CN113689137A - Rapid communication method in medical insurance system - Google Patents
Rapid communication method in medical insurance system Download PDFInfo
- Publication number
- CN113689137A CN113689137A CN202111036369.4A CN202111036369A CN113689137A CN 113689137 A CN113689137 A CN 113689137A CN 202111036369 A CN202111036369 A CN 202111036369A CN 113689137 A CN113689137 A CN 113689137A
- Authority
- CN
- China
- Prior art keywords
- pharmacy
- pharmacies
- medicine
- minutes
- method further
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Pending
Links
Classifications
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q10/00—Administration; Management
- G06Q10/06—Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
- G06Q10/063—Operations research, analysis or management
- G06Q10/0631—Resource planning, allocation, distributing or scheduling for enterprises or organisations
- G06Q10/06315—Needs-based resource requirements planning or analysis
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q10/00—Administration; Management
- G06Q10/08—Logistics, e.g. warehousing, loading or distribution; Inventory or stock management
- G06Q10/087—Inventory or stock management, e.g. order filling, procurement or balancing against orders
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q10/00—Administration; Management
- G06Q10/10—Office automation; Time management
-
- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
- G06Q40/08—Insurance
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
- G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/20—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
Landscapes
- Business, Economics & Management (AREA)
- Engineering & Computer Science (AREA)
- Human Resources & Organizations (AREA)
- General Business, Economics & Management (AREA)
- Strategic Management (AREA)
- Economics (AREA)
- Entrepreneurship & Innovation (AREA)
- Theoretical Computer Science (AREA)
- Health & Medical Sciences (AREA)
- Physics & Mathematics (AREA)
- General Physics & Mathematics (AREA)
- Marketing (AREA)
- Operations Research (AREA)
- Quality & Reliability (AREA)
- Development Economics (AREA)
- Tourism & Hospitality (AREA)
- Finance (AREA)
- Accounting & Taxation (AREA)
- Public Health (AREA)
- Primary Health Care (AREA)
- Medical Informatics (AREA)
- General Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Medicinal Chemistry (AREA)
- Bioinformatics & Cheminformatics (AREA)
- Chemical & Material Sciences (AREA)
- Data Mining & Analysis (AREA)
- Technology Law (AREA)
- Educational Administration (AREA)
- Game Theory and Decision Science (AREA)
- Biomedical Technology (AREA)
- Medical Treatment And Welfare Office Work (AREA)
Abstract
The invention belongs to the technical field of medical insurance services, and particularly discloses a quick communication method in a medical insurance system, which comprises the following steps: s1: when a patient needs to go to a pharmacy for getting medicines, the system inquires the pharmacy with sufficient medicine stock; s2: in pharmacies with sufficient drug inventory, sorting the pharmacies from near to far according to the distance between the pharmacies and the system position; s3: performing pharmacy allocation for the first time according to the sequencing sequence, after the allocated pharmacies are selected, notifying the pharmacies by the VMS, wherein the notifying times are 3 times, the interval time is 5 minutes, if the pharmacies return a confirmation order receiving result within any notified 5 minutes, ending the step, and if the pharmacies do not respond within 5 minutes after the notification for 3 times, performing pharmacy allocation for the second time according to the sequencing sequence number; s4: when the distribution frequency of the pharmacy exceeds three times, the operator performs manual intervention.
Description
Technical Field
The invention relates to the technical field of medical insurance services, in particular to a quick communication method in a medical insurance system.
Background
Medical insurance generally refers to basic medical insurance, and is a social insurance system established to compensate economic losses of workers due to disease risks. The medical insurance fund is established by paying with personnel units and individuals, and after medical expenses occur when the insured personnel see a doctor, the medical insurance institution gives certain economic compensation to the insured personnel; the medicine payment is an innovative medical payment platform under the magnesium credit health flag, and provides innovative payment services such as medicine welfare and medicine staging for patients through cooperation with a medicine enterprise, a financial institution and a pharmacy.
In the existing medical insurance system, after the claim rationality is checked and approved, a corresponding pharmacy needs to be manually allocated to allow a patient to receive medicines, and certain uncertain factors exist in the medicine receiving process, so that the medicine receiving process period is too long.
