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Medical expense abnormity monitoring method, monitoring server and storage medium

An abnormal and cost-effective technology, applied in the direction of medical care resources or facilities, special data processing applications, instruments, etc., can solve problems such as heavy workload, low accuracy, and huge medical data, so as to maintain interests and improve comparison accuracy rate effect

Pending Publication Date: 2019-04-12
PING AN MEDICAL & HEALTHCARE MANAGEMENT CO LTD
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  • Abstract
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  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0003] The main purpose of the present invention is to provide a monitoring method for abnormal medical expenses, a monitoring server and a computer-readable storage medium, aiming at solving the problem of analyzing and identifying the charging behavior of medical institutions exceeding the maximum price due to the huge medical data of each medical institution Technical problems with large volume and low accuracy

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  • Medical expense abnormity monitoring method, monitoring server and storage medium
  • Medical expense abnormity monitoring method, monitoring server and storage medium
  • Medical expense abnormity monitoring method, monitoring server and storage medium

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Embodiment Construction

[0052] It should be understood that the specific embodiments described here are only used to explain the present invention, not to limit the present invention.

[0053] Please refer to figure 1 , figure 1It is a schematic diagram of the hardware structure of the monitoring server 100 in various embodiments of the present invention. The monitoring server 100 can be a server connected to the terminal for reimbursement of medical expenses by the insured person or a medical institution, or it can be connected to the server and the terminal that handles medical expenses reimbursement. A monitoring service platform dedicated to data monitoring that is connected to the terminal communication of medical expense reimbursement. The monitoring server 100 provided by the present invention includes components such as a communication module 10 , a memory 20 and a processor 30 . Wherein, the processor 30 is respectively connected to the memory 20 and the communication module 10 , the memor...

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Abstract

The invention discloses a medical expense abnormity monitoring method, a monitoring server and a storage medium, the method comprises the following steps: receiving medical data sent by a medical institution server, the medical data comprising a medical institution identifier, a medical project code and an actual unit price corresponding to the medical project code; Matching the medical project code with a standard project code of a preset highest price limit table, wherein the preset highest price limit table comprises a plurality of standard project codes and limiting unit prices corresponding to the standard project codes respectively; if the medical project code is matched with the standard project code, determining a limit unit price corresponding to the standard project code matchedwith the medical project code according to the preset highest limit price table; Judging whether the actual unit price is greater than the limited unit price; and if the actual unit price is greater than the limited unit price, setting an abnormal mark and associating the abnormal mark with the medical institution identifier. Based on the neural network, the ultra-highest limit price charging behavior of the medical institution can be conveniently and quickly identified.

Description

technical field [0001] The invention relates to the technical field of medical behavior monitoring, in particular to a monitoring method for abnormal medical expenses, a monitoring server and a computer-readable storage medium. Background technique [0002] In order to obtain more medical expenses, the actual charges of medical institutions for drugs, diagnosis and treatment items, equipment, inspection and testing items exceed the maximum price set by the price department. In the existing technology, the staff of the relevant management departments need to check the medical data of each medical institution to analyze and identify the behavior of the medical institution's charging beyond the maximum price limit. This not only consumes a lot of manpower, but also has low accuracy and is likely to lead to malicious The identification of medical institutions is not comprehensive. Contents of the invention [0003] The main purpose of the present invention is to provide a met...

Claims

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Application Information

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IPC IPC(8): G16H40/20G06F16/2455
CPCG16H40/20
Inventor 陈明东黄越胥畅
Owner PING AN MEDICAL & HEALTHCARE MANAGEMENT CO LTD
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