CN113870036A - Medical insurance remote medical treatment clearing and settlement system and method based on block chain - Google Patents
Medical insurance remote medical treatment clearing and settlement system and method based on block chain Download PDFInfo
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Abstract
The invention discloses a block chain-based medical insurance remote hospitalizing clearing and settlement system, which comprises a data center system, a data center system and a data processing system, wherein the data center system is used for responding to a remote settlement request submitted by a user and acquiring a settlement data request; after the control system of the medical service unit signs the calculated data by using the private key of the submitting party, the public key of the receiving party is used for encrypting and compressing the signed calculated data to obtain first data, and uplink operation is submitted to a data center system; the medical insurance unit control system is used for monitoring and acquiring the first data, decompressing the data, decrypting the data by using a private key and finishing integrity verification by using a signature to obtain complete medical settlement list data; and the medical clearing unit control system is used for acquiring the public information in the medical settlement list data on the chain, counting the limit of each medical insurance unit and finishing the clearing process. The system provides uniform block chain data service through the data center, avoids the problem of inconsistent uplink and downlink of data caused by different block chain platforms, and reduces the use difficulty of users.
Description
Technical Field
The invention relates to the technical field of block chains, in particular to a block chain-based medical insurance remote medical treatment clearing and settlement system and method.
Background
The remote medical settlement refers to a remote medical expense instant settlement service provided by a medical insurance handling institution (hereinafter referred to as a medical insurance institution) when medical services are acquired by personnel (hereinafter referred to as a insured person) participating in social medical insurance in a region other than the insured region. In the prior art, the current remote medical insurance settlement mechanism is performed in a multi-centralization mode. Due to the fact that medical insurance reimbursement ranges and policy regulations in different regions are different, for example, financing standards are different, reimbursement catalogues are different, reimbursement levels are different, the individual remote medical settlement, settlement of medical insurance funds of handling institutions of different places and settlement of funds between the handling institutions and medical institutions need to pass through a plurality of centralized links, the process is difficult to disclose and transparent, and settlement efficiency is low.
For example, if the insurer at location a goes to visit location B for medical treatment, since the insurer is not at location B, the insurer needs to pay the medical expenses of location B hospital first, then the hospital at location B submits the settlement document to the corresponding medical insurance institution, then the multi-level medical insurance institution processes the settlement for medical treatment at different locations, and finally pays the medical insurance expenses. This process is shown as a in fig. 1:
and (3) settlement information submission: the medical insurance management institution of the B place hospital (information of the ginseng insurance people) ═ B place provincial level data exchange center ═ A place medical insurance management institution;
and (4) settlement process: the medical insurance institution in the A place calculates the detailed information of expense reimbursement according to the medical insurance in the A place and the local reimbursement policy and reimburses the expense reimbursement for the insured person so as to complete settlement of hospitalization in different places at one time.
Clearing process: the medical insurance institutions of the B place and the A place periodically submit data to the national data exchange center, and the medical insurance national clearing center carries out clearing.
The settlement process of the remote medical care of the insured person needs at least 6 intermediate nodes, the direct communication settlement between the hospital which is in remote medical care and the local medical care institution cannot be realized, meanwhile, no encryption measure is carried out in the data transmission and acquisition process to protect the data, and if the data is lost or tampered, the data is difficult to recover and decide.
At present, although a unified medical insurance system for remote clearing and settlement is realized in some regions, the unified medical insurance system is basically a solution scheme using a centralized node, the updating cost of an informatization system is high, the clearing and settlement calculation logic is still controlled by the central node, the clearing and settlement efficiency between institutions is reduced, direct settlement service between the institutions and hospitals cannot be realized, the clearing process needs to submit data again, and the process is complicated.
The block chain is a point-to-point public account book established on the Internet, participants of the block chain network add, check and identify account book data through a consensus algorithm according to a time sequence, each participant is guaranteed to have an independent account book with the same content, and the account book data is public and can not be tampered. The decentralized deployment mode can ensure that data on the block chain has high credibility by combining cryptography and a consensus mechanism, and can be used for the requirements of data safety, quality guarantee, audit tracing, openness and transparency and the like. However, the current blockchain technology is still in the exploration stage, various technical routes exist, no very mature technical standard exists, and a single blockchain platform has certain difficulty and risk.
