CN102111336A - Message switching equipment for networked settlement of social security and medical insurance - Google Patents
Message switching equipment for networked settlement of social security and medical insurance Download PDFInfo
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- CN102111336A CN102111336A CN2011100523867A CN201110052386A CN102111336A CN 102111336 A CN102111336 A CN 102111336A CN 2011100523867 A CN2011100523867 A CN 2011100523867A CN 201110052386 A CN201110052386 A CN 201110052386A CN 102111336 A CN102111336 A CN 102111336A
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Abstract
The invention relates to message switching equipment for networked settlement of social security and medical insurance. The message switching equipment comprises a plurality of groups of data switching modules which are connected with one another, wherein each data switching module comprises an input unit, an authentication unit, a processing unit, an underlying communication unit, a network segment configuration unit, a journal unit and an output unit, and is connected with a data transmission network or an application server for data transmission and data switching. The message switching equipment adopts a four-layer structure, namely, asocial security and medical insurance networked settlement interface, a data switching layer configuration management device, a central data switching and processing unit and a message switching operation system. The invention aims to achieve real-time networking and unified settlement of a larger administrative region, utilizes the centralized data switching application mode to achieve regional social security and medical insurance networked settlement service, provides a reliable data switching mechanism for social security and medical insurance networked settlement, ensures high efficiency of the networked settlement and data switching, and has a favorable interface expansibility.
Description
Technical field
The present invention relates to the computer data switching system, especially a kind of message switching equipment that carries out real time medical treatment capital settlement about Social Security Fund Mangt Center and each medical institutions.
Background technology
Social security medical insurance networking clearing are one of emphasis development projects of China gold guarantor engineering social insurance funds payment system, and it belongs to accurate financial sector.Early stage medical insurance reimbursement is based on large hospital, carry out inner special line networking mode, mainly carry out exchanges data by EJB or Socket mode, this type of data exchange ways, the development technique complexity, exchanges data efficient is low, and shortcoming network security monitoring management is had relatively high expectations and medical institutions' network cost has high input to the software developer.
On the other hand, the clearing detail that medical institutions upload is null, and when medical insurance treatment dispute occurring, settlement data can not be as effective legal argument, and its Information Security is relatively poor.Along with medical insurance reimbursement scope constantly enlarges, general out patient service is planned as a whole the implementation of reimbursement, and community medicine mechanism can't bear the software development expense and the networking expense of great number, therefore, early stage technology can not satisfy the business development demand of medical insurance reimbursement, has influence on the development of medical insurance cause.
Summary of the invention
The objective of the invention is to utilize existing computer information management system, computer network security technology and computer hardware technology, a kind of social security medical treatment networking settlement information switch of managing formula concentratedly is provided, solve the networking difficulty that present social security medical insurance networking clearing run into, networking is slow, the problem that cost is high.
The objective of the invention is by realizing by the following technical solutions:
Social security medical treatment networking settlement information switch, described message switching equipment comprises body and is located at many groups of interior interconnective data exchange modules of body that described every group of data exchange module comprises interconnective input unit, authentication ' unit, processing unit, bottom communication unit, network segment dispensing unit, log unit and output unit respectively; Described every group of data exchange module is connected and carries out the transmission and the exchange of settlement data with data transmission network or application server according to specific format and security configuration.
As the preferred technical solution of the present invention, described message switching equipment comprises four-layer structure, and wherein, the ground floor structure is social security medical treatment networking clearing interfaces, and this layer carries out the configuration of settlement data organization definition according to national social security medical insurance data standard;
Second layer structure is an exchanges data layer configuration management device, and this device comprises input unit, processing unit, output unit and the log unit of every group of exchanges data layer;
Three-decker is the central data switch processing unit, and this unit comprises data transmission device, safety certification device, DEU data exchange unit and the network segment spacer assembly of every group of exchanges data interlayer;
Four-layer structure is a message switching equipment operating system, and this system comprises the computer hardware resource control device.
As the preferred technical solution of the present invention, described message switching equipment one end is connected with data transmission network by Switching Module 2, outer net fire compartment wall; The described message switching equipment other end is connected with application server by Switching Module 1.
As the preferred technical solution of the present invention, described application server connects database server respectively and calamity is equipped with server, and described database server is equipped with server with calamity and is connected.
As the preferred technical solution of the present invention, described database server is equipped with server with calamity and is connected disk array and magnetic tape station respectively.
As the preferred technical solution of the present invention, described data transmission network comprises bank's private network, government affairs outer net, health private network and public internet.
