Top > ご連絡など > ケアマネジャーの介護保険NEWS > 【介護支援専門員 NEWS】レセプト突合・縦覧点検「歴史的な転換点」- 支払基金・河内山理事長
【介護支援専門員 NEWS】レセプト突合・縦覧点検「歴史的な転換点」- 支払基金・河内山理事長
河内山理事長はあいさつの中で、▽レセプトの突合点検・縦覧点検の実施▽審査の不合理な差異の解消▽全国組織としての事業運営―を当面の課題として挙げた。
このうち、突合・縦覧点検の実施については、「名寄せ・突合、月をまたいだ縦覧ができるようになることからすると、歴史的な転換点だ」と述べた。
一方、審査の不合理な差異の解消に向けては、特に審査委員と支部の担当職員の連携を強化するよう求めた。
事業運営については、今後も47の審査委員会・支部を維持するほか、来年度からブロック中核支部が他の支部を支援する体制をつくると説明し、「組織として最高の力を発揮できるようにマネジメントしていきたい」と意欲を示した。
この日、来賓として招かれた厚生労働省保険局の西辻浩保険課長は、レセプトの突合点検について「大変画期的な取り組みだ。私どもとしても、円滑な実施に向けて関係者の理解を得ながら取り組みをサポートしていきたい」と述べた。
このほか、同省の「審査支払機関の在り方に関する検討会」の昨年末までの議論を踏まえ、審査の不合理な差異の解消とサービス向上に向けた取り組みの推進や、審査委員会での薬剤師の活用に期待を示した。
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【介護支援専門員 NEWS】レセプト突合・縦覧点検「歴史的な転換点」- 支払基金・河内山理事長
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