A voice input system and settlement method for outpatient settlement

By combining the related diagnosis and treatment items of disease type and historical diagnosis and treatment data, and combining voice data for screening and verification of settlement items, the problem of missed or wrong records during outpatient settlement is solved, and the accuracy and efficiency of settlement is improved.

CN119230072BActive Publication Date: 2025-04-08THE FIRST AFFILIATED HOSPITAL ZHEJIANG UNIV COLLEGE OF MEDICINE
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Patent Information

Application Number
CN202411746932.0
Authority / Receiving Office
CN · China
Patent Type
Patents(China)
Current Assignee / Owner
Filing Date
2024-12-02
Publication Date
2025-04-08
Estimated Expiration
2044-12-02

AI Technical Summary

Technical Problem

The prior art is prone to missed or misrepresented during outpatient settlement, resulting in missed or misreceived settlement results.

Method used

By determining the associated diagnosis and treatment items of the disease type, combining historical diagnosis and treatment data and voice data, the diagnosis and treatment items to be settled are determined, and secondary verification is carried out to ensure the accuracy of the settlement items.

Benefits of technology

It realizes effective screening and verification processing of verification items, improves the accuracy and efficiency of settlement processing, and avoids the occurrence of missed or misconsumed collections.

✦ Generated by Eureka AI based on patent content.

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Abstract

The present invention provides a voice entry system and a settlement method for outpatient settlement, which belongs to the technical field of settlement processing, and specifically includes: taking the to-be-settled medical treatment items as basic items, determining the settlement medical treatment items and to-be-verified items in the basic items according to the matching situation between the basic items and the voice data in the medical treatment process and in combination with the disease correlation coefficient, determining the types of the to-be-verified items and the settlement medical treatment items based on the historical medical treatment data of the to-be-verified items in the disease types, determining the secondary verification items in the to-be-verified items based on the types, manually verifying the secondary verification items to obtain the verified settlement items, obtaining the correlation between the verified settlement items in the historical medical treatment times, and determining whether the settlement processing can be performed in combination with the predicted processing time of the verified settlement items and the settlement medical treatment items, thereby avoiding the occurrence of missed detection or wrong detection.
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Description

Technical Field

[0001] The invention belongs to the technical field of settlement processing, and in particular relates to a voice input system and a settlement method for outpatient settlement. Background Art

[0002] In order to realize the settlement of outpatient expenses, the invention patent application CN202311414988.1 "Expense management method and system based on APG packaged payment document grouping" classifies and groups medical treatment items, packages and prices them, and performs outpatient settlement, which helps to achieve the control of medical expenses, the improvement of service quality, and the optimization of resource allocation. However, there are the following technical problems:

[0003] In the existing technical solutions, when treating a patient's wound, it is often necessary to first treat the patient's wound and then settle the medical expenses according to the diagnosis and treatment items. Therefore, it is inevitable that the diagnosis and treatment items that have already occurred will be forgotten, which may cause omissions or wrong collections in the settlement results.

[0004] In view of the above technical problems, the present invention provides a voice entry system and a settlement method for outpatient settlement. Summary of the invention

[0005] To achieve the purpose of the present invention, the present invention adopts the following technical solutions:

[0006] According to one aspect of the present invention, a voice entry system and a settlement method for outpatient settlement are provided.

[0007] A settlement method, comprising:

[0008] S1 determines the associated diagnosis and treatment items of a disease type, determines the disease association coefficients between different associated diagnosis and treatment items and the disease type according to the historical diagnosis and treatment data of the associated diagnosis and treatment items of the disease type, and determines the diagnosis and treatment items to be settled among the associated diagnosis and treatment items according to the disease association coefficients;

[0009] S2 takes the diagnosis and treatment items to be settled as the basic items, and determines the settlement diagnosis and treatment items and the items to be verified in the basic items according to the matching of the basic items with the voice data in the diagnosis and treatment process and the disease association coefficient;

[0010] S3 determines the types of the items to be verified and the settlement diagnosis and treatment items based on the historical diagnosis and treatment data of the disease type of the items to be verified, and determines the secondary verification items in the items to be verified based on the types;

[0011] S4 manually verifies the secondary verification items to obtain verification settlement items, obtains the correlation between the verification settlement items and the historical number of medical treatments, and determines whether settlement processing can be performed in combination with the predicted processing time of the verification settlement items and the settlement medical treatment items.

