Medical insurance supervision method, equipment and device and computer readable storage medium

A technology for medical insurance and preset words, applied in the medical insurance field, can solve the problems of regulatory loopholes, low accuracy, and difficulty in rehabilitation projects.

Pending Publication Date: 2019-04-19
PING AN MEDICAL & HEALTHCARE MANAGEMENT CO LTD
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  • Abstract
  • Description
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Problems solved by technology

[0004] The main purpose of the present invention is to provide a medical insurance supervision method, which aims to solve the technical problems of the above-mentioned medical insurance supervision and rehabilitation items, such as high difficulty, low accuracy, and easy supervision loopholes, so as to reduce the difficulty of supervision of rehabilitation projects in medical insurance and improve medical insurance supervision accuracy and rigor

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  • Medical insurance supervision method, equipment and device and computer readable storage medium
  • Medical insurance supervision method, equipment and device and computer readable storage medium
  • Medical insurance supervision method, equipment and device and computer readable storage medium

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Embodiment Construction

[0050] It should be understood that the specific embodiments described here are only used to explain the present invention, not to limit the present invention.

[0051] The main solution of the embodiment of the present invention is: based on the preset model, analyze the content related to the rehabilitation project in the insured person's medical treatment data, and extract the suspected abnormal cases.

[0052]Due to the fact that medical insurance supervision is usually implemented manually in the existing technology, the supervision is difficult and requires a large number of professional human resources, and the accuracy of manual supervision is low, and it is easy to produce regulatory loopholes.

[0053] The present invention provides a solution. Based on the preset model, the contents related to the rehabilitation items in the insured's medical treatment data are analyzed, and the suspected abnormal cases are extracted, so as to realize the automatic supervision of the...

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Abstract

The invention discloses a medical insurance supervision method. The medical insurance supervision method is realized based on an intelligent decision. The medical insurance supervision method comprises the following steps: obtaining treatment data of an insured person; Extracting a preset field corresponding to a rehabilitation project in the treatment data; Analyzing the preset field based on a preset model to obtain an analysis result, and extracting suspected abnormal cases according to the analysis result. The invention further discloses medical insurance supervision equipment, a medical insurance supervision device and a computer readable storage medium. According to the technical scheme, the supervision difficulty of rehabilitation projects in medical insurance can be reduced, and the accuracy and the tightness of medical insurance supervision are improved.

Description

technical field [0001] The present invention relates to the technical field of medical insurance, in particular to a medical insurance supervision method, equipment, device and computer-readable storage medium. Background technique [0002] With the development of social economy, the national medical insurance policy is gradually optimized, including covering some rehabilitation projects. However, how to conduct accurate and efficient supervision of medical insurance costs, avoid unreasonable expenditures on rehabilitation projects, reduce the waste of medical insurance pooling funds, and how to avoid including false or self-funded rehabilitation projects in the name of rehabilitation projects covered by medical insurance Among the medical insurance expenses, the illegal collection of medical insurance expenses has always been an urgent problem to be solved. Different from treatment programs for common diseases, rehabilitation programs have the characteristics of many times...

Claims

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Application Information

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IPC IPC(8): G06Q40/08
CPCG06Q40/08
Inventor 陈明东黄越胥畅
Owner PING AN MEDICAL & HEALTHCARE MANAGEMENT CO LTD
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