The data center is a center technology for providing uniform data service for users, can get through data of different services, and has functions of data aggregation integration and sharing. By using the data center platform technology, a uniform service interface can be established between various block chain platforms and users, the use difficulty of the users is reduced, and the data service quality is ensured.
In the prior art, no good scheme for perfectly combining remote clearing of medical insurance, block chaining and data middling stations in the related technology exists. Some existing solutions based on block chains also have technical problems of inconsistent data chaining and reading, high user using difficulty and the like.
Disclosure of Invention
Aiming at the defects in the prior art, the invention provides a block chain-based medical insurance remote hospitalizing clearing settlement system and method.
In order to solve the technical problem, the invention is solved by the following technical scheme:
a block chain-based medical insurance remote hospitalizing clearing and settlement system comprises a data center system, a medical service unit control system, a medical insurance unit control system and a medical clearing unit control system;
the data center system is used for responding to the remote settlement data requirement submitted by the user and the remote settlement data acquisition requirement to obtain medical settlement list data and providing public key information required by verification and encryption;
the medical service unit control system acquires settlement data based on medical settlement list data, utilizes a private key to carry out signature, encrypts and compresses the settlement data needing to be encrypted by using a public key to obtain first data, and submits the first data to a data center system for uplink operation;
the medical insurance unit control system is used for monitoring a data center system and acquiring first data, decompressing the first data, decrypting the encrypted data part by using a private key, and performing integrity verification by using a digital signature and a public key to acquire complete medical settlement list data;
and the medical clearing unit control system is used for acquiring medical clearing list data on the chain, counting the amount of each medical insurance unit based on the medical clearing list data and finishing clearing operation.
As an implementable embodiment, the data center system is configured to:
providing public key information of a medical service unit and a medical insurance unit;
providing block link interface information bearing medical settlement list data;
performing chain linking operation on the settlement data submitted by the control system of the medical service unit and returning a chain linking receipt hashed value to the control system of the medical service submitting unit;
and setting monitoring conditions for the medical insurance unit control system and the medical clearing unit control system, and acquiring and transmitting corresponding settlement data on the block chain.
As an implementable embodiment, the health care unit system is configured to:
acquiring a public key and appointed blockchain information of a medical insurance unit from a data center system;
signing the complete medical settlement list data by using a private key of a medical service unit;
encrypting and compressing a part needing encryption by using a public key of a medical insurance unit to obtain first data;
the first data is submitted to the specified blockchain to the data staging system.
As an implementable embodiment, the medical insurance unit control system is configured to:
submitting conditions for monitoring data to a data center system, wherein the conditions comprise a specified block chain and a medical service unit;
acquiring first data from a data console system and decompressing the first data;
decrypting the encrypted data in the first data using a private key of the medical insurance unit;
and verifying the integrity of the first data by using public key information disclosed by the medical service unit to obtain medical settlement list data.
The data center system comprises an interface module, a data center module and a block chain module general interface module;
the interface module responds to a remote settlement request triggering operation submitted by a user and acquires settlement data based on medical settlement list data; signing the medical settlement list data by using a private key of a medical service unit; encrypting the encrypted partial data by using a public key of an insurance unit; carrying out data compression on the encrypted data to obtain first data;
the data intermediate station module is in butt joint with the interface module, determines the operation to be executed and the appointed block chain platform according to the keywords in the settlement request, and carries out uplink operation on the first data;
the block chain universal interface module is used for submitting and acquiring first data, namely data uplink and downlink, and providing a block chain node monitoring interface.
As an implementable manner, the interface module includes a first data I/O unit, a digital signature unit, a data compression unit, a data encryption unit, a data submission unit, and a data acquisition unit;
the first data I/O unit is used for formulating a data standard conforming to the data console module and converting the received data to be settled into a format conforming to the data console module, such as public key information added into a receiver and a sender;
a data compression unit: compressing and decompressing data conforming to the data center module format;
a digital signature unit: the system is used for carrying out serialization processing on data conforming to the data middle station module format, taking a hashed value, carrying out digital signature by using a private key of an account, and carrying out public verification by using a public key of the account;
a data encryption unit: the device is used for encrypting data to be encrypted in the data conforming to the data center module format by using a public key and decrypting the received encrypted data by using a private key;
a data submission unit: and calling the API of the data center module to uplink the data and returning the uplink hash value.