[0012] The beneficial effects of the present invention are:

[0013] The secondary verification items in the items to be verified are determined based on the types of the items to be verified and the settlement treatment items, thereby realizing the screening of the items to be verified that are exclusive of the settlement treatment items, and further realizing the screening of situations where the types of the items to be verified and the types of the settlement treatment items have the same function and are unlikely to appear at the same time, and further improving the verification processing efficiency of the secondary verification items.

[0014] Whether settlement processing can be carried out is determined based on the correlation between the verification and settlement items in the historical number of medical treatments and the predicted processing time between the verification and settlement items and the settlement medical treatment items. This takes into account the differences in the probabilities of different verification and settlement items appearing at the same time in the same historical number of medical treatments due to differences in their types, as well as the abnormal situations of verification and settlement items caused by the deviation between the predicted processing time and the current processing time of the verification and settlement items. This enables the identification and processing of abnormal settlement orders from multiple angles, thus avoiding the occurrence of missed or wrong collections.

[0015] A further technical solution is that the associated diagnosis and treatment items of the disease type are determined based on the diagnosis and treatment items of the disease type in the historical diagnosis and treatment process.

[0016] A further technical solution is that the historical diagnosis and treatment data includes diagnosis and treatment items of the disease type at different historical diagnosis and treatment times.

[0017] A further technical solution is that the method for determining the disease correlation coefficient between the associated diagnosis and treatment items and the disease type is:

[0018] Using the historical diagnosis and treatment data of the associated diagnosis and treatment item in the disease type, determine the number of historical diagnosis and treatment times that include the associated diagnosis and treatment item, and use it as the number of associated diagnosis and treatment times;

[0019] The disease correlation coefficient between the associated diagnosis and treatment items and the disease type is determined according to the proportion of the associated diagnosis and treatment times in the historical diagnosis and treatment times.

[0020] A further technical solution is that the medical treatment items to be settled are related medical treatment items whose disease correlation coefficient is greater than a preset correlation coefficient.

[0021] A further technical solution is to determine whether settlement processing can be performed, specifically including:

[0022] Based on the distribution data of the verification and settlement items in different historical diagnosis and treatment times, determine the historical diagnosis and treatment times that also have the verification and settlement items, and use them as the matching diagnosis and treatment times;

[0023] Determine the correlation coefficients between different verification and settlement items according to the proportion of the number of matched diagnosis and treatment times, and use the correlation coefficients to determine the correlation deviation items in the verification and settlement items;

[0024] The time deviation is determined based on the deviation between the predicted processing time of the verified settlement items and the settlement treatment items and the wound treatment time of the patient. The comprehensive deviation coefficient is determined by the proportion of the number of related deviation items and the time deviation. The comprehensive deviation coefficient is used to determine whether settlement processing can be carried out.

[0025] A further technical solution is to determine the comprehensive deviation coefficient by the quantity proportion and duration deviation amount in the associated deviation items, specifically including:

[0026] The product of the ratio of the duration deviation to the wound treatment duration and the number of the associated deviation items is taken as the comprehensive deviation coefficient.

[0027] In a second aspect, the present invention provides a voice entry system for outpatient settlement, which adopts the above-mentioned settlement method and specifically includes:

[0028] Module for determining projects to be settled, module for dividing projects, module for verifying project determination, and module for settlement processing;

[0029] The to-be-settled item determination module is responsible for determining the to-be-settled medical treatment items among the associated medical treatment items;

[0030] The project division module is responsible for determining the settlement diagnosis and treatment items and the items to be verified in the basic projects;

[0031] The verification item determination module is responsible for determining the secondary verification items among the items to be verified;

[0032] The settlement processing module is responsible for determining whether settlement processing can be performed.

[0033] Other features and advantages will be described in the following description. The objects and other advantages of the present invention are realized and obtained by the structures particularly pointed out in the description and drawings.

[0034] In order to make the above-mentioned objects, features and advantages of the present invention more obvious and easy to understand, preferred embodiments are given below and described in detail with reference to the accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS

[0035] The above and other features and advantages of the present invention will become more apparent by describing in detail exemplary embodiments thereof with reference to the attached drawings.

