Medical insurance reimbursement system and reimbursement method

Abstract

The invention relates to the technical field of data processing, in particular to a medical insurance reimbursement system and reimbursement method. The medical insurance reimbursement system comprises a verification module and a modulation module, medicinal material information is verified through the verification module, and whether medicinal materials are uploaded to the medical insurance reimbursement system for reimbursement for the first time or not is judged; and the identity of the user and the medicinal material information are matched through input parameters, so that accurate reimbursement of medical insurance is realized, and reimbursed medicines are prevented from flowing back to the market.

Description

Technical Field

[0001] This invention relates to the fields of data processing and analysis technology, and in particular to medical insurance reimbursement systems and methods. Background Technology

[0002] With the increase in medical insurance reimbursement rates, many middlemen are using people's medical insurance accounts to purchase high-priced drugs at low prices at pharmacy A (hospital), and then resell them to pharmacy B (hospital) at normal prices, thereby earning huge profits.

[0003] The common solution currently is to prevent this from happening through a traceability system. However, existing traceability systems rely on data uploaded by the dispensing pharmacy to track medicinal materials. During peak periods when patients are seeking medical treatment, this undoubtedly puts even greater pressure on already overburdened pharmacies and is also detrimental to hospitals in treating patients.

[0004] If patients were to scan a code and upload the information themselves for reimbursement, the actual reimbursement process would be complex and difficult to implement due to varying reimbursement rates for different medications among different patients.

[0005] For example, for patients with chronic disease A who need long-term medication, the reimbursement rates for specific medications A1 and A2 are relatively high, while the reimbursement rates for other medications are lower. Since patients themselves are not experts in this area, it is quite difficult for them to upload their medical insurance reimbursement information. Summary of the Invention

[0006] The present invention aims to solve the following problems: ① the problem of medical insurance drugs flowing back into the market and depleting the medical insurance fund; ② the problem of different reimbursement ratios for different drugs for different patients.

[0007] To address the aforementioned issues, and to avoid placing excessive pressure on prescription dispensers while improving the patient experience, this invention specifically employs the following technical means:

[0008] A medical insurance reimbursement system includes two verification modules and one modulation module:

[0009] Among them, the medicinal material traceability code is a unique code corresponding to the medicinal material, which is uploaded to the medical insurance reimbursement system during the reimbursement process; the medical insurance reimbursement system stores the medicinal material status attribute code corresponding to the medicinal material, and the field length of the medicinal material status attribute code is such that it can represent at least two status values; the medical insurance reimbursement system includes two verification modules and a modulation module:

[0010] The first verification module verifies the user's identity and prescription drug information. After verification, it determines whether the prescription contains reimbursable drugs based on the verification results.

[0011] The second verification module verifies the medicinal material information and determines whether the medicinal material corresponding to the traceability code meets the reimbursement conditions. The second verification module queries the medicinal material data according to the traceability code and reads the medicinal material status attribute code corresponding to the traceability code after the query is completed.

[0012] Modulation module: Determines the reimbursement ratio based on the data uploaded to the medical insurance reimbursement system.

[0013] It is worth noting that the first verification module is not a necessary module. Attached Figure Description

[0014] Figure 1 Flowchart corresponding to Example 1

[0015] Figure 2 Flowchart corresponding to Example 2

[0016] Figure 3 Flowchart corresponding to Example 3 Detailed Implementation

[0017] To more conveniently illustrate the objectives, technical solutions, and advantages of the present invention, the technical solutions of the present invention will be clearly and completely described below in conjunction with the embodiments and accompanying drawings. Obviously, the described embodiments are only some, not all, of the embodiments of the present invention. All other embodiments obtained by those skilled in the art based on the embodiments of the present invention without creative effort are within the scope of protection of the present invention.

[0018] It should be noted that the definitions in this application are only for explaining the present invention and should not be construed as limiting the present invention. Data processing procedures obtained by simple modifications, alterations and combinations based on specific embodiments should be understood as not exceeding the protection scope of the present invention, and the present invention also intends to include these modifications and alterations.

