医保费用电子化审核系统设计

Design of Charges of Medical Insurance Electronic Audit System

目的:实现对医保收费项目进行电子化审核,方便北京医保住院病人结算。方法:开发医保费用电子化审核系统,实现对医保费用项目的电子化审核。结果:医疗保险办公室通过该系统进行费用审核,住院收费处从该系统中直接导出审核后的数据,并导入北京医疗保险系统医疗端子系统进行费用结算。结论:节省病人结算等候时间,提高住院收费处工作效率,减少出错与医保拒付,具有较强的现实意义。

Objective： To electronic audit charges of medical insurance, facilitate inpatient discharged settlement. Methods： Developed the charges of medical insurance electronic audit system, provide electronic audit function. Results： First, the development of medical insurance audits the charges to use the system. Then the development of inpatient cashier exports these audited data, and import to another system for settlement. Conclusion to ease the patient＇s waiting time of payment, improve the work efficiency of inpatient cashier, reduce the risk of missed payments, which has a strong practical significance.