[0036] Figure 1 It is a flow chart of a settlement method;

[0037] Figure 2 is a flow chart of a method for determining a disease correlation coefficient of a related diagnosis and treatment item and the disease type;

[0038] Figure 3 It is a flow chart of the method for determining the identification reliability coefficient of the basic item;

[0039] Figure 4 is a flow chart of a method for determining whether settlement processing can be performed;

[0040] Figure 5 It is a framework diagram for the voice entry system for outpatient settlement. DETAILED DESCRIPTION

[0041] In order to enable those skilled in the art to better understand the technical solutions in this specification, the technical solutions in the embodiments of this specification will be clearly and completely described below in conjunction with the drawings in the embodiments of this specification. Obviously, the described embodiments are only part of the embodiments of this specification, not all of the embodiments. Based on the embodiments of this specification, all other embodiments obtained by ordinary technicians in this field without creative work should fall within the scope of protection of this specification.

[0042] In the existing technical solutions, when treating a patient's wound, it is often necessary to first treat the patient's wound and then settle the medical expenses according to the diagnosis and treatment items. Since the diagnosis and treatment items that have already occurred may be forgotten, omissions or wrong charges may occur.

[0043] Related diagnosis and treatment items: diagnosis and treatment items of the disease type in the historical diagnosis and treatment process;

[0044] Disease association coefficient: It is determined based on the proportion of diagnosis and treatment times of related diagnosis and treatment items. Specifically, when the proportion of diagnosis and treatment times is 0.8, the disease association coefficient is 0.8.

[0045] Medical treatment items to be settled: related medical treatment items with disease treatment coefficient greater than 0.7.

[0046] Settlement diagnosis and treatment items and items to be verified in basic items: The settlement diagnosis and treatment items and items to be verified in basic items are determined based on the matching of basic items with the voice data during the diagnosis and treatment process and the disease correlation coefficient;

[0047] Specifically, the ratio of the number of voice data matches to the preset number of times and the product of the disease association coefficient are used as the recognition reliability coefficient. The recognition reliability coefficient greater than 0.7 will be used as a settlement diagnosis and treatment item, and the recognition reliability coefficient not greater than 0.7 will be used as an item to be verified.

[0048] Secondary verification items among the items to be verified: Based on the types of the items to be verified and the settlement medical treatment items, determine whether there are settlement medical treatment items that are exclusive of the items to be verified. If so, determine that the items to be verified do not belong to secondary verification items; if not, determine that the items to be verified belong to secondary verification items.

[0049] Determine whether settlement processing can be carried out: use the distribution data of the verification and settlement items in different historical treatment times to determine the historical treatment times that also have the verification and settlement items, and use them as the matching treatment times, determine the correlation coefficients between different verification and settlement items according to the number ratio in the matching treatment times, use the correlation coefficients to determine the associated deviation items in the verification and settlement items, determine the time deviation amount by the deviation between the predicted processing time of the verification and settlement items and the wound treatment time of the patient, determine the comprehensive deviation coefficient by the number ratio of the associated deviation items and the time deviation amount, and use the comprehensive deviation coefficient to determine whether settlement processing can be carried out.

[0050] Embodiment 1 To solve the above problem, according to one aspect of the present invention, Figure 1 As shown, a settlement method is provided, which specifically includes:

[0051] S1 determines the associated diagnosis and treatment items of a disease type, determines the disease association coefficients between different associated diagnosis and treatment items and the disease type according to the historical diagnosis and treatment data of the associated diagnosis and treatment items of the disease type, and determines the diagnosis and treatment items to be settled among the associated diagnosis and treatment items according to the disease association coefficients;

[0052] S2 takes the diagnosis and treatment items to be settled as the basic items, and determines the settlement diagnosis and treatment items and the items to be verified in the basic items according to the matching of the basic items with the voice data in the diagnosis and treatment process and the disease association coefficient;

[0053] S3 determines the types of the items to be verified and the settlement diagnosis and treatment items based on the historical diagnosis and treatment data of the disease type of the items to be verified, and determines the secondary verification items in the items to be verified based on the types;

[0054] S4 manually verifies the secondary verification items to obtain verification settlement items, obtains the correlation between the verification settlement items and the historical number of medical treatments, and determines whether settlement processing can be performed in combination with the predicted processing time of the verification settlement items and the settlement medical treatment items.

