On 01/14/98 02:28:05, [log in to unmask] wrote:
> I agree about the simple technology, here today. But I have a query
> or two
> * which Pharmacy does the e-script go to?
Any, all, a pick list. The idea is to *enable* the 3 parties (4, in
the case of card) to the transaction; presciber, dispenser and PPA (+
patient in the case of e-card)
Re: swipe cards:
> again agreed about the technology. But there are two sorts of fraud
> 1 false claims by patients that they are exempt from charges
Code from DSS/whoever when Practice downloads patient list, or code
obtained from an online source (notwithstanding security) of who is
exempt. This process, of course, can be automated and made totally
transparent to all parties. Goes like this:
Doctor e-writes script or swipes card, info goes to validation
database and back with nay or yae (this can happen at dispensing end,
btw). Neat.
> (the system outlined will trap most of that)
Should do.
> 2 false claims by colluding prescribers & pharmacists that
> prescriptions have been issued and fulfilled, with the subsequent
> payment split between the conspirators
> (the system outlined will not trap these; indeed it might even make
> it easier)
Not really. This type of fraud relies on the total ignorance of the
patient of the prescribed and not-dispensed script. Getting a large
number of patients to collude with that in order to make it work is
difficult.
The e-card involves the patient as she is the carrier of that card.
Nothing is dispensed or authorised for payment until patient presents
e-card at both ends.
So, this system would actually make a lot harder rather than easier.
> Note that my type 2 fraud here is an example of criminal activity by
> those working INSIDE the system. That sort is always harder to
> detect and prevent.
Unless you involve an outsider, in this case, the patient!
Ahmad
-----------------------------------------------------------------------------
Dr Ahmad Risk
http://www.cybermedic.org
Chairman British Healthcare Internet Association <http://www.bhia.org>
Director Internet Healthcare Coalition - USA <http://www.ihc.net>
Home: +44 1273 724866/748198
Work: +44(1737)240022 Fax: +44 1737 244660
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|