased patient satisfaction 

Increased patient satisfaction 

Patient’s waiting time is reduced due to streamlining accounting and other clerical tasks, which results in improved patient satisfaction and leads to better turnover rates in hospitals and clinics. 

Medical Japan will hold a Pharmacy Solution EXPO! It is an exhibition visited by pharmacy managers, supervising pharmacists, and pharmacists.

Products and services used in pharmacies, such as receipt computers and automatic payment machines, were exhibited. We look forward to your visit.

Difference between receipt computer and electronic medical record 

Difference between receipt computer and electronic medical record

One of the things that is similar to a receipt computer is an electronic medical record. Both are important systems used in medical institutions, but their purposes and functions are different. 

An electronic medical record (EMR) system manages patient records digitally instead of using paper. Healthcare professionals, such as doctors and nurses, record the contents of the patient's interview, examination findings, and treatments. Electronic medical records have a legal status and must be stored electronically as required by the Medical Care Act.  

On the other hand, a receipt computer is a system that supports medical fee billing. Typically, the receipt computer and EMR are used together, with EMR serving as the basis for receipt preparation. Nowadays, there are systems that integrate both, making them worth considering for implementation. 

Types and manufacturers of receipt computers 

Types and manufacturers of receipt computers 

There are different types of receipt computers, including an integrated type that includes the functions of an electronic medical record and a separate type with distinct functions. Additionally, manufacturers can be broadly categorized into the standard receipt software ‘ORCA’ and receipt computers from other manufacturers. Here, we will explain in detail the types and manufacturers of receipt computers. 

Integrated and separate types of receipt computer and electronic medical record 

Integrated and separate types of receipt computer and electronic medical record 

There are two types of receipt computers: "integrated" and "separated," based on how they are linked to electronic medical records. The main difference is whether the operation of the electronic medical record and the receipt computer can be completed with a single terminal. The advantage of the integrated receipt computer is that it combines both functions, eliminating the need to launch two separate software programs, thus significantly reducing the time and effort required for operation. For the separated type, if an electronic medical record system is already in place, the implementation cost may be kept low, as only the functionality of the claims processing system needs to be added. 

Separate and integrated types have their own advantages and disadvantages. The differences between the two are summarized in an easy-to-understand table below. 

Manufacturer of receipt computer 

Manufacturer of receipt computer 

Receipts are categorized into Japan Medical Association Standard Medical Billing Software "ORCA" and those from other manufacturers. "ORCA" is a standard receipt software developed by the Japan Medical Association, notable for its open-source nature, allowing not only doctors nationwide but also everyone involved in medical care to use and improve it free of charge. On the other hand, non-ORCA receipt computers vary in functions, features, and support content depending on the manufacturer of the seller, so it is recommended to compare them in advance. 

How to choose a receipt computer, and what are the points for introducing it? 

How to choose a receipt computer, and what are the points for introducing it? 

Here, we will explain how to choose a receipt computer and the points of introduction. 

Can it be linked with the electronic medical record you want to use? 

Can it be linked with the electronic medical record you want to use? 

If you are already using an electronic medical record, check whether it can be linked with a receipt computer. While it can be used without linking, integrating the receipt computer with the electronic medical record allows for centralized management of information from reception to accounting operations. In the case of a separate type in which each system is installed, it is recommended to select a receipt computer first. The reason for this is that the receipt computer is easy to migrate data, and the workload is low even when changing to another receipt. 

Does it have the features and performance you want? 

Does it have the features and performance you want? 

The receipt computer has various functions, such as creating receipts and issuing prescriptions. Therefore, it is important to choose a receipt computer with the necessary functions based on the size of your clinic, the subjects you treat, and the workflow of your billing work. Also, in terms of processing performance, ensure that the receipt computer has sufficient capacity for the number of medical examinations and claims. Delays in business processing can interfere with operations, so it is important to compare them in terms of performance. 

Is it easy for medical office staff to operate? 

Is it easy for medical office staff to operate? 

In many cases, the final user of the receipt computer is the person in charge of medical administration. Ease of operation leads to operational efficiency and reduced risk of human error. Besides the clarity of the operation screen, it’s also important to consider whether the specifications can reduce the workload of the person in charge, such as ease of input and UI design that follows the business flow. 

It is also advisable to check the actual operation screen and consider the opinions of those who use the receipt computer at similarly sized medical institutions. In order to ensure smooth operation after installation, it is important to choose a receipt computer with excellent operability. 

Support system in case of trouble 

Support system in case of trouble 

Especially if you are installing a receipt computer for the first time, you may find it challenging to use. If the system has a support system, such as being able to ask questions until you get used to using it, you can use it with confidence. It is also important to be able to respond quickly in the unlikely event of a problem. It is advisable to check in advance whether there is a track record and system for addressing failures, such as a hotline for issues, technician dispatch, and regular maintenance. If recovery takes a long time, it may cause inconvenience to patients, so be careful. 

It is also recommended to see the real thing at the exhibition 

It is also recommended to see the real thing at the exhibition 

There are many factors to consider, such as which type of receipt computer to use and how to link it with electronic medical records, and you would typically want to actually try multiple devices. In such cases, it is recommended to go to an exhibition where medical equipment and services are showcased. You can also directly ask the person in charge of the device whether it can be coordinated in your own medical environment or test the usability with the actual device. RX Japan holds an exhibition called "MEDICAL JAPAN" in Osaka in the spring and in Tokyo in the fall. Please visit the exhibition, which is visited by more than 10,000 people in total.

Medical Japan will hold a Pharmacy Solution EXPO! It is an exhibition visited by pharmacy managers, supervising pharmacists, and pharmacists.

Products and services used in pharmacies, such as receipt computers and automatic payment machines, were exhibited. We look forward to your visit.

Summary

Summary

Receipt computers are indispensable for improving the efficiency of administrative work related to medical fees at medical institutions, but their features and functions vary depending on the type and manufacturer. When introducing one, be sure to consider the advantages and disadvantages and refer to the "Points for Selection and Introduction" introduced in this article to select the most suitable receipt computer for your hospital.


Supervisor: Konosuke Nakaji

Career: After graduating from Hyogo Medical University in 1991, he worked at Hyogo Medical University and Dokkyo Medical University. In 1998, he joined Kyowa Medical Corporation. Since 2003, he has been engaged in clinical practice at the Endoscopic Treatment Center of Aishinkai Nakae Hospital. He specializes in capsule endoscopy, gastrointestinal endoscopy, and gastrointestinal diseases. He is also active in academic activities and writing papers. He is a general internal medicine specialist and supervisor of the Japan Society of Internal Medicine; a specialist, supervisor, and councilor of the Japan Society of Gastroenterology; a specialist, supervisor, and academic councilor of the Japan Society of Gastroenterological Endoscopy; a delegate of the Japan Society of Gastroenterology; and secretary of the branch; a certified physician, supervisor, and delegate of the Japan Society of Capsule Endoscopy; and a senior member (Fellow) of the American College of Internal Medicine (ACP).


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