[0055] Furthermore, the associated diagnosis and treatment items of the disease type are determined based on the diagnosis and treatment items of the disease type in the historical diagnosis and treatment process.

[0056] Specifically, the historical diagnosis and treatment data includes diagnosis and treatment items of the disease type at different historical diagnosis and treatment times.

[0057] It should be noted that if Figure 2 As shown, the method for determining the disease correlation coefficient between the associated diagnosis and treatment items and the disease type is:

[0058] Using the historical diagnosis and treatment data of the associated diagnosis and treatment item in the disease type, determine the number of historical diagnosis and treatment times that include the associated diagnosis and treatment item, and use it as the number of associated diagnosis and treatment times;

[0059] The disease correlation coefficient between the associated diagnosis and treatment items and the disease type is determined according to the proportion of the associated diagnosis and treatment times in the historical diagnosis and treatment times.

[0060] Furthermore, the medical treatment items to be settled are related medical treatment items whose disease correlation coefficient is greater than a preset correlation coefficient.

[0061] In another embodiment, the method for determining the disease correlation coefficient between the associated diagnosis and treatment items and the disease type is:

[0062] Based on the historical diagnosis and treatment data of the disease type, determine the number of historical diagnosis and treatment of the disease type; when the number of historical diagnosis and treatment of the disease type is less than the preset number of diagnosis and treatment, determine that the associated diagnosis and treatment items all belong to the diagnosis and treatment items to be settled, and use the historical diagnosis and treatment numbers of the associated diagnosis and treatment items to determine the disease association coefficients of different diagnosis and treatment items to be settled;

[0063] When the number of historical diagnosis and treatment of the disease type is not less than the preset number of diagnosis and treatment:

[0064] Based on the historical diagnosis and treatment data of the associated diagnosis and treatment item in the disease type, determine the number of historical diagnosis and treatments including the associated diagnosis and treatment item, and use it as the associated diagnosis and treatment number. When the associated diagnosis and treatment number is less than the preset diagnosis and treatment number, determine that the associated diagnosis and treatment item does not belong to the diagnosis and treatment items to be settled;

[0065] When the number of associated diagnosis and treatment is not less than the preset number of diagnosis and treatment:

[0066] The treatment frequency ratio of the associated treatment item is determined by the proportion of the associated treatment frequency in the historical treatment frequency. When the treatment frequency ratio is less than the preset ratio, it is determined that the associated treatment item does not belong to the treatment item to be settled.

[0067] When the ratio of the number of treatments is less than the preset ratio:

[0068] Determine the interval correlation coefficients of different divided time periods according to the proportion of the number of associated diagnosis and treatment in different divided time periods to the number of historical diagnosis and treatment and the number of associated treatments; when the interval correlation coefficients in the divided time periods do not meet the requirements, determine that the associated diagnosis and treatment items do not belong to the diagnosis and treatment items to be settled;

[0069] When the interval correlation coefficient within the divided time period meets the requirement, the disease correlation coefficient between the associated diagnosis and treatment item and the disease type is determined by using the interval correlation coefficients within different divided time periods.

[0070] Specifically, Figure 3 As shown, the method for determining the identification reliability coefficient of the basic project is:

[0071] Determine the similarity between the voice data in the diagnosis and treatment process and the basic items based on the matching of the voice data in the diagnosis and treatment process, and determine the number of matches in the voice data based on the similarity;

[0072] A matching coefficient of the basic item is determined based on the number of matches, and an identification reliability coefficient of the basic item is determined by the matching coefficient and a disease association coefficient.

[0073] Furthermore, the matching coefficient is determined by multiplying the number of matches by a preset proportional factor.

[0074] It should be noted that the identification reliability coefficient of the basic items is determined according to the average value of the matching coefficient and the disease association coefficient.

[0075] Optionally, the method for determining the identification reliability coefficient of the basic item is:

[0076] Determine the similarity between the voice data in the diagnosis and treatment process and the basic items based on the matching of the voice data in the diagnosis and treatment process, and determine the number of matches in the voice data based on the similarity;

[0077] Determine similarity coefficients of different matching times according to similar situations of different matching times, and determine the matching coefficient of the basic item according to the weights of the similarity coefficients of different matching times;

[0078] The identification reliability coefficient of the basic item is determined by the matching coefficient and the disease association coefficient.