[0019] Furthermore, the term "inclusion" includes equality, such as A being included in AB, and A being included in A.

[0020] First, medical institutions (including hospitals, clinics, and pharmacies) enter the traceability code (TC-C) for the entire package of medicinal materials. The traceability code for the sub-package is TC-D, the drug traceability code is the unique code corresponding to the medicinal material (TC-D1), and the medicinal material status attribute code TC-Ds is stored in the medical insurance server.

[0021] The length of the medicinal herb status attribute encoding field is greater than or equal to one bit, so that it can represent at least two status values.

[0022] Based on the different acquisition time points of the medicinal herb state attribute codes (TC-Ds), the following TC-Ds codes are defined: First medicinal herb state attribute code TC-Ds1, Second medicinal herb state attribute code TC-Ds2, Third medicinal herb state attribute code TC-Ds3, etc.

[0023] The first medicinal material status attribute code has the same meaning as the original medicinal material status attribute code.

[0024] Wherein, I represents the suppressed state of the medicinal material's status attribute encoding; II represents the inactive state; and III represents the active state. Preferably, to reduce server storage pressure, II and III can share the same status identifier.

[0025] Prescription information includes, but is not limited to, at least one of the following: patient identification attribute code (ID-A, such as: 1 for continued medication for chronic diseases; 2 for urban employees; 3 for cooperative medical care, etc.), drug category code (such as the code for Class A drugs, Class B drugs, or the reimbursement identifier for the corresponding Class A, Class B, Class C, etc. of the drug), prescription date, medical institution code, medical insurance physician code, prescription unique code, etc. The medical insurance reimbursement system has a reimbursement status code corresponding to the prescription (prescription reimbursement status code). The prescription reimbursement status code field is longer than or equal to one digit, so that it can represent at least two status values.

[0026] Based on the different time points at which the prescription reimbursement status code (P-Cs) is obtained, the prescription reimbursement status code is divided into the first prescription reimbursement status code (P-Cs1), the second prescription reimbursement status code (P-Cs2), the third prescription reimbursement status code (P-Cs3), and so on.

[0027] The first prescription reimbursement status code has the same meaning as the original prescription reimbursement status code.

[0028] Where i represents the suppressed state of the prescription reimbursement status code; ii represents the inactive state of the prescription reimbursement status code; and iii represents the active state of the prescription reimbursement status code. Preferably, to reduce server storage pressure, ii and iii can share the same status identifier.

[0029] The patient's identity attribute code can be filled in by the patient themselves, but to improve the reliability of the patient's identity attribute code, it is preferable that the patient's identity attribute code be uploaded by the medical institution.

[0030] Example 1

[0031] To improve the accuracy of medical insurance reimbursement, both to prevent fraud and to avoid reimbursement failures due to misoperation:

[0032] The original / first medicinal material status attribute code (P-Cs1, TC-Ds1) of the prescription reimbursement status code and the medicinal material status attribute code is inactive (inactive means different from active, such as set to 0). The data upload terminal is mounted on the patient's terminal (such as a smartphone). After the medicine is sold normally, the patient uploads the medicinal material traceability code to realize reimbursement (preferably, here the patient refers to the person using the patient's identity information to upload the traceability code and other information, that is, it does not exceed the concept of the patient uploading the traceability code and other information by someone other than the actual patient using the patient's identity information). The specific steps are as follows:

[0033] S1: The doctor writes a prescription and uploads the prescription information at the same time;

[0034] S2: The patient makes a normal payment. The medical insurance reimbursement system calls the first verification module to obtain P-Cs1, and judges whether to set P-Cs based on the prescription information and patient identity attribute code transmitted by the medical institution. The specific method is as follows:

[0035] S2.1: The first verification module determines whether the patient meets the reimbursement conditions based on the patient's identity attribute code, payment method, and medicinal material category code (DC).