A data acquisition unit: and receiving corresponding data and transmitting the corresponding data to the data output module by calling the API of the data center module.
As an implementation manner, the interface module further includes an account unit, and the account unit is configured to store a private key and a public key pair of the user and correspond to the medical insurance unit and the medical clearing unit that actually participate in clearing settlement, so that the registered user can obtain a required public key and private key.
As an implementation manner, the data console module includes the account management unit, a second data I/O unit, an API management unit, and a data security unit;
the account management unit provides key accounts of the block chain for the medical service units, the medical insurance units and the medical clearing units, and the key accounts correspond to the medical service units, the medical insurance units and the medical clearing units which actually participate in clearing and settlement;
the second data I/O unit is in butt joint with the first data I/O of the interface module, determines the operation to be executed and the specified block chain platform according to the keywords in the settlement request, and further calls the corresponding block chain API command to complete the operation;
the API management unit is used for being in butt joint with the block chain universal interface system;
the data security unit is used for providing data security functions, wherein the data security functions comprise data backup and data recovery.
A block chain-based medical insurance remote hospitalizing clearing settlement method comprises the following steps:
the system is used for responding to the remote settlement data requirement and the remote settlement data acquisition requirement submitted by the user to obtain medical settlement list data and providing public key information required by verification and encryption;
acquiring settlement data based on medical settlement list data, signing by using a private key, encrypting and compressing the settlement data to be encrypted by using a public key to obtain first data, and submitting the first data to a data center system for uplink operation;
monitoring a data center system and acquiring first data, decompressing the first data, decrypting the encrypted data part by using a private key, and performing integrity verification by using a digital signature and a public key to obtain complete medical settlement list data;
and acquiring medical settlement list data on the chain, and counting the limit of each medical insurance unit based on the medical settlement list data to finish clearing operation.
As an implementation manner, the acquiring of the settlement data based on the medical settlement list data, the signing with the private key, and the encrypting and compressing of the settlement data to be encrypted with the public key to obtain the first data specifically includes:
carrying out digital signature on the complete medical settlement list data by using a private key of a medical service unit, and adding the signature into the uplink data so as to verify the integrity of the data;
encrypting part of data to be encrypted in the medical settlement list data by using a public key of a medical insurance unit, and adding the encrypted data into the uplink data;
adding the remaining data of the medical settlement list data into the uplink data;
and performing data compression on the uplink data to obtain first data.
As an implementable embodiment, the monitoring a data console system and acquiring first data, decompressing the first data, decrypting an encrypted part of the data using a private key, and performing integrity verification using a digital signature and a public key specifically includes:
after first data are obtained from the chain, decompressing the data to obtain downlink data;
decrypting the encrypted part in the downlink data by using a private key of a medical insurance unit;
and verifying the integrity of all data by using public key information disclosed by the medical service unit based on the decrypted data and the public data to obtain complete medical settlement list data.
Due to the adoption of the technical scheme, the invention has the remarkable technical effects that:
the service development cost of each participant of the service is reduced by a mode of 'block chains + a local central system'. Service participants do not need to operate blockchain nodes, access is realized through the middleboxes, the information systems of the existing medical institutions and medical insurance management institutions are fully utilized, the special functions of the blockchain can be realized only by opening the existing local pre-settlement data interfaces, re-development and construction are not needed, and development and implementation costs are reduced;
the path of data transmission is shortened, and point-to-point information interaction between a remote medical service organization and a local medical insurance organization is realized when the insured person visits the doctor and settles accounts at the remote place;
the medical service organization, the medical insurance organization and the medical clearing unit can utilize a block chain consensus mechanism to realize the synchronous and credible process of data at different places, improve the transmission efficiency and shorten the clearing and settlement intermediate link;
the safety of data and the privacy of users are protected by cryptography in the process of uploading and sharing medical settlement list data;
in the process of evaluating, clearing and settling the service of seeking medical advice at different places, the service logic can be further automatically completed by using an intelligent contract technology which is automatically executed and cannot be tampered, so that excessive manual intervention is avoided and the manual burden is reduced, and meanwhile, the result is monitored by multiple parties and is public and transparent;
the settlement electronic bill can carry out multi-party approval and deposit with the invoicing tax authority, and the result is open and transparent and accords with the supervision regulation;
unified data service is provided through the data center, the problem of inconsistent data submission and data acquisition caused by different block chain platforms can be avoided, and the use difficulty of a user is reduced.
