Abstract
A bill of the treatment procedure in health insurance has been manually calculated by the total of the charge of treatment, medicine, and medical material. Among these, the charge of treatment was the claim to a “procedure” without substance, and was difficult to systematize. It aimed at construction of the system which generates the treatment claim information from the clinical information system(CIS). In order to gather treatment claim from CIS, treatment claim code column was added to each item in the master of CIS. After medical-examination record is completed, the item which has a medical-affairs code in the column was sampled, and then the treatment claim bill is created. Comparing the insurance claim points of a handwriting check bill and of the system, the average of the treatment claim derived from the system was 13,493 points, and the average of the handwriting check was 6,893 points. It is concluded that this system was effective in calculation of the charge of disposal.