As the preferred technical solution of the present invention, described message switching equipment comprises CPU, disk, network adapter.
The invention has the beneficial effects as follows: with respect to prior art, the present invention is to realize that the unified clearing of networking in real time of bigger administrative region are target, with centralized exchanges data application model, realize regional social security medical insurance networking account settlement business, have following characteristics: 1, have outer net and Intranet physics network segment isolation features; 2, set up unified social security medical insurance networking data structure, guarantee that data qualification meets national medical insurance data standard; 3, adopt the standard XML markup language to describe settlement data structure, 4, realize interconnecting of outer net and Intranet by the WebServic technology; 5, all data exchange processes are all noted by the journal file mode.
The present invention networks to settle accounts for social insurance funds in real time provides reliable data exchange mechanism, can ensure the high efficiency of networking settlement data exchange, has the excellent interface autgmentability simultaneously, can adapt to the continuous expansion of medical insurance business.
Description of drawings
The invention will be further described below in conjunction with accompanying drawing and specific embodiment:
Fig. 1 is a structural representation of the present invention;
Fig. 2 is a workflow schematic diagram of the present invention;
Fig. 3 is an operation principle schematic diagram of the present invention.
Embodiment
Social security medical treatment networking settlement information switch, comprise body and be located at many groups of interior interconnective data exchange modules of body, described every group of data exchange module comprises interconnective input unit, authentication ' unit, processing unit, bottom communication unit, network segment dispensing unit, log unit and output unit respectively; Described every group of data exchange module is connected and carries out the transmission and the exchange of settlement data with data transmission network or application server according to specific format and security configuration.
The present embodiment message switching equipment comprises four-layer structure, and wherein, the ground floor structure is social security medical treatment networking clearing interfaces, and this layer carries out the configuration of settlement data organization definition according to national social security medical insurance data standard; Second layer structure is an exchanges data layer configuration management device, and this device comprises input unit, processing unit, output unit and the log unit of every group of exchanges data layer; Three-decker is the central data switch processing unit, and this unit comprises data transmission device, safety certification device, DEU data exchange unit and the network segment spacer assembly of every group of exchanges data interlayer; Four-layer structure is a message switching equipment operating system, and this system comprises the computer hardware resource control device.
Described message switching equipment one end of present embodiment is connected with data transmission network by Switching Module 2, outer net fire compartment wall, and the other end is connected with application server by Switching Module 1.Described application server connects database server respectively and calamity is equipped with server, and database server is equipped with server with calamity and is connected, and database server is equipped with server with calamity and is connected disk array and magnetic tape station respectively.The described data transmission network of present embodiment comprises bank's private network, government affairs outer net, health private network and public internet; Described message switching equipment comprises CPU, disk, network adapter.
As shown in Figure 1, in the present embodiment, described social security medical treatment networking settlement information switch, be to be deployed among the application service network segment VLAN_2, application server is connected to the network interface of the Switching Module 1 of message switching equipment, and the outer net network segment is used the network interface of the Switching Module 2 that is linked into message switching equipment, and application server is connected to data center's network segment by Intranet again, carry out data access, and network segment access information switch of living in is separately passed through in the outer net application.
The described transfer of data of present embodiment comprises bank's private network, government affairs outer net, health private network and public internet etc.Described message switching equipment comprises CPU, disk, network adapter etc.
As shown in Figure 2, it is workflow of the present invention, medical institutions will transform the charge client of HIS system according to social security medical treatment networking clearing interface specification, the patient is when the payment medical expense, medical institutions can send insured people's ID card No. to message switching equipment, solicited message such as name and insured insurance kind, the outer net data exchange module of message switching equipment is after receiving solicited message, data are carried out the grammer verification in meeting and request permissions is checked, if request is correct, the information exchange chance forwards the request to the data exchange module of Intranet, after the data exchange module of Intranet is received request, can carry out data structure decomposes, call the relevant interface at social security center, request results is returned to the outer net Switching Module, the outer net Switching Module is after receiving the result, be returned to the client of medical institutions again, at this time, client will show insured personnel's basic document, enjoys relevant treatment information such as reimbursement amount and reimbursement ratio.
Medical institutions are according to insured people's data, the charge detail is combined into request msg according to interface specification, send to message switching equipment, the same with above-mentioned process, after the data exchange module of outer net receives request, can hand to the data exchange module of Intranet, the data that clearing are detailed are analyzed, calculate the amount of money of checking and approving of social security, the individual is the amount of money at one's own expense, the disbursement from fund amount of money and individual pay results such as the amount of money for oneself, and settle accounts operations such as flowing water book keeping operation, the last client that is returned to medical institutions again by the data exchange module of Intranet through the data exchange module of outer net, after client receives the result, only collect the individual and use expense at one's own expense at one's own expense, do not collect the disbursement from fund amount of money with the individual, thereby finish real-time networking settlement function, the patient only need pay the expense that oneself should give.