Drawings
In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to these drawings without creative efforts.
FIG. 1 is a schematic diagram of a block chain and a remote medical insurance payment system in the prior art;
FIG. 2 is a schematic diagram of the system of the present invention;
FIG. 3 is a schematic overall flow diagram of the process of the present invention;
FIG. 4 is a schematic diagram of a process for sharing data between a health care unit and a health insurance unit.
Detailed Description
The present invention will be described in further detail with reference to examples, which are illustrative of the present invention and are not to be construed as being limited thereto.
Example 1:
a block chain-based medical insurance remote hospitalizing clearing and settlement system is shown in figure 2 and comprises a data center system, a medical service unit control system, a medical insurance unit control system and a medical clearing unit control system;
the data center system is used for responding to the triggering operation of receiving a remote settlement request submitted by a user and providing public key information of a medical service unit and a medical insurance unit; providing block chain interface information capable of downloading settlement data; performing chain winding operation on the settlement data submitted by the medical service unit and returning the chain winding receipt hashed value to the medical service submitting unit; acquiring data on a corresponding block chain and transmitting the data to a corresponding receiving unit under monitoring conditions set for medical insurance and medical clearing units;
the medical service unit control system acquires settlement data based on the medical settlement list data; acquiring a public key and appointed block chain information of a medical insurance unit from a data center; signing the complete medical settlement list data by using a private key of a medical service unit; encrypting the part needing encryption by using a public key of a medical insurance unit; compressing all data to obtain first data; submitting an uplink operation to the data center, namely saving the first data to a designated block chain;
the medical insurance unit control system is used for monitoring and acquiring first data, carrying out decompression processing on the first data, carrying out decryption processing on encrypted data, and verifying the integrity of the data by using a signature to ensure that complete medical settlement list data is obtained;
and the medical clearing unit control system is used for acquiring complete medical clearing list data on the chain, counting the limit of each medical insurance unit based on the complete medical clearing list data and finishing the clearing process.
In one embodiment, the data center system is configured to:
providing public key information of a medical service unit and a medical insurance unit;
providing block chain interface information capable of bearing settlement data;
triggering operation in response to receiving a remote settlement request submitted by a user;
performing chain winding operation on the settlement data submitted by the medical service unit and returning a chain winding receipt hashed value to the medical service unit;
acquiring data on a corresponding block chain and transmitting the data to a receiving unit under monitoring conditions set for medical insurance and medical clearing units;
in one embodiment, the healthcare system is arranged to:
signing the complete settlement data by using a private key of the institution to obtain a digital signature;
encrypting the encrypted part in the settlement data by using a public key of a medical insurance unit;
and performing data compression on the calculation data to obtain first data.
In one embodiment, the medical insurance unit control system is arranged to:
monitoring and acquiring first data, and performing line decompression processing on the first data;
carrying out decryption processing on the encrypted data;
and verifying the integrity of the settlement data by using public key information disclosed by the medical service unit to ensure that the complete medical settlement list data is obtained.
As shown in fig. 2 and 3, the data center system includes an interface module, a data center module, and a block chain universal interface system;
the interface module responds to a remote settlement request triggering operation submitted by a user, acquires settlement data based on medical settlement list data, signs by using a private key, encrypts by using a public key, and then compresses the data to obtain first data;
the data intermediate station module is in butt joint with the interface module, determines the operation to be executed and the appointed block chain platform according to the keywords in the settlement request, and carries out uplink operation on the first data;
the block chain universal interface system module is used for submitting and receiving first data and providing a block chain monitoring interface and a corresponding data format.
