智能化医疗保险自动计价系统的应用

Application of Intellectualized Automatic Pricing System of Medical Insurance

目的:为提高医院医疗保险的审核效率,对医保的自动计价系统进行了深入研究和改造升级。方法:对原医保后台计价监管程序进行重新设计,完善每日医保费用的实报实销,实现特殊费用的自动计价,建立维护日志和字典等功能。结果:满足了医疗保险的政策需求,建立了新的医保智能审核监管系统,提高了医疗保险计价的工作效率。结论:通过分析后台划价系统的实际需求,对医院的后台划价系统实施相应的调整和升级,实现了医疗保险计价流程的全方位监控。

Objective： To improve the efficiency of hospital medical insurance audit, this paper has conducted the research and upgrade of the automatic price system of medical insurance. Methods： The background of the original medicare regulatory programs were modified, health care costs was perfected, achieve accountable special charges and the establishment of automatic meter maintenance log and dictionary lamp function. Results： To meet the medical insurance policy needs, a new health insurance intelligent audit supervision system was established, improving the efficiency of medical insurance pricing. Conclusion： Through the analysis of the actual needs of the background the price system, it is realized the implementation of the adjustment and upgrading of the corresponding price system on the background of the hospital and achieved a comprehensive monitoring of medical insurance pricing process.