Disclosure of Invention
The present invention is directed to a method for fast communication in a medical insurance system, so as to solve the problems mentioned in the background art.
In order to achieve the purpose, the invention provides the following technical scheme: a quick communication method in a medical insurance system comprises the following steps:
s1: when a patient needs to go to a pharmacy to receive medicines after the patient passes the examination of the rationality of claims, the system inquires the pharmacy with sufficient medicine inventory;
s2: in pharmacies with sufficient drug inventory, sorting the pharmacies from near to far according to the distance between the pharmacies and the system position, and generating a sorted list;
s3: performing pharmacy allocation for the first time according to the sequence of the sorted list, after the allocated pharmacies are selected, notifying the pharmacies by the VMS, wherein the notifying times are 3 times, the interval time is 5 minutes, if the pharmacies return a confirmed order receiving result within 5 minutes after any notification, ending the step, and if the pharmacies do not respond within 5 minutes after the notification for 3 times, performing pharmacy allocation for the second time according to the sorted serial number;
s4: when the distribution frequency of the pharmacy exceeds three times, the operator performs manual intervention;
s5: and taking the month as a unit, carrying out data statistics on each pharmacy, and carrying out data analysis on the statistical result by an operator after the statistics is finished.
Further, in the step S1, when querying the pharmacy, the system queries the pharmacies with radii of 5KM, 10KM, 15KM, and 20KM in sequence, with the system location as the center.
Further, in step S4, after the operator performs manual intervention, the operator performs manual telephone inquiry to the pharmacies in turn according to the sorted list in step S2.
Further, the statistics of data in the step S5 include VMS response time of the pharmacy, pharmacy order amount, and medicine sufficiency rate.
Further, in step S3, if a plurality of orders are simultaneously dispensed to the same pharmacy, the dispensed pharmaceutical prescription is frozen.
Further, after the freezing process, if the patient goes to a store to take a medicine, the number of the dispensed medicine prescriptions is subtracted in the medicine library, and if the patient returns to a claim, the dispensed medicine prescriptions are thawed in the medicine library.
Further, in step S2, pharmacies with insufficient drug libraries are excluded from the ordered list.
Compared with the prior art, the invention has the beneficial effects that: after the examination of the rationality of claims is passed, the pharmacy with sufficient drug libraries is inquired by outward diffusion with the system address as the center, the sorted list is produced according to the distance sequence and then is sorted and distributed, and after the pharmacy is distributed, the pharmacy can be informed through the VMS, so that the communication between a patient and the pharmacy is quicker and more convenient, the condition that the patient cannot receive the drugs after reaching the designated pharmacy is avoided, and the serviceability of the patient is guaranteed.
Detailed Description
The technical solutions in the embodiments of the present invention will be clearly and completely described below with reference to the embodiments of the present invention, and it is obvious that the described embodiments are only a part of the embodiments of the present invention, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present invention.
The invention provides a quick communication method in a medical insurance system, which comprises the following steps:
s1: when a patient needs to go to a pharmacy for receiving medicines after checking the rationality of claims, the system inquires the pharmacy with sufficient medicine stock, and during inquiry, the pharmacy within the radius of 5km is inquired by taking the system address as the center, if no matched pharmacy exists, the radius is sequentially increased by 5kn until the matched pharmacy with sufficient medicine stock is inquired;
s2: sorting the pharmacies from near to far according to the distance between the pharmacies and the system position in the pharmacies with sufficient drug inventory to generate a sorted list, and excluding the pharmacies with insufficient drug inventory from the sorted list;
s3: performing first-time pharmacy allocation according to the sequence of the ordered list, after the allocated pharmacies are selected, notifying the pharmacies by the VMS, wherein the notification times are 3 times, the interval time is 5 minutes, if the pharmacies return a confirmation order receiving result within 5 minutes after any notification, ending the step, and if the pharmacies do not respond within 5 minutes after the notification for 3 times, performing second-time pharmacy allocation according to the sequence number of the ordered list; when a plurality of orders are distributed to the same pharmacy at the same time, the distributed medicine prescription is frozen, so that the condition that the quantity of the medicines in the pharmacy is not consistent with the actual quantity is prevented from occurring subsequently;
s4: when the number of times of pharmacy allocation exceeds three, the operator performs manual intervention, and after the intervention, the operator sequentially notifies pharmacies in the ordered list through a telephone;
s5: and counting data of each pharmacy by taking a month as a unit, wherein the statistical data comprises the VMS response time of the pharmacy, the order quantity of the pharmacy and the medicine sufficiency rate, and after the statistics is finished, carrying out data analysis on the statistical result by an operator.