[0036] S2.2; If P-Cs1 is in the suppression state (i), then reimbursement is terminated;

[0037] If P-Cs1 is in a non-suppressed state but does not meet the reimbursement conditions, then reimbursement is terminated; preferably, P-Cs is set to a suppressed state (i) at this time; if P-Cs1 is in a non-suppressed state and meets the reimbursement conditions, then P-Cs is set to an activated state.

[0038] Preferably, if the reimbursement conditions are met, the status attribute coding status of the medicinal material can also be maintained; especially when the inactive (ii) and active (iii) statuses are identified by the same value.

[0039] Further preferred, the modification of P-Cs to the inhibited state is a unidirectional and irreversible modification, which can only occur along the path of "inactivation > activation > inhibition".

[0040] The "control" direction is modified unidirectionally.

[0041] S3: Dispensing medicine at the pharmacy;

[0042] S4: The patient scans the traceability code of the medicine. If the reimbursement process did not terminate at S2, it will continue.

[0043] S4.1: Patients scan the drug traceability code and upload the obtained drug traceability code (TC-D); it is worth noting that patients can also fill in their own patient identity attribute code at this time to complete the prescription information.

[0044] S4.2: The medical insurance reimbursement system calls the second verification module. The second verification module first queries the traceability code of the medicinal materials, based on the TC-D...

[0045] Alternatively, query TC-D1. After the query is completed, read the medicinal material status attribute code as the second medicinal material status attribute code (TC-Ds2), and change the status of TC-D to the inhibition state (e.g., assign the medicinal material status attribute code of TC-Ds2 a value of -1).

[0046] S4.2.1: If TC-Ds2 is in an inhibited state, TC-D related data (such as medical institution name, address, code, or one or more other data) can be uploaded to the medical insurance supervision platform to facilitate subsequent investigation of the cause. At the same time, the medical insurance reimbursement function of the medicine can be closed and reimbursement can be terminated. The medicine-related data can be presented only to the patient, or the patient can make a further appeal.

[0047] If TC-Ds2 is in a non-inhibited (i.e., active or inactive) state, the modulation module is invoked to determine the reimbursement ratio based on the patient's identity attribute code (ID-A) and the drug category code (DC), and at least one parameter is returned. Based on this parameter, the reimbursement fee is returned to the patient's account to complete the reimbursement.

[0048] In a further preferred embodiment, if TC-Ds2 is in a non-inhibited (i.e., activated or inactive) state and P-Cs is in state ii or iii, then the modulation module is invoked to determine the reimbursement ratio based on the patient's identity attribute code (ID-A) and the drug category code (DC), and at least one parameter is returned. Based on this parameter, the reimbursement fee is returned to the patient's account to complete the reimbursement.

[0049] Example 2

[0050] With the advancement of data sharing among medical institutions, patients may obtain medication from medical institution A and then pick it up from medical institution B.

[0051] Therefore, based on Example 1, a further preferred embodiment is to add a verification module three during the reimbursement process. Verification module three determines whether to enable the reimbursement function based on the medical institution where the patient obtained the medication, thereby further improving the security of medical insurance funds.

[0052] First, medical institutions (including hospitals, clinics, and pharmacies) enter the traceability code of medicinal materials when they are put into storage, and at the same time upload the information of the medicinal materials and the medical institution code (storage institution code, H-C1) at the time of storage to the medical insurance reimbursement system.

[0053] Preferably, medical institutions enter the whole package of medicinal materials traceability code (TC-C), the TC-C associated with the sub-package of medicinal materials traceability code (TC-D), and H-C1.

[0054] The traceability code TC-D on the sub-package is the unique code TC-D1 corresponding to the medicinal material.

[0055] TC-Ds1 and P-Cs1 are in an inactive state (inactive state refers to a state different from active state, such as set to 0). The data upload terminal is installed on the patient's end (such as a smartphone). After normal sales, the patient uploads the medicine traceability code to realize reimbursement.