As an implementable manner, the interface module includes a first data I/O unit, a digital signature unit, a data compression unit, a data encryption unit, a data submission unit, and a data acquisition unit;
a first data I/O unit: input and output (i.e. I/O) are connected with the existing information system, different data interfaces are provided, and the user requirements are met. The main function establishes a data standard in data, for example, referring to the medical insurance fund settlement list filling standard issued by the office of the national medical insurance agency or other local standards, so as to interface medical service units and medical insurance units in different regions. In addition, the module is responsible for converting the information system output of the existing medical service unit into the standard of the data center, such as JSON format data, so as to facilitate further processing.
A digital signature unit: for data meeting the data center standard, after the data is serialized, a HASH value (HASH) is taken, a private key of an account is used for digital signature, and other users can use a public key of a signature account for public verification so as to achieve the purposes of protecting the integrity and the creditability of the uplink data. The digital signature can have different implementation methods for different blockchain platforms, for example, a cryptographic signature algorithm is supported.
A data compression unit: and compressing and decompressing the data meeting the data center standard so as to reduce the data transmission quantity and ensure the data integrity.
A data encryption unit: the data meeting the data center standard is processed by adopting an asymmetric encryption technology, namely a public key of an account of a receiving unit is used for encryption, the receiving unit uses a private key of the account for decryption, and the data is only visible for a receiving party, so that the purposes of protecting uplink data and ensuring data privacy are achieved.
A data submission unit: and after the data processing is finished, realizing data chaining and returning the hashed value of the data chaining by calling the API of the data center station.
A data acquisition unit: and receiving corresponding data and transmitting the data to the data output module by calling the API of the data center.
The block chain universal interface system is communicated with an API management module of a data center station in an API service mode and provides the following main functions:
data uplink: facing the interface of the block chain data uplink, the encrypted data can be uploaded and is in butt joint with the API of the data center station, and the requirement of data submission uplink is met.
Data downlinking: the block chain needs to provide a block data receiving interface and a corresponding data format, and is in butt joint with an API of a data center station to meet the data acquisition requirement.
Monitoring the nodes: the blockchain needs to provide an interface for monitoring the node state, so that the data center can know the working state of the blockchain node, and can provide monitoring and management functions for users through the API management of the center.
The data center module comprises the account management unit, a second data I/O unit, an API management unit and a data security unit;
the account management unit provides key accounts of the block chain for the medical insurance units and the medical clearing units, and the key accounts correspond to the medical insurance units and the medical clearing units which actually participate in clearing settlement;
a second data I/O unit: and the first data submitting and data acquiring unit of the interface module is in butt joint, so that the requirements of authorized users for submitting and accessing data can be in butt joint with the corresponding block chains. After receiving a request of a user, the module determines an operation to be executed and an appointed block chain platform according to keywords in the request, then calls a corresponding block chain API command to complete the operation, and returns corresponding information to the user.
An API management unit: the module connected with the plurality of block chain interfaces can support various block chain platforms, uses the unified interface standard for communication with the data I/O, and can avoid uplink operation difference caused by different block chain platforms.
A data security unit: and providing data security functions, such as a function of periodically performing incremental backup and recovery on historical data of the node, and providing security assurance on online information and the historical data.
In one embodiment, the interface module further comprises an account unit, wherein the account unit is used for storing a private key and a public key pair of the user and corresponds to the medical service unit, the medical insurance unit and the medical clearing unit which actually participate in clearing settlement, so that approved units can access the platform system to provide security guarantee of data exchange.
Example 2:
a block chain-based medical insurance remote hospitalizing clearing settlement method comprises the following steps:
s100, responding to a remote settlement request trigger operation submitted by a user, and acquiring settlement data based on medical settlement list data;
s200, the medical service unit control system signs the data to be settled by using a private key, encrypts the data by using a public key, compresses the data to obtain first data, and performs chain linking operation on the first data;
s300, monitoring and acquiring first data by a medical insurance unit control system, decompressing the first data, decrypting encrypted data, and verifying the integrity of the decrypted data by using a digital signature to obtain complete medical settlement list data;
s400, the medical clearing unit control system acquires complete medical clearing bill data on the chain, and counts the amount of each medical insurance unit based on the complete medical clearing bill data to complete the clearing process.
