Introduction

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Sumex I+; 26.08.22 04:21; 1 © TMR AG TMR AG Introduction Sumex I+ Quality assurance and electronic transfer of physician’s invoice

description

Introduction. Sumex I+ Quality assurance and electronic transfer of physician’s invoice. Schedule. Beta-Release as soon as possible Final-Release for all modules 1.5.2000 Download & documentation area www.tarmed.net www.xmldata.ch (schema files) Mailing list, Support & FAQ - PowerPoint PPT Presentation

Transcript of Introduction

Page 1: Introduction

Sumex I+; 19.04.23 18:29; 1© TMR AG TMR AG

Introduction

Sumex I+

Quality assurance and electronic transfer of physician’s invoice

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Schedule

Beta-Release

as soon as possible

Final-Release for all modules

1.5.2000

Download & documentation area

www.tarmed.net

www.xmldata.ch (schema files)

Mailing list, Support & FAQ

www.tarmed.net

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Goals of Sumex I+

Reduction of costs by

improvement of quality

automated data acquisition and control

no media breaks

Realization by

tariff and drug validation

generation of standardized XML invoice

integration of electronic invoice transfer

integration of printing of standardized invoice form

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Boundary conditions for Sumex I+

Boundary conditions relevant for physicians

No increased costs

No increased time requirement

Free choice of the clearing center

Boundary conditions relevant for software houses

Publication and standardization of all interfaces

Hiding of XML standard and OCR-Print layout behind functional interfaces

Automatic update of data and software

Quality and continuity guaranty of project by the healthcare insurance companies

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Sumex I+ implementation

Validator modules:

Search & browsing of tariff database

Validation of services against the tariff rules (tarmedValidator, labValidator, etc.)

Invoice module:

Generation and printing of standardized OCR invoice

Generation and transfer of XML invoice to insurance

Automatic usage of validator modules internally

netUpdate package:

Keeping software modules and databases up-to-date

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Sumex I+ modules

Validators

tarmedValidator

labValidator

migelValidator

drugValidator

physioValidator

Managers

MDInvoiceManager

netUpdate Package

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Technical implementation

MDInvoiceManager and validation modules

ATL-DLL modules written in C++

netUpdate package

MFC-EXE modules written in C++

Database access

OleDB access on local ready-only mdb-File

All databases are password protected

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Interface definition - tarmedValidator

TarmedValidator handles connections to the Tarmed database

Catalog retrieval of catalog information from the Tarmed database for populating lists or combo boxes

Search browsing of and retrieval of detailed information from the Tarmed database

Utility automatically generates service records for a given code

Validatechecks whether supplied service data conform to the Tarmed rules

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tarmedValidator browser & validate functionality

Initialize module

Quit?

Initialize GUI

Set input data ITarmedInputPutPatSex

Search data

Validate data IValidateAddService

ITarmedValidatorSetLanguage

ICatalogGetFirstUnit

ISearch & IUtilitySearchCode

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recordTarmedType: fields to store in physician software

code ref_code quantity date number (session number) ean_provider ean_responsible billing_role (both | mt | tt | none) medical_role (self_employed | employee) body_location (none | left | right) external_factor.mt (default=1.0) external_factor.tt (default=1.0) validate remark

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recordTarmedType: fields set by tarmedValidator

record_id unit.mt unit_factor.mt scale_factor.mt amount.mt unit.tt unit_factor.tt scale_factor.tt amount.tt amount vat_rate

anaesthesia (obsolete) medical_indicated (obsolete) ean_section (obsolete)

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Invoice Manager

CommunicationValidators

Man

ag

er F

acto

ry

Va

lida

tor

Fac

tory

Co

mm

un

ica

tio

n F

acto

ry

Physician software

Insurance software

Communication

Architectural blue print

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MDInvoiceManager overview

Physiciansoftware

COM / XML

COM

tarmedValidator

COMData Validation

XML Data Modeler

Server

SecureCommunication

(MediPort)PrinterOCRprint

Invoice Manager

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Interface definition - MDInvoiceManager

IMDInvoiceRequestManagermanagement of the InvoiceRequests (creation and further processing)

IMDInvoiceRequestsetting the XMLContents (invoice standard)

IMDInvoiceResultproviding the invoice results

ITarmedInputsetting tarmed specific input data

IAddresssetting address data

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MDInvoiceRequestManager

Physician software

MDInvoiceRequestManager

MDInvoiceResult

MDInvoiceRequest

Address

TarMedInput

Get

Valu

es

Pu

tV

alues

Create

Sto

re

Sp

ecial D

ataS

pecial

Data

MDInvoiceRequestManager

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MDInvoiceRequestManager methods

CreateMDInvoiceRequest

Print

Store

Send

PrintAndStore

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MDInvoiceRequest methods

Initialize

CreateTarmedInput

CreateAddress

SetHeader, SetInvoice, SetESR, SetBiller, SetProvider, SetInsurance, SetPatient, SetGuarantor, SetReferrer, SetEmployer, SetTreatment, SetKVG, SetVVG, SetUVG, SetICG, SetMVG

AddDiagnosis, AddSurgery, AddTarmedService, AddTarmedServiceEx, AddCantonalService, AddLagService, AddDrugService, AddMigelService, AddPhysioService, AddUnclassifiedService

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netUpdate package

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Hardware & Software requirements

Software

Windows 98 or higher

Windows 2000 or higher recommended

Note: Windows 95 is not supported by MSXML4

Hardware

Pentium III 500 MHz

250 MB free disk space

128 MB RAM

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Summary: win-win situation for all

physician

can produce a correct invoice according to the rules

has a free choice of the intermediate or print locally

software house

have to implement only one interface

Hiding of standards behind functional interfaces

insurance

receive high quality invoices

automated data processing is possible (XML or OCR invoices)


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