After the examination of the rationality of claims is passed, the pharmacy with sufficient drug libraries is inquired by outward diffusion with the system address as the center, the sorted list is produced according to the distance sequence and then is sorted and distributed, and after the pharmacy is distributed, the pharmacy can be informed through the VMS, so that the communication between a patient and the pharmacy is quicker and more convenient, the condition that the patient cannot receive the drugs after reaching the designated pharmacy is avoided, and the serviceability of the patient is guaranteed.
Although embodiments of the present invention have been shown and described, it will be appreciated by those skilled in the art that changes, modifications, substitutions and alterations can be made in these embodiments without departing from the principles and spirit of the invention, the scope of which is defined in the appended claims and their equivalents.
Claims (7)
1. A quick communication method in a medical insurance system is characterized by comprising the following steps:
s1: when a patient needs to go to a pharmacy to receive medicines after the patient passes the examination of the rationality of claims, the system inquires the pharmacy with sufficient medicine inventory;
s2: in pharmacies with sufficient drug inventory, sorting the pharmacies from near to far according to the distance between the pharmacies and the system position, and generating a sorted list;
s3: performing pharmacy allocation for the first time according to the sequence of the sorted list, after the allocated pharmacies are selected, notifying the pharmacies by the VMS, wherein the notifying times are 3 times, the interval time is 5 minutes, if the pharmacies return a confirmed order receiving result within 5 minutes after any notification, ending the step, and if the pharmacies do not respond within 5 minutes after the notification for 3 times, performing pharmacy allocation for the second time according to the sorted serial number;
s4: when the distribution frequency of the pharmacy exceeds three times, the operator performs manual intervention;
s5: and taking the month as a unit, carrying out data statistics on each pharmacy, and carrying out data analysis on the statistical result by an operator after the statistics is finished.
2. The method of claim 1, wherein the method further comprises: in step S1, when querying the pharmacy, the system queries the pharmacies with radii of 5KM, 10KM, 15KM, and 20KM in sequence, with the system location as the center.
3. The method of claim 1, wherein the method further comprises: in step S4, after the operator performs manual intervention, the pharmacy is sequentially queried by telephone according to the sorted list in step S2.
4. The method of claim 1, wherein the method further comprises: the statistics of data in the step S5 include VMS response time of pharmacy, pharmacy order quantity, and medicine sufficiency rate.
5. The method of claim 1, wherein the method further comprises: in step S3, if a plurality of orders are simultaneously dispensed to the same pharmacy, the dispensed pharmaceutical prescription is frozen.
6. The method of claim 5, wherein the method further comprises: after the freezing process, if the patient arrives at the store to take the medicine, the number of the dispensed medicine prescriptions is subtracted in the medicine storage, and if the patient returns to the claim, the dispensed medicine prescriptions are unfrozen in the medicine storage.
