drug Insurance pricing method, device and device and computer readable storage medium
A drug and pricing technology, applied in the field of data processing, can solve problems such as low data processing efficiency, low accuracy of insurance pricing results, and calculation errors
Inactive Publication Date: 2019-04-16
深圳平安医疗健康科技服务有限公司
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Problems solved by technology
However, the price of special-effect drugs is usually relatively expensive, and the price of drugs is generally around several thousand yuan or even tens of thousands of yuan, which has caused a serious economic burden to patients.
In order to reduce the economic burden of patients, the government and the Bureau of Human Resources and Social Security have proposed to include the medical expenses of some specific drugs into the scope of insurance reimbursement. However, how to determine the receivable premiums (that is, insurance pricing) of the insurance plan for specific drugs is currently mainly through Manual statistical sorting and calculation of various data materials, the process is more complicated, and the data processing efficiency is low. At the same time, due to human factors, calculation errors or mistakes will inevitably occur, which will lead to the accuracy of insurance pricing results. lower
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[0043] It should be understood that the specific embodiments described here are only used to explain the present invention, not to limit the present invention.
[0044] The drug insurance pricing method involved in the embodiment of the present invention is mainly applied to drug insurance pricing equipment, which may be PC (Personal Computer, personal computer), notebook computer, server and other equipment with display and processing functions.
[0045] refer to figure 1 , figure 1It is a schematic diagram of the hardware structure of the medical insurance pricing equipment involved in the embodiment of the present invention. In the embodiment of the present invention, the medical insurance pricing device may include: a processor 1001 , such as a CPU (Central Processing Unit, central processing unit), a communication bus 1002 , a user interface 1003 , a network interface 1004 , and a memory 1005 . Wherein, the communication bus 1002 is used to realize the connection and co...
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The invention provides a drug insurance pricing method based on big data, and the method comprises the steps: obtaining the drug information of a corresponding drug when receiving an insurance pricingrequest of the drug, and calculating the per capita cost of the drug; Obtaining a compensation rule of an insurance plan corresponding to the medicine, and calculating a predicted per capita compensation expense of the medicine according to the compensation rule of the insurance plan and the per capita expense of the medicine; Obtaining the utilization rate of the medicine, and calculating the risk insurance premium of the medicine according to the utilization rate of the medicine and the predicted per capita compensation cost; Obtaining operation parameters corresponding to the insurance plan, and calculating the insurance pricing of the drug according to the operation parameters and the risk insurance premium of the drug and a first preset calculation formula. The invention further provides a drug insurance pricing device and device and a computer readable storage medium. The insurance pricing of the medicine can be automatically calculated based on the medicine information, the compensation rule of the insurance plan and other information, the data processing efficiency can be improved, and meanwhile the accuracy of the insurance pricing result can be improved.
Description
technical field [0001] The present invention relates to the technical field of data processing, in particular to a drug insurance pricing method, device, equipment and computer-readable storage medium. Background technique [0002] With the advancement of science and technology and the improvement of the level of drug research and development, pharmaceutical companies have developed corresponding special drugs for diseases such as hepatitis, lung cancer, and leukemia. However, the price of special-effect drugs is usually relatively expensive, and the price of drugs is generally around several thousand yuan or even tens of thousands of yuan, which has caused a serious economic burden to patients. In order to reduce the economic burden of patients, the government and the Bureau of Human Resources and Social Security have proposed to include the medical expenses of some specific drugs into the scope of insurance reimbursement. However, how to determine the receivable premiums (...
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IPC IPC(8): G06Q30/02G06Q40/08
CPCG06Q30/0283G06Q40/08
Inventor 李云峰
Owner 深圳平安医疗健康科技服务有限公司