The above process can be summarized in conjunction with fig. 3 as follows:
data uplink:
after the payment of the patient is finished, the information enters a local information system of a medical unit, and settlement data are generated according to the medical insurance settlement list data acquisition standard;
the medical service unit control system uses a private key of the institution to carry out digital signature through an interface module, uses a public key of a medical insurance unit to carry out encryption, and then carries out data compression on the calculated data to obtain first data;
the control system of the medical service unit sends uplink operation to the first data according to the accessed block chain through the interface module;
after the identification confirmation of the access block chain system is completed, the control system of the medical service unit receives the hashed value of the data uplink and stores the hashed value into a local database;
(II) data collection:
the control system of the medical insurance unit monitors the medical settlement list data sent to the unit through the interface module;
after receiving the information from the platform, decompressing according to the platform standard, decrypting the data by using a private key of the insurance unit, and verifying the integrity of the data by using public key information of a medical service unit to obtain complete medical settlement list data;
storing medical settlement list data into a local information system;
completing settlement with the patient and paying the medical insurance cost in the local database according to the medical settlement list data;
(III) clearing medical insurance cost:
the medical settlement unit can collect the medical settlement list data on the chain through the interface module, count the amount of each unit and complete the settlement process without submitting the medical settlement list data again by each unit. The whole process is completely and automatically carried out;
for problematic chain settlement data, a data fingerprint of the chain data can be inquired according to the chain hash value of the data, and a submitting unit is required to provide original data for verification.
In other embodiments, the signing is performed on the data to be settled by using a private key, the encrypting is performed by using a public key, and the data compression is performed to obtain the first data, which specifically includes the following steps:
signing the complete medical settlement list data by using a private key of a medical service unit;
encrypting part of data to be encrypted by using a public key of a medical insurance unit;
and compressing all data including the digital signature and the encrypted data to obtain first data.
In an embodiment, the decompressing the first data, decrypting the encrypted part, and verifying the integrity of the first data by using the digital signature specifically includes:
monitoring and acquiring first data, and performing line decompression processing on the first data;
carrying out decryption processing on encrypted data in the decompressed data by using a corresponding private key;
and verifying the integrity of the settlement data by using public key information disclosed by the medical service unit to ensure that the complete medical settlement list data is obtained.
In an embodiment, as shown in fig. 4, the acquiring of the settlement data based on the medical settlement list data, the signing with the private key, and the encrypting and compressing the settlement data to be encrypted with the public key to obtain the first data specifically includes:
carrying out digital signature on the complete medical settlement list data by using a private key of a medical service unit, and adding the signature into the uplink data so as to verify the integrity of the data;
encrypting part of data to be encrypted in the medical settlement list data by using a public key of a medical insurance unit, and adding the encrypted data into the uplink data;
adding the remaining data of the medical settlement list data into the uplink data;
and performing data compression on the uplink data to obtain first data.
In addition, in fig. 4: after the first data is decompressed, the encrypted data is decrypted, and integrity verification is performed, specifically comprising the following steps:
after the first data are obtained, decompressing to obtain downlink data;
decrypting the encrypted data using a private key of the medical insurance unit;
and verifying the integrity of the decrypted data by using public key information disclosed by the medical service unit and the digital signature in the downlink data to obtain complete medical settlement list data.
For the device embodiment, since it is basically similar to the method embodiment, the description is simple, and for the relevant points, refer to the partial description of the method embodiment.
The embodiments in the present specification are described in a progressive manner, each embodiment focuses on differences from other embodiments, and the same and similar parts among the embodiments are referred to each other.
As will be appreciated by one skilled in the art, embodiments of the present invention may be provided as a method, apparatus, or computer program product. Accordingly, the present invention may take the form of an entirely hardware embodiment, an entirely software embodiment or an embodiment combining software and hardware aspects. Furthermore, the present invention may take the form of a computer program product embodied on one or more computer-usable storage media (including, but not limited to, disk storage, CD-ROM, optical storage, and the like) having computer-usable program code embodied therein.
The present invention has been described with reference to flowchart illustrations and/or block diagrams of methods, terminal devices (systems), and computer program products according to the invention. It will be understood that each flow and/or block of the flow diagrams and/or block diagrams, and combinations of flows and/or blocks in the flow diagrams and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, embedded processor, or other programmable data processing terminal to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing terminal, create means for implementing the functions specified in the flowchart flow or flows and/or block diagram block or blocks.