7. The method of claim 1, wherein the method further comprises: in step S2, pharmacies with insufficient drug libraries are excluded from the ordered list.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111036369.4A CN113689137A (en) | 2021-09-06 | 2021-09-06 | Rapid communication method in medical insurance system |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN202111036369.4A CN113689137A (en) | 2021-09-06 | 2021-09-06 | Rapid communication method in medical insurance system |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN113689137A true CN113689137A (en) | 2021-11-23 |
Family
ID=78585445
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN202111036369.4A Pending CN113689137A (en) | 2021-09-06 | 2021-09-06 | Rapid communication method in medical insurance system |
Country Status (1)
| Country | Link |
|---|---|
| CN (1) | CN113689137A (en) |
Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109598584A (en) * | 2018-11-28 | 2019-04-09 | 孝感诚志维康医药科技有限公司 | A kind of medicine state information query system and method for commerce |
| CN110322331A (en) * | 2019-07-18 | 2019-10-11 | 徐志颖 | A kind of medicine marketing method based on cloud computing and big data |
| CN111950831A (en) * | 2019-05-17 | 2020-11-17 | 拉扎斯网络科技（上海）有限公司 | Order assignment method and device, readable storage medium and electronic equipment |
| CN112200687A (en) * | 2020-10-29 | 2021-01-08 | 上海镁信健康科技有限公司 | Special drug claims and accepts platform |
| CN112508713A (en) * | 2020-11-30 | 2021-03-16 | 泰康保险集团股份有限公司 | Task management method, system, device, storage medium and electronic terminal |
-
2021
- 2021-09-06 CN CN202111036369.4A patent/CN113689137A/en active Pending
Patent Citations (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109598584A (en) * | 2018-11-28 | 2019-04-09 | 孝感诚志维康医药科技有限公司 | A kind of medicine state information query system and method for commerce |
| CN111950831A (en) * | 2019-05-17 | 2020-11-17 | 拉扎斯网络科技（上海）有限公司 | Order assignment method and device, readable storage medium and electronic equipment |
| CN110322331A (en) * | 2019-07-18 | 2019-10-11 | 徐志颖 | A kind of medicine marketing method based on cloud computing and big data |
| CN112200687A (en) * | 2020-10-29 | 2021-01-08 | 上海镁信健康科技有限公司 | Special drug claims and accepts platform |
| CN112508713A (en) * | 2020-11-30 | 2021-03-16 | 泰康保险集团股份有限公司 | Task management method, system, device, storage medium and electronic terminal |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| Ahtiainen et al. | Safety, time and cost evaluation of automated and semi-automated drug distribution systems in hospitals: a systematic review | |
| US11393580B2 (en) | Systems and methods for determining and communicating a prescription benefit coverage denial to a prescriber | |
| US8738399B1 (en) | Methods and systems for drug purchase validation | |
| US20110196804A1 (en) | Computer-enabled method and system for facilitating veterinary pharmaceutical and other animal-related product transactions | |
| US20040230502A1 (en) | System and method for distributing healthcare products | |
| US11430554B2 (en) | Pharmacy stock supply tracking system | |
| CN109767157B (en) | Medicine sales system based on cloud computing and big data | |
| de-Carvalho et al. | Impact assessment of an automated drug-dispensing system in a tertiary hospital | |
| CN110993052A (en) | Physician prescription circulation auditing system | |
| Kazemzadeh et al. | Design and analysis of a health care supply chain management | |
| CN109273068B (en) | DTP pharmacy management method, DTP pharmacy management system and readable storage medium | |
| US20120203645A1 (en) | Computer-enabled method and system for automated application, determination and distribution of taxes and fees on the sale of products for animals | |
| CN107358044A (en) | Intelligent drugstore management method and system | |
| CN113948191A (en) | Hospital drug inventory intelligent management method and system based on big data | |
| CN113689137A (en) | Rapid communication method in medical insurance system | |
| CN112070433A (en) | Intelligent drug supply chain management system | |
| US20090319293A1 (en) | Virtual inventory system and methods for covered entities | |
| CN113241141A (en) | Medicine service information interaction system | |
| US20230066432A1 (en) | Multi-furcated allocation system | |
| KR20130007009A (en) | Distribution management system of medicines | |
| Cattell et al. | Pharmacist integration into the discharge process: a qualitative and quantitative impact assessment | |
| Pinna et al. | The drug logistics between efficiency and safety for patients: The experience of an Italian region | |
| Miljković et al. | Managing medicine shortages toolkit | |
| Nadhifah et al. | Evaluation of Drug Management Indicators in a Pharmacy Installation of Private Hospital Banyumas Regency | |
| US20230077660A1 (en) | Intelligent system for automatically testing and selecting from multiple data models for accurate diversion prediction |
Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| PB01 | Publication | ||
| PB01 | Publication | ||
| SE01 | Entry into force of request for substantive examination | ||
| SE01 | Entry into force of request for substantive examination |