Hospitalization expense medical insurance expenditure checking system and method

Abstract

The invention provides a hospitalization expense medical insurance expenditure checking system and method. The hospitalization expense medical insurance expenditure checking method comprises the following steps: obtaining medicine actual purchase-sale-stock information of a to-be-audited hospital, electronic medical record information of hospitalization people and use record information of diagnosis and treatment equipment in an audit time period, analyzing the electronic medical record information of the hospitalization people; according to the electronic medical record information, carryingout statistics on medicine use information and inspection item information of the hospitalization hospital in the audit time period, and determining whether the medical insurance expenditure of the hospital is reasonable or not by checking whether the medicine use information of the hospital to be audited is consistent with the actual medicine purchase-sale-stock information and whether the inspection item information is consistent with the use record information of the diagnosis and treatment equipment or not in the auditing time period. By implementing the invention, whether the expenditureof the traditional Chinese medicine insurance of the hospitalization cost is reasonable can be automatically checked.

Description

technical field [0001] The invention relates to the technical field of medical informatization, in particular to a system and method for calculating hospitalization expenses and medical insurance expenditures. Background technique [0002] In recent years, with the country's continuous investment in basic medical insurance, the total amount of medical insurance funds has become larger and larger. How to manage and use the medical insurance funds is related to the normal operation of the entire basic medical insurance system and the vital interests of the insured. However, the existing medical insurance audit system has a technical defect that it cannot automatically audit the actual expenditure of medical insurance. Driven by economic interests, there are situations where people use various methods to defraud medical insurance cash, which violates the interests of all insured persons. [0003] Therefore, it is of great significance for the construction of medical information...

AI Technical Summary

Problems solved by technology

[0004] The main purpose of the present invention is to provide a hospitalization expense medical insurance accounting system and method that avoids false hospitalization to obtain medical insurance, and aims to solve the technical problem that the existing medical insurance audit system cannot automatically calculate the actual expenditure of part of the medical insurance for hospitalization

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