[0056] S1: The doctor issues a prescription and uploads the prescription information at the same time; preferably, a unique prescription code is generated when the doctor issues the prescription, and the unique prescription code is uploaded to the medical insurance reimbursement system as part of the prescription information.

[0057] S2: The patient makes a normal payment. The medical insurance reimbursement system activates the first verification module to determine whether to set P-Cs based on the prescription information transmitted from the medical insurance network and the patient's identity attribute code.

[0058] S2.1: The first verification module obtains P-Cs1 and determines whether it meets the reimbursement conditions based on the patient's identity attribute code, payment method, and medicinal material category code (DC);

[0059] S2.2: If P-Cs1 is in a suppressed state, then reimbursement shall be terminated;

[0060] If P-Cs1 is not in a suppressed state and meets the reimbursement conditions, then P-Cs is set to an active state (iii) or its original state is maintained (ii); if it does not meet the reimbursement conditions, then P-Cs is set to a suppressed state (i) and reimbursement is terminated.

[0061] S3: The pharmacy dispenses the medication and simultaneously uploads the medical institution code (dispensing institution code, H-C2) to which the pharmacy belongs and the prescription information (preferably, the uploaded prescription information includes the unique prescription code);

[0062] S4: The patient scans the medicine traceability code. If the reimbursement process did not terminate in S2, it will continue.

[0063] S4.1: Patients scan the traceability code of medicinal materials and upload the read traceability code (TC-D);

[0064] S4.2: The medical insurance reimbursement system calls the third verification module. The third verification module queries based on TC-D1 and prescription information (preferably, the prescription information includes a unique prescription code). After the query is completed, it reads H-C1 and compares H-C2. If H-C1 and H-C2 are consistent, it proceeds to S4.3. If H-C1 and H-C2 are inconsistent, the medicinal material has a high risk of being returned to its source and is considered a questionable medicinal material. It then proceeds to S5.

[0065] Preferably, H-C1 is queried based on the traceability code of the medicinal material, and H-C2 is queried based on the unique prescription code.

[0066] S4.3: The medical insurance reimbursement system calls the second verification module. The second verification module reads the medicinal material status attribute code of TC-D as the second medicinal material status attribute code (TC-Ds2) and changes the status of TC-D to the inhibition state (I).

[0067] S4.3.1: If TC-Ds2 is in an inhibited state, TC-D related data (such as the name, address, code, or one or more other data of the medical institution) can be uploaded to the medical insurance supervision platform to facilitate subsequent investigation of the cause. At the same time, reimbursement can be terminated. Only the data related to the medicine can be presented to the patient, or the patient can make a further appeal.

[0068] If TC-Ds2 is in a non-suppressed state (i.e., active or inactive), the modulation module is invoked to determine the reimbursement ratio based on the patient's identity attribute code (ID-A) and the drug category code (DC), and a parameter is returned. Based on this parameter, the reimbursement fee is returned to the patient's account to complete the reimbursement.

[0069] Preferably, when both TC-Ds2 and P-C2 are in a non-inhibited (i.e., activated or inactive) state, the modulation module is invoked to determine the reimbursement ratio based on the patient's identity attribute code (ID-A) and the drug category code (DC), and a parameter is returned. Based on this parameter, the reimbursement fee is returned to the patient's account to complete the reimbursement.

[0070] S5: Upload the information on the questionable medicinal materials and H-C1 and H-C2 to the medical insurance platform as the basis for subsequent rectification.

[0071] Example 3

[0072] Furthermore, to reduce server load, the first verification module is not mandatory.

[0073] The first medicinal herb status attribute code (TC-Ds1) of the medicinal herb traceability code is inactive (inactive means different from active, such as set to 0). The data upload terminal is installed on the patient's terminal (such as a smartphone). After normal sales, the patient uploads the medicinal herb traceability code to realize reimbursement.