As shown in Figure 3, the HIS system of the medical institutions of outer net all must unifiedly insert the social security core system by message switching equipment, the data of all requests all are described with the XML form, data transfer mode with WebService, request is sent to the outer net data exchange module of message switching equipment, and the input unit of outer net data exchange module can be received the request from medical institutions.
The outer net data exchange module of message switching equipment receives request at every turn, at first input unit carries out log record, collect critical datas such as request IP, request text, medical institutions' numbering and request time, processing unit can be all necessary through the certificate server verification all requests, after if data check passes through, the processing unit of outer net data exchange module just is transmitted to the intranet data Switching Module, otherwise, directly return the client that medical institutions are given in error message.
The processing unit of outer net and intranet data Switching Module are to carry out packet exchange by the bottom communication unit, outer net the bottom communication unit can be split as several packets to the XML text, send to the intranet data Switching Module then, the bottom communication unit of intranet data Switching Module reduces the XML text again after receiving packet.
During the request of intranet data Switching Module after receiving reduction, at first input unit also is to carry out log record, processing unit can be explained appealing structure then, isolate clearing personnel's major key, medical institutions' numbering, the medical technologies project of clearing, data such as medicine catalogue and settlement amounts, then processing unit can inquire insured people's the account of paying the fees by the data center of social security by SQL statement, judged whether the arrearage record, whether the allowable amount of money of medical treatment has reached information such as the line that binds, processing unit can be according to the Policy Conditions after being provided with, the reimbursement ratio that comprises corresponding insurance kind, conditions such as reimbursement accumulative total total amount and reimbursement time period, calculate the amount of money of checking and approving of social security, the individual is the amount of money at one's own expense, the disbursement from fund amount of money and individual pay results such as the amount of money for oneself, and clearing flowing water are accessed in the data center of social security.
At last, by the output unit of intranet data Switching Module the clearing serial number, the amount of money, the disbursement from fund amount of money and individual pay the packet that result such as the amount of money is packaged into the XML structure for oneself at one's own expense to check and approve the amount of money, individual, be returned to the processing unit of outer net again by the bottom communication module, by the mode of WebService the result returned to the client of medical institutions again by the output unit of outer net.
Claims (7)
1. social security medical treatment networking settlement information switch, it is characterized in that: described message switching equipment comprises body and is located at many groups of interior interconnective data exchange modules of body that described every group of data exchange module comprises interconnective input unit, authentication ' unit, processing unit, bottom communication unit, network segment dispensing unit, log unit and output unit respectively; Described every group of data exchange module is connected and carries out the transmission and the exchange of settlement data with data transmission network or application server according to specific format and security configuration.
2. social security medical treatment networking settlement information switch according to claim 1, it is characterized in that: described message switching equipment comprises four-layer structure, wherein, the ground floor structure is social security medical treatment networking clearing interfaces;
Second layer structure is an exchanges data layer configuration management device, and this device comprises input unit, processing unit, output unit and the log unit of every group of exchanges data layer;
Three-decker is the central data switch processing unit, and this unit comprises data transmission device, safety certification device, DEU data exchange unit and the network segment spacer assembly of every group of exchanges data interlayer;
Four-layer structure is a message switching equipment operating system, and this system comprises the computer hardware resource control device.
3. social security medical treatment networking settlement information switch according to claim 1, it is characterized in that: described message switching equipment one end is connected with data transmission network by Switching Module 2, outer net fire compartment wall; The described message switching equipment other end is connected with application server by Switching Module 1.
4. social security medical treatment networking settlement information switch according to claim 3, it is characterized in that: described application server connects database server respectively and calamity is equipped with server, and described database server is equipped with server with calamity and is connected.
5. social security medical treatment networking settlement information switch according to claim 4, it is characterized in that: described database server is equipped with server with calamity and is connected disk array and magnetic tape station respectively.
6. according to claim 1 or 3 described social security medical treatment networking settlement information switches, it is characterized in that: described data transmission network comprises bank's private network, government affairs outer net, health private network and public internet.
7. social security medical treatment networking settlement information switch according to claim 1, it is characterized in that: described message switching equipment comprises CPU, disk, network adapter.