[0079] Furthermore, the similarity coefficient is determined according to the similarity between the speech data and the basic item.

[0080] Optionally, the method for determining the identification reliability coefficient of the basic item is:

[0081] S21 determines the similarity between the voice data in the diagnosis and treatment process and the basic project based on the matching of the voice data in the diagnosis and treatment process, and determines the number of matches in the voice data based on the similarity;

[0082] Optionally, the above step S21 includes the following contents:

[0083] S211: When the disease correlation coefficient of the basic item is within the preset correlation coefficient interval, the process proceeds to step S212; when the disease correlation coefficient of the basic item is not within the preset correlation coefficient interval, the process proceeds to step S213;

[0084] S212 determines the similarity between the voice data in the diagnosis and treatment process and the basic item based on the matching of the voice data of the basic item in the diagnosis and treatment process. When it is determined by the similarity that there is no similar voice data in the voice data, it is determined that the diagnosis and treatment item belongs to the item to be verified. When it is determined by the similarity that there is similar voice data in the voice data, the process proceeds to step S213.

[0085] S213 uses the similar voice data to determine the number of matches in the voice data. When the number of matches is greater than the preset number of matches, it is determined that the medical treatment item belongs to a settlement medical treatment item. When the number of matches is not greater than the preset number of matches, it proceeds to step S22.

[0086] S22: determining the credibility coefficients of different matching times according to the semantic analysis results of the speech data corresponding to different matching times, and determining the matching coefficient of the basic item in combination with the similarity coefficients of different matching times;

[0087] Optionally, the above step S22 includes the following contents:

[0088] S221 determines the credibility coefficients of different matching times according to the semantic analysis results of the voice data corresponding to different matching times. When there is no matching time with a credibility coefficient that meets the requirement, it is determined that the medical treatment item does not belong to the settlement medical treatment item. When there is a matching time with a credibility coefficient that meets the requirement, it proceeds to step S222;

[0089] S222: When it is determined that there is no matching number with a similarity coefficient that meets the requirement by using the similarity coefficients of different matching times, it is determined that the medical treatment item does not belong to the settlement medical treatment item. When there is a matching number with a similarity coefficient that meets the requirement, the process proceeds to step S223;

[0090] S223 determines the comprehensive credibility coefficients of different matching times by using the credibility coefficients and similarity coefficients of different matching times. When there is no matching number with the comprehensive credibility coefficient meeting the requirement, it is determined that the medical treatment item does not belong to the settlement medical treatment item. When there is a matching number with the comprehensive credibility coefficient meeting the requirement, the process proceeds to step S224.

[0091] S224: The number of matches for which the comprehensive credibility coefficient is greater than the preset coefficient threshold is taken as the number of matches that are credibility. When the number of matches that are credibility is greater than the preset credibility threshold, it is determined that the medical treatment item belongs to the settlement medical treatment item. When the number of matches that are credibility is not greater than the preset credibility threshold, the process proceeds to step S225.

[0092] S225 determines the matching coefficient of the basic item according to the comprehensive credibility coefficient of different matching times. When the matching coefficient of the basic item is greater than the preset matching coefficient threshold, it is determined that the medical treatment item belongs to the settlement medical treatment item. When the matching coefficient of the basic item is not greater than the preset matching coefficient threshold, proceed to step S23.

[0093] S23 determines the identification reliability coefficient of the basic item through the matching coefficient and the disease association coefficient.

[0094] Furthermore, when the identification reliability coefficient of the basic item meets the requirements, the basic item is determined to be a settlement and treatment item; when the identification reliability coefficient of the basic item does not meet the requirements, the basic item is determined to be an item to be verified.

[0095] Specifically, the method for determining the secondary verification items among the items to be verified is:

[0096] Based on the types of the items to be verified and the settlement medical treatment items, determine whether there are settlement medical treatment items that are exclusive of the items to be verified. If so, determine that the items to be verified do not belong to the secondary verification items. If not, determine that the items to be verified belong to the secondary verification items.

