IBM Japan Health Insurance Association

IBM Japan Health Insurance Association

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Pharmacy information

With the implementation of a system of direct examination and payment of detailed prescription statements, the Society Committee approved changes in rules governing the addition of pharmacies. With the approval of the Ministry of Health, Labour and Welfare, this system went into force with prescriptions dispensed in June 2010 at participating pharmacies across Japan. Previously, increases in, decreases to, or changes in these pharmacies had required application to and approval of the Ministry of Health, Labour and Welfare. Now, the only requirement is that pharmacies must be listed on the health insurance society’s website.

The system of direct examination and payment of detailed prescription statements

Until now, when insured persons or dependents had prescriptions filled at pharmacies other than those affiliated with hospitals, the pharmacies had to request the payment of prescription costs from the health insurance society through Health Insurance Claims Review & Reimbursement Services. Using this system of direct examination and payment of detailed prescription statements, pharmacies can now request payment directly from the health insurance society, with the society directly assessing the details of payment requests and making payments accordingly.
While this has not changed the amounts paid by insured persons or dependents at pharmacies or the nature of the prescriptions, it helps reduce costs to the health insurance society by reducing the processing fees paid to Health Insurance Claims Review & Reimbursement Services.

The Society will continue to work to increase cost savings by increasing the number of participating pharmacies.

The attached document lists pharmacies participating in the Society’s system of direct examination and payment of detailed prescription statements. The list posted to the Society’s website will be updated to reflect changes in the participating pharmacies.

Note: Detailed prescription statements are invoices issued by pharmacies to the health insurance society.

Most participating pharmacies post the following logo in their stores:

Pharmacies participating in the system of direct examination and payment of detailed prescription statements

See here.

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