These computer program instructions may also be stored in a computer-readable memory that can direct a computer or other programmable data processing terminal to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including instruction means which implement the function specified in the flowchart flow or flows and/or block diagram block or blocks.
These computer program instructions may also be loaded onto a computer or other programmable data processing terminal to cause a series of operational steps to be performed on the computer or other programmable terminal to produce a computer implemented process such that the instructions which execute on the computer or other programmable terminal provide steps for implementing the functions specified in the flowchart flow or flows and/or block diagram block or blocks.
In addition, it should be noted that the specific embodiments described in the present specification may differ in the shape of the components, the names of the components, and the like. All equivalent or simple changes of the structure, the characteristics and the principle of the invention which are described in the patent conception of the invention are included in the protection scope of the patent of the invention. Various modifications, additions and substitutions for the specific embodiments described may be made by those skilled in the art without departing from the scope of the invention as defined in the accompanying claims.
Claims (11)
1. A block chain-based medical insurance remote hospitalizing clearing and settlement system is characterized by comprising a data center system, a medical service unit control system, a medical insurance unit control system and a medical clearing unit control system;
the data center system is used for responding to the remote settlement data requirement submitted by the user and the remote settlement data acquisition requirement to obtain medical settlement list data and providing public key information required by verification and encryption;
the medical service unit control system acquires settlement data based on medical settlement list data, utilizes a private key to carry out signature, encrypts and compresses the settlement data needing to be encrypted by using a public key to obtain first data, and submits the first data to a data center system for uplink operation;
the medical insurance unit control system is used for monitoring a data center system and acquiring first data, decompressing the first data, decrypting the encrypted data part by using a private key, and performing integrity verification by using a digital signature and a public key to acquire complete medical settlement list data;
and the medical clearing unit control system is used for acquiring medical clearing list data on the chain, counting the amount of each medical insurance unit based on the medical clearing list data and finishing clearing operation.
2. The blockchain-based medical insurance remote hospitalization clearing and settlement system of claim 1, wherein said data staging system is configured to:
providing public key information of a medical service unit and a medical insurance unit;
providing block link interface information bearing medical settlement list data;
performing chain linking operation on the settlement data submitted by the control system of the medical service unit and returning a chain linking receipt hashed value to the control system of the medical service submitting unit;
and setting monitoring conditions for the medical insurance unit control system and the medical clearing unit control system, and acquiring and transmitting corresponding settlement data on the block chain.
3. The blockchain-based medical insurance remote hospitalization clearing and settlement system of claim 1, wherein said medical service unit system is configured to:
acquiring a public key and appointed blockchain information of a medical insurance unit from a data center system;
signing the complete medical settlement list data by using a private key of a medical service unit;
encrypting and compressing a part needing encryption by using a public key of a medical insurance unit to obtain first data;
the first data is submitted to the specified blockchain to the data staging system.
4. The blockchain-based medical insurance remote hospitalization clearing and settlement system of claim 1, wherein the medical insurance unit control system is configured to:
submitting conditions for monitoring data to a data center system, wherein the conditions comprise a specified block chain and a medical service unit;
acquiring first data from a data console system and decompressing the first data;
decrypting the encrypted data in the first data using a private key of the medical insurance unit;
and verifying the integrity of the first data by using public key information disclosed by the medical service unit to obtain medical settlement list data.
5. The block chain-based medical insurance remote hospitalization clearing and settlement system of claim 1, wherein the data center system comprises an interface module, a data center module and a block chain module general interface module;
the interface module responds to a remote settlement request triggering operation submitted by a user and acquires settlement data based on medical settlement list data; signing the medical settlement list data by using a private key of a medical service unit; encrypting the encrypted partial data by using a public key of an insurance unit; carrying out data compression on the encrypted data to obtain first data;
the data intermediate station module is in butt joint with the interface module, determines the operation to be executed and the appointed block chain platform according to the keywords in the settlement request, and carries out uplink operation on the first data;
the block chain universal interface module is used for submitting and acquiring first data, namely data uplink and downlink, and providing a block chain node monitoring interface.