[0097] Specifically, Figure 4 As shown, determine whether settlement processing can be performed, including:

[0098] Based on the distribution data of the verification and settlement items in different historical diagnosis and treatment times, determine the historical diagnosis and treatment times that also have the verification and settlement items, and use them as the matching diagnosis and treatment times;

[0099] Determine the correlation coefficients between different verification and settlement items according to the proportion of the number of matched diagnosis and treatment times, and use the correlation coefficients to determine the correlation deviation items in the verification and settlement items;

[0100] The time deviation is determined based on the deviation between the predicted processing time of the verified settlement items and the settlement treatment items and the wound treatment time of the patient. The comprehensive deviation coefficient is determined by the proportion of the number of related deviation items and the time deviation. The comprehensive deviation coefficient is used to determine whether settlement processing can be carried out.

[0101] Furthermore, the comprehensive deviation coefficient is determined by the quantity ratio and duration deviation of the associated deviation items, specifically including:

[0102] The product of the ratio of the duration deviation to the wound treatment duration and the number of the associated deviation items is taken as the comprehensive deviation coefficient.

[0103] It should be noted that when the comprehensive deviation coefficient does not meet the requirements, it is determined that settlement processing cannot be performed.

[0104] Embodiment 2 In the second aspect, as Figure 5 As shown, the present invention provides a voice input system for outpatient settlement, which adopts the above settlement method and specifically includes:

[0105] Module for determining projects to be settled, module for dividing projects, module for verifying project determination, and module for settlement processing;

[0106] The to-be-settled item determination module is responsible for determining the to-be-settled medical treatment items among the associated medical treatment items;

[0107] The project division module is responsible for determining the settlement diagnosis and treatment items and the items to be verified in the basic projects;

[0108] The verification item determination module is responsible for determining the secondary verification items among the items to be verified;

[0109] The settlement processing module is responsible for determining whether settlement processing can be performed.

[0110] Optionally, determining whether settlement processing can be performed includes:

[0111] When it is determined that there is no historical diagnosis and treatment number that has the verification and settlement item at the same time based on the distribution data of the verification and settlement item in different historical diagnosis and treatment times, it is determined that the settlement process cannot be performed;

[0112] When there are historical medical consultations with the above verification and settlement items:

[0113] The number of historical medical consultations and treatments that have the verification and settlement items at the same time is used as the matching medical consultations and treatments, and the correlation coefficients between different verification and settlement items are determined according to the proportion of the number of matching medical consultations and treatments. When the average value of the correlation coefficients between different verification and settlement items does not meet the requirements, it is determined that settlement processing cannot be performed;

[0114] When the average value of the correlation coefficients between different verification and settlement items meets the requirements:

[0115] Determine the associated deviation items in the verified settlement items by using the associated coefficient, and when the number of associated deviation items does not meet the requirement, determine that settlement processing cannot be performed;

[0116] When the number of associated deviation items meets the requirement, the associated deviation coefficient is determined by the associated coefficients of different associated deviation items, and when the associated deviation coefficient does not meet the requirement, it is determined that the settlement process cannot be performed;

[0117] When the correlation deviation coefficient meets the requirement: the time deviation is determined based on the deviation between the predicted processing time of the verification settlement item and the settlement diagnosis and treatment item and the wound treatment time of the patient; when the time deviation does not meet the requirement, it is determined that the settlement process cannot be performed;

[0118] When the duration deviation meets the requirement:

[0119] The comprehensive deviation coefficient is determined by the quantity ratio of the associated deviation items and the duration deviation, and the comprehensive deviation coefficient is used to determine whether settlement processing can be performed.

[0120] Each embodiment in this specification is described in a progressive manner, and the same or similar parts between the embodiments can be referred to each other, and each embodiment focuses on the differences from other embodiments. In particular, for the device, equipment, and non-volatile computer storage medium embodiments, since they are basically similar to the method embodiments, the description is relatively simple, and the relevant parts can be referred to the partial description of the method embodiment.

[0121] The above is a description of a specific embodiment of the specification. Other embodiments are within the scope of the appended claims. In some cases, the actions or steps recorded in the claims can be performed in an order different from that in the embodiments and still achieve the desired results. In addition, the processes depicted in the drawings do not necessarily require the specific order or continuous order shown to achieve the desired results. In some embodiments, multitasking and parallel processing are also possible or may be advantageous.