[0074] S1: The doctor writes a prescription and uploads the prescription information at the same time;

[0075] S2: Patients pay normally;

[0076] S3: Dispensing medicine at the pharmacy;

[0077] S4: Patients scan the medicine traceability code to complete the reimbursement process.

[0078] S4.1: Patients scan and upload the medicinal material traceability code (TC-D);

[0079] S4.2: The medical insurance reimbursement system calls the second verification module. The second verification module first queries the traceability code of the medicinal materials, and reads the medicinal material status attribute code according to TC-D1 as the second medicinal material status attribute code (TC-Ds2), and changes the status of TC-D to the inhibited state (I).

[0080] S4.2.1: If TC-Ds2 is in an inhibited state, TC-D related data (such as medical institution name, address, code, or one or more other data) can be uploaded to the medical insurance platform to facilitate subsequent investigation of the cause. At the same time, the medical insurance reimbursement function of the medicine can be turned off and reimbursement can be terminated. The medicine-related data can be presented only to the patient, or the patient can make a further appeal.

[0081] If TC-Ds2 is in a non-suppressed state (i.e., II or III), the modulation module is invoked to determine the reimbursement ratio based on the patient's identity attribute code (ID-A) and the drug category code (DC), and at least one parameter is returned to complete the reimbursement.

[0082] Furthermore, if reimbursement fails due to questionable medication, patients can be advised to visit a nearby pharmacy to exchange the questionable medication for legitimate medication.

[0083] Furthermore, medical institutions can file appeals regarding questionable medicinal materials.

[0084] Furthermore, the normal reimbursement rate can be deducted first, and the initial medical insurance payment can be deducted if the user fails to upload the traceability code of the medicine in time.

[0085] Furthermore, provided that the reimbursement conditions are met, the modification of TC-Ds to the suppressed state and the reimbursement are combined into a single transaction to maintain the security of database operations.

[0086] Furthermore, in Embodiment 2, the first verification module is also a non-essential module.

[0087] It is worth noting that the medicinal materials referred to in this invention include pharmaceutical preparations as well as medical consumables, examination and testing items, and other medical insurance reimbursement items.

[0088] Those skilled in the art will understand that embodiments of the present invention can be provided as a method, system, or computer program module, etc., combined with hardware to form a device. Therefore, the present invention can be implemented entirely in hardware, entirely in software, or in a combination of software and hardware. Furthermore, the present invention can take the form of a computer document product stored on one or more computer-usable storage media (including but not limited to disk storage and optical storage) containing computer-usable code.

[0089] This invention is described with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of the invention. It should be understood that the flowchart illustrations and / or blocks, and combinations thereof, can be implemented by computer program instructions. These computer program instructions can be provided to a processor of a general-purpose computer, special-purpose computer, embedded processor, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable processing apparatus, generate instructions for implementing the flowchart illustrations and / or block diagrams. Figure 1 One or more processes and / or boxes Figure 1 A device that provides the functions specified in one or more boxes.

Claims

1. A medical insurance reimbursement system, characterized in that: The medicinal herb traceability code is a unique code corresponding to each medicinal herb. During the reimbursement process, the medicinal herb traceability code is uploaded to the medical insurance reimbursement system. The medical insurance reimbursement system stores the medicinal herb status attribute code corresponding to each medicinal herb. The field length of the medicinal herb status attribute code is such that it can represent at least two status values. The medical insurance reimbursement system includes a second verification module and a modulation module. The second verification module verifies the medicinal material information and determines whether the medicinal material corresponding to the traceability code uploaded to the medical insurance reimbursement system meets the reimbursement conditions. The second verification module queries and reads the medicinal material status attribute code corresponding to the medicinal material traceability code based on the medicinal material traceability code; Modulation module: Determines the reimbursement ratio based on the data uploaded to the medical insurance reimbursement system.

