Medical insurance in-hospital supervisory system

Abstract

The invention belongs to the technical field of medical insurance supervisory, and particularly relates to a medical insurance in-hospital supervisory system. The medical insurance in-hospital supervisory system is composed of a supervisory center platform, a hospital terminal application platform and in-hospital patient individual terminals. The supervisory center platform is a data and service center of the whole system, the hospital terminal application platform is arranged at a medical insurance appointed hospital, and the in-hospital patient individual terminals are wearable devices and are worn by in-hospital patients, so that the formed medical insurance in-hospital supervisory system is connected through the internet, and data and information are transmitted in real time. The medical insurance in-hospital supervisory system can perform real-time supervision on appointed hospital and patient in-hospital illegal behaviors, the problems that some appointed hospitals receive and cure insured patients illegal, the in-hospital patient number or frequency is increased virtually, and medical insurance pooling funds are extracted are solved, and the medical insurance pooling funds are prevented from being lost.

Description

technical field [0001] The invention belongs to the technical field of medical insurance supervision, and particularly relates to a medical insurance hospitalization supervision system, which can supervise medical insurance patients and hospitalization violations in designated hospitals. Background technique [0002] At present, most of the settlement of basic medical insurance hospitalization expenses in my country's medical insurance pooling areas adopts the fixed amount settlement model under the constraint of the total amount, that is, the medical insurance institutions calculate the inpatient expenses of designated hospitals in a per capita quota way according to the number of inpatients admitted to designated hospitals. settlement. Therefore, effective supervision of the number and frequency of inpatients admitted to designated hospitals and ensuring the standardized use of medical insurance pooling funds is an important part of the supervision of medical insurance pool...

AI Technical Summary

Problems solved by technology

[0003] During the supervision process of the medical insurance pooling fund, due to the lack of personnel in the supervision agency, the large number of supervision objects, and the difficulty of on-site inspections, some designated hospitals have experienced false hospitalizations or hang-ups. The number of times, the problem of arbitrarily obtaining fixed settlement funds caused the loss of medical insurance pooling funds

[0004] At present, medical insurance regulatory agencies mainly rely on traditional methods such as surprise inspections and on-site inspections. A few regions even invest a lot of money in installing video surveillance and fingerprint sign-in equipment for designated hospitals. To a certain extent, supervision has been strengthened, but none of them can Fundamentally solve the problem, but also greatly increase the expenditure of capital and labor costs

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