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| Application Number | Priority Date | Filing Date | Title |
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| CN2011100523867A CN102111336A (en) | 2011-03-04 | 2011-03-04 | Message switching equipment for networked settlement of social security and medical insurance |
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| Application Number | Priority Date | Filing Date | Title |
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| CN2011100523867A CN102111336A (en) | 2011-03-04 | 2011-03-04 | Message switching equipment for networked settlement of social security and medical insurance |
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| CN102111336A true CN102111336A (en) | 2011-06-29 |
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Cited By (9)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103124259A (en) * | 2012-06-27 | 2013-05-29 | 上海感信信息科技有限公司 | Device and method for exchanging information among different networks |
| CN104573992A (en) * | 2014-11-27 | 2015-04-29 | 苏州市公安局交通巡逻警察支队 | Non-motor vehicle management system |
| CN105245559A (en) * | 2014-07-10 | 2016-01-13 | 甘肃诚创电子科技有限公司 | Queuing-free information system |
| CN106530089A (en) * | 2015-09-15 | 2017-03-22 | 平安科技（深圳）有限公司 | Method and server for obtaining insurance claim settlement quota |
| CN107463767A (en) * | 2017-07-06 | 2017-12-12 | 深圳市坐标软件开发有限公司 | Cloud HIS medical insurances data processing method and system |
| CN109460912A (en) * | 2018-10-31 | 2019-03-12 | 泰康保险集团股份有限公司 | Data processing method, device, storage medium and electronic equipment |
| CN111047452A (en) * | 2019-11-22 | 2020-04-21 | 泰康保险集团股份有限公司 | Insurance expense settlement data processing method, insurance expense settlement data processing device, insurance expense settlement medium and electronic equipment |
| CN107734034B (en) * | 2017-10-17 | 2021-01-26 | 泰康保险集团股份有限公司 | Server docking system, method, computer-readable storage medium and front-end processor |
| CN112789666A (en) * | 2018-10-05 | 2021-05-11 | Jcm美国公司 | Equipment for modifying auxiliary serial communication port in coin-feed accounting system |
-
2011
- 2011-03-04 CN CN2011100523867A patent/CN102111336A/en active Pending
Cited By (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN103124259A (en) * | 2012-06-27 | 2013-05-29 | 上海感信信息科技有限公司 | Device and method for exchanging information among different networks |
| CN103124259B (en) * | 2012-06-27 | 2016-05-25 | 上海感信信息科技股份有限公司 | A kind of rete mirabile information interactive device and exchange method thereof |
| CN105245559A (en) * | 2014-07-10 | 2016-01-13 | 甘肃诚创电子科技有限公司 | Queuing-free information system |
| CN104573992A (en) * | 2014-11-27 | 2015-04-29 | 苏州市公安局交通巡逻警察支队 | Non-motor vehicle management system |
| CN106530089A (en) * | 2015-09-15 | 2017-03-22 | 平安科技（深圳）有限公司 | Method and server for obtaining insurance claim settlement quota |
| CN107463767A (en) * | 2017-07-06 | 2017-12-12 | 深圳市坐标软件开发有限公司 | Cloud HIS medical insurances data processing method and system |
| CN107734034B (en) * | 2017-10-17 | 2021-01-26 | 泰康保险集团股份有限公司 | Server docking system, method, computer-readable storage medium and front-end processor |
| CN112789666A (en) * | 2018-10-05 | 2021-05-11 | Jcm美国公司 | Equipment for modifying auxiliary serial communication port in coin-feed accounting system |
| CN109460912A (en) * | 2018-10-31 | 2019-03-12 | 泰康保险集团股份有限公司 | Data processing method, device, storage medium and electronic equipment |
| CN111047452A (en) * | 2019-11-22 | 2020-04-21 | 泰康保险集团股份有限公司 | Insurance expense settlement data processing method, insurance expense settlement data processing device, insurance expense settlement medium and electronic equipment |
| CN111047452B (en) * | 2019-11-22 | 2023-10-03 | 泰康保险集团股份有限公司 | Insurance expense settlement data processing method and device, medium and electronic equipment |
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Address after: 519015 Guangdong province Zhuhai Jida Approach Road 333 Building No. 12 Applicant after: GUANGDONG ZONNY HEALTHCARE TECHNOLOGY CO., LTD. Address before: 519000 Guangdong province Zhuhai Jida approach road No. 333 building 11-12 Applicant before: Zhuhai Zhongyi Software Technology Co., Ltd. |
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Application publication date: 20110629 |