[0122] The above description is only one or more embodiments of this specification and is not intended to limit this specification. For those skilled in the art, one or more embodiments of this specification may have various changes and variations. Any modification, equivalent replacement, improvement, etc. made within the spirit and principle of one or more embodiments of this specification shall be included in the scope of the claims of this specification.

Claims

1. A settlement method, characterized in that: Specifically include: Determine the associated diagnosis and treatment items of the disease type, determine the disease correlation coefficients between different associated diagnosis and treatment items and the disease type based on the historical diagnosis and treatment data of the associated diagnosis and treatment items of the disease type, and determine the diagnosis and treatment items to be settled in the associated diagnosis and treatment items based on the disease correlation coefficients; The to-be-settled diagnosis and treatment items are taken as the basic items, and the settlement diagnosis and treatment items and the to-be-verified items in the basic items are determined based on the matching of the basic items with the voice data during the diagnosis and treatment process and in combination with the disease association coefficient; Based on the historical diagnosis and treatment data of the item to be verified for the disease type, determine the types of the item to be verified and the settlement diagnosis and treatment items, and determine the secondary verification items in the item to be verified based on the types; Manually verify the secondary verification items to obtain verification settlement items, obtain the correlation between the verification settlement items and the number of historical diagnosis and treatment times, and determine whether settlement processing can be performed in combination with the predicted processing time of the verification settlement items and the settlement diagnosis and treatment items; The method for determining the secondary verification items in the items to be verified is: Based on the types of the items to be verified and the settlement medical treatment items, determine whether there are settlement medical treatment items that are exclusive of the items to be verified. If so, determine that the items to be verified do not belong to the secondary verification items. If not, determine that the items to be verified belong to the secondary verification items.

2. The settlement method according to claim 1, characterized in that: The associated diagnosis and treatment items of the disease type are determined based on the diagnosis and treatment items of the disease type in the historical diagnosis and treatment process.

3. The settlement method according to claim 1, characterized in that: The historical diagnosis and treatment data includes diagnosis and treatment items of the disease type at different historical diagnosis and treatment times.

4. The settlement method according to claim 1, characterized in that: The method for determining the disease correlation coefficient between the associated diagnosis and treatment items and the disease type is: Using the historical diagnosis and treatment data of the associated diagnosis and treatment item in the disease type, determine the number of historical diagnosis and treatment times that include the associated diagnosis and treatment item, and use it as the number of associated diagnosis and treatment times; The disease correlation coefficient between the associated diagnosis and treatment items and the disease type is determined according to the proportion of the associated diagnosis and treatment times in the historical diagnosis and treatment times.

5. The settlement method according to claim 4, characterized in that: The medical treatment items to be settled are related medical treatment items whose disease correlation coefficient is greater than the preset correlation coefficient.

6. The settlement method according to claim 1, characterized in that: The method for determining the settlement diagnosis and treatment items and the items to be verified in the basic items is as follows: Determine the similarity between the voice data in the diagnosis and treatment process and the basic items based on the matching of the voice data in the diagnosis and treatment process, and determine the number of matches in the voice data based on the similarity; Determine the matching coefficient of the basic item based on the matching number, and determine the identification reliability coefficient of the basic item through the matching coefficient and the disease association coefficient; When the identification reliability coefficient of the basic item meets the requirements, the basic item is determined to be a settlement diagnosis and treatment item. When the identification reliability coefficient of the basic item does not meet the requirements, the basic item is determined to be an item to be verified.

7. The settlement method according to claim 6, characterized in that: The matching coefficient is determined by multiplying the number of matches by a preset proportional factor.

8. The settlement method according to claim 6, characterized in that: The identification reliability coefficient of the basic item is determined according to the average value of the matching coefficient and the disease association coefficient.

9. A voice entry system for outpatient settlement, using a settlement method according to any one of claims 1 to 8, characterized in that: Specifically include: Module for determining projects to be settled, module for dividing projects, module for verifying project determination, and module for settlement processing; The to-be-settled item determination module is responsible for determining the to-be-settled medical treatment items among the associated medical treatment items; The project division module is responsible for determining the settlement diagnosis and treatment items and the items to be verified in the basic projects; The verification item determination module is responsible for determining the secondary verification items among the items to be verified; The settlement processing module is responsible for determining whether settlement processing can be performed.

Citation Information

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