CN115131160A - Medical insurance information platform and method for configuring medical insurance policy based on planning tree - Google Patents
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Abstract
The invention relates to the technical field of new-generation information, and discloses a medical insurance information platform and a method for configuring a medical insurance policy based on a planning tree, so as to be compatible with local medical insurance policy differences. The method comprises the following steps: screening dynamic parameters capable of being associated for a user to select so as to establish an association relation with the current maintained calculation rule; loading at least one dynamic parameter associated with a user in an editing process, wherein the information list can be retrieved and taken by the user in combination with a calculation formula list, a calculation symbol list and condition option information to complete the configuration of the planning tree of which each dynamic parameter meets the local medical insurance policy, and converting the operation of the user on the planning tree into the operation of a corresponding code in real time in the configuration process; and incorporating the calculation rules of the configured planning tree into the corresponding calculation rule group according to the user operation, and then executing corresponding issuing processing to execute medical insurance settlement of the medical insurance users administered in the corresponding medical insurance division range according to the planning tree.
Description
Technical Field
The invention relates to the technical field of new-generation information, in particular to a data processing system or method specially suitable for the purposes of administrative management, supervision or prediction, and particularly discloses a medical insurance information platform and a method for configuring medical insurance policies based on a planning tree.
Background
With the continuous development of the Chinese social insurance system, the number of medical insurance participants is continuously increased, and the data of the urban social insurance information system is increasingly improved. Today, the payment policies of medical insurance institutions are also constantly being adjusted over time. Due to the fact that medical insurance payment policies are complex and changeable, different provinces, cities and counties have different dangerous variety collection policies, particularly some local policies, no unified algorithm can meet the complex policies, and program codes need to be modified by developers of software providers to meet the requirