基于财经平台医疗保险账目核对系统的设计与实现

Design and Implementation of the Medical Insurance Reconciliation Subsystem Based on Financial and Economic Platform

目的:从医院医疗保险账目核对工作出发,研究医院医疗保险账目核对系统的规范化和流程化,将传统的手工账目核对信息化,对优化医院资金的使用流程具有重要的作用。方法:对接医院HIS、HRP系统现有数据,通过数据自动提取与回款数据的审核录入,实现医院医疗保险数据账目核对的智能化、自动化。结果及结论:医疗保险账目核对子系统的设计与实现将改变组织模式和管理机制等要素的制约现状,最大限度地发挥医疗保险风险管理及医疗保险账目核对的价值。

Objective:Starting from the actual work of hospital medical insurance reconciliation,researching on standardization and process of hospital medical insurance reconciliation subsystem,and the traditional manual reconciliation information,which plays an important role in optimizing the use process of hospital funds.Methods:Docking the existing data of HIS and HRP system in hospital,automatically extracting data and checking and inputting the data of reimbursement,the intelligent and automatic checking of medical insurance data in hospital was realized.Results and Conclusion:The design and implementation of medical insurance reconciliation subsystem will change the constraints of organizational model and management mechanism,and maximize the value of medical insurance risk management and medical insurance reconciliation.