6. The block chain-based medical insurance remote hospitalization clearing and settlement system of claim 1, wherein said interface module comprises a first data I/O unit, a digital signature unit, a data compression unit, a data encryption unit, a data submission unit and a data acquisition unit;
the first data I/O unit is used for formulating a data standard conforming to the data console module and converting the received data to be settled into a format conforming to the data console module, such as public key information added into a receiver and a sender;
a data compression unit: compressing and decompressing data conforming to the data center module format;
a digital signature unit: the system is used for carrying out serialization processing on data conforming to the data middle station module format, taking a hashed value, carrying out digital signature by using a private key of an account, and carrying out public verification by using a public key of the account;
a data encryption unit: the device is used for encrypting data to be encrypted in the data conforming to the data center module format by using a public key and decrypting the received encrypted data by using a private key;
a data submission unit: and calling the API of the data center module to uplink the data and returning the uplink hash value.
A data acquisition unit: and receiving corresponding data and transmitting the corresponding data to the data output module by calling the API of the data center module.
7. The system according to claim 5, wherein the interface module further comprises an account unit, and the account unit is used for storing the private key and the public key pair of the user and corresponding to the medical insurance unit and the medical clearing unit actually participating in clearing and settling, so that the registered user can obtain the required public key and private key.
8. The system according to claim 5, wherein the data center module comprises the account management unit, a second data I/O unit, an API management unit and a data security unit;
the account management unit provides key accounts of the block chain for the medical service units, the medical insurance units and the medical clearing units, and the key accounts correspond to the medical service units, the medical insurance units and the medical clearing units which actually participate in clearing and settlement;
the second data I/O unit is in butt joint with the first data I/O of the interface module, determines the operation to be executed and the specified block chain platform according to the keywords in the settlement request, and further calls the corresponding block chain API command to complete the operation;
the API management unit is used for being in butt joint with the block chain universal interface system;
the data security unit is used for providing data security functions, wherein the data security functions comprise data backup and data recovery.
9. A block chain-based medical insurance remote hospitalizing clearing settlement method is characterized by comprising the following steps:
the system is used for responding to the remote settlement data requirement and the remote settlement data acquisition requirement submitted by the user to obtain medical settlement list data and providing public key information required by verification and encryption;
acquiring settlement data based on medical settlement list data, signing by using a private key, encrypting and compressing the settlement data to be encrypted by using a public key to obtain first data, and submitting the first data to a data center system for uplink operation;
monitoring a data center system and acquiring first data, decompressing the first data, decrypting the encrypted data part by using a private key, and performing integrity verification by using a digital signature and a public key to obtain complete medical settlement list data;
and acquiring medical settlement list data on the chain, and counting the limit of each medical insurance unit based on the medical settlement list data to finish clearing operation.
10. The method for clearing and settling medical insurance allopatric hospitalization of claim 9, wherein the settlement data is obtained based on the medical settlement list data, the private key is used for signing, and the public key is used for encrypting and compressing the settlement data to be encrypted to obtain the first data, and the method comprises the following specific steps:
carrying out digital signature on the complete medical settlement list data by using a private key of a medical service unit, and adding the signature into the uplink data so as to verify the integrity of the data;
encrypting part of data to be encrypted in the medical settlement list data by using a public key of a medical insurance unit, and adding the encrypted data into the uplink data;
adding the remaining data of the medical settlement list data into the uplink data;
and performing data compression on the uplink data to obtain first data.
11. The method according to claim 9, wherein the monitoring of the data center system and the acquisition of the first data, the decompression of the first data, the decryption of the encrypted data part by using a private key, and the integrity verification by using a digital signature and a public key specifically comprises:
after first data are obtained from the chain, decompressing the data to obtain downlink data;
decrypting the encrypted part in the downlink data by using a private key of a medical insurance unit;
and verifying the integrity of all data by using public key information disclosed by the medical service unit based on the decrypted data and the public data to obtain complete medical settlement list data.
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN115021940A (en) * | 2022-07-14 | 2022-09-06 | 国网浙江省电力有限公司电力科学研究院 | Load regulation and control data storage method, device, equipment and medium |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CN115021940A (en) * | 2022-07-14 | 2022-09-06 | 国网浙江省电力有限公司电力科学研究院 | Load regulation and control data storage method, device, equipment and medium |
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