2. The medical insurance reimbursement system as described in claim 1, characterized in that: After a prescription is issued, the medical insurance reimbursement system receives the uploaded prescription information, which includes at least one of the following: patient identity attribute code, drug category code, etc. The medicinal herb status attribute code is capable of storing two possible status values, I and II; the second verification module reads the medicinal herb status attribute code and sets the medicinal herb status attribute code to I; if the medicinal herb status attribute code read by the second verification module is I, the reimbursement is terminated; if the medicinal herb status attribute code read is II, the process continues. Based on the different time points at which the medicinal material status attribute codes are read, the medicinal material status attribute codes read at different time points are defined as the first medicinal material status attribute code, the second medicinal material status attribute code, etc. The second verification module reads the medicinal material status attribute code corresponding to the medicinal material traceability code to obtain the second medicinal material status attribute code; the server side of the medical insurance reimbursement system stores the medicinal material status attribute code. After verification by the second verification module, the medical insurance reimbursement system calls the modulation module to obtain the reimbursement parameter return value based on the prescription information.

3. The medical insurance reimbursement system as described in claim 2, characterized in that: The medical insurance reimbursement system has a reimbursement status code corresponding to the prescription (hereinafter referred to as: prescription reimbursement status code). The prescription reimbursement status code field length is greater than or equal to one digit, so that it can represent at least two status values. According to different prescription reimbursement status code acquisition time nodes, prescription reimbursement status codes are divided into first prescription reimbursement status codes, second prescription reimbursement status codes, etc. Among them, the prescription reimbursement status code can store two status values ​​including i and ii. The medical insurance reimbursement system also includes a first verification module, which verifies the prescription information based on the prescription reimbursement status code, the patient's identity attribute code, and the drug category code, and determines whether the prescription contains reimbursable drugs. The first verification module is called by the medical insurance reimbursement system after the prescription is uploaded, and the second verification module is called by the medical insurance reimbursement system after the drugs are dispensed.

4. The medical insurance reimbursement system as described in claim 2 or 3, characterized in that: The medical insurance reimbursement system also includes a third verification module. The medical insurance reimbursement system receives the medical institution code uploaded when the medicine is put into storage (hereinafter referred to as: storage institution code), the medical institution code uploaded when the medicine is dispensed (hereinafter referred to as: dispensing institution code), and prescription information. The medical insurance reimbursement system calls the third verification module to obtain the storage institution code and the dispensing institution code. It then compares the storage institution code with the dispensing institution code. If the storage institution code and the dispensing institution code are inconsistent, the reimbursement is terminated. If the warehouse entry code matches the dispensing organization code, proceed to the next step of the reimbursement process; The third verification module is called by the medical insurance reimbursement system after the patient uploads the medicine traceability code; the patient's identity attribute code is uploaded to the medical insurance reimbursement system by the medical institution when the prescription is issued.

5. The medical insurance reimbursement system as described in claim 2, characterized in that: The medical insurance reimbursement system requires patients to upload drug traceability codes to complete the reimbursement process. The system calls the second verification module and the modulation module in the following manner: S4.2: The medical insurance reimbursement system calls the second verification module to obtain the status attribute code of the second medicinal material; S4.2.1: If the status attribute code of the second medicinal material is I, then the reimbursement shall be terminated; if the status attribute code of the second medicinal material is not I, then the modulation module shall be called to determine the reimbursement ratio based on the patient's identity attribute code and the medicinal material category code, and the reimbursement shall be completed.

6. The medical insurance reimbursement system as described in claim 3, characterized in that: The medical insurance reimbursement system allows patients to upload drug traceability codes to complete reimbursement. The system calls the first verification module, the second verification module, and the modulation module in the following ways: S2.1: After the prescription information is uploaded, the first verification module determines whether the prescription contains reimbursed medicinal materials; S2.2: The medical insurance reimbursement system reads the prescription reimbursement status code. If the prescription reimbursement status code is i, the reimbursement is terminated. If the prescription reimbursement status code is not i, and the person seeking reimbursement meets the reimbursement conditions, the prescription reimbursement status code is set to iii or the original prescription reimbursement status code is maintained. If the person seeking reimbursement does not meet the reimbursement conditions, the prescription reimbursement status code is set to i, and the reimbursement is terminated. S4.2: The medical insurance reimbursement system calls the second verification module to obtain the status attribute code of the second medicinal material; S4.2.1: If the status attribute code of the second medicinal material is I, then the reimbursement is terminated; if the status attribute code of the second medicinal material is not I, and the prescription reimbursement status code is not i, then the modulation module is called to determine the reimbursement ratio based on the patient's identity attribute code and the medicinal material category code, and the reimbursement is completed.

7. The medical insurance reimbursement system as described in claim 4, characterized in that: The medical insurance reimbursement system allows patients to upload drug traceability codes to complete reimbursement. The system invokes the third verification module, the second verification module, and the modulation module in the following manner: When medicinal materials are received into the warehouse, the medical institution shall upload the warehouse institution code and the medicinal material traceability code to the medical insurance reimbursement system. When a doctor writes a prescription, a unique prescription code is generated, and the prescription information includes the unique prescription code. S3: When dispensing medication at a pharmacy, upload the dispensing organization code and the corresponding unique prescription code; S4.2: After the patient uploads the drug traceability code, the medical insurance reimbursement system calls the third verification module. The third verification module reads the warehouse institution code based on the drug traceability code and the dispensing institution code based on the prescription unique code. If the warehouse institution code and the dispensing institution code are inconsistent, the reimbursement is terminated; if the warehouse institution code and the dispensing institution code are consistent, the process continues. S4.3: The medical insurance reimbursement system calls the second verification module to obtain the second medicinal material status attribute code and sets the medicinal material status attribute code to I; S4.3.1: If the status attribute code of the second medicinal material is I, then medical insurance reimbursement is terminated; if the status attribute code of the second medicinal material is not I, then the modulation module is called to complete the reimbursement; when the reimbursement conditions are met, the modification of the status attribute code of the medicinal material to the I status is bound to the reimbursement operation as a transaction.

8. A method for medical insurance reimbursement, using the medical insurance reimbursement system as described in claim 5, characterized in that: The reimbursement process is as follows: Step 1: The doctor writes a prescription and uploads the prescription information; Step 2: The patient makes payment as usual; Step 3: Dispensing medication at the pharmacy; Step 4; The patient scans the medicine traceability code to complete the reimbursement process: Step 4.1: The patient scans and uploads the medicine traceability code; Step 4.2: The medical insurance reimbursement system calls the second verification module; Step 4.2.1: If the status attribute code of the second medicinal material is not I, then call the modulation module.

9. A method for medical insurance reimbursement, using the medical insurance reimbursement system as described in claim 6, characterized in that: The reimbursement process is as follows: Step 1: The doctor writes a prescription and uploads the prescription information; Step 2: The medical insurance reimbursement system calls the first verification module; Step 4: The patient scans the medicine traceability code to complete the reimbursement process. Step 4.1: The patient scans and uploads the medicine traceability code; Step 4.2: The medical insurance reimbursement system calls the second verification module; Step 4.2.1: If the status attribute code of the second medicinal material is not I and the prescription reimbursement status code is not i, then call the modulation module.

10. A method for medical insurance reimbursement, using the medical insurance reimbursement system as described in claim 7, characterized in that: The reimbursement process is as follows: Step 0: When medicinal materials are received into the warehouse, the medical institution uploads its code and the traceability code of the medicinal materials to the medical insurance reimbursement system; the first medicinal material status attribute code of the traceability code is II; Step 1: The doctor writes a prescription and uploads the prescription information, which includes the unique prescription code: Step 2: The patient pays; Step 3: The pharmacy dispenses the medication; Step 4: The patient scans the medicine traceability code: Step 4.1: The patient scans and uploads the medicine traceability code; Step 4.2: The medical insurance reimbursement system calls the third verification module; Step 4.3: The medical insurance reimbursement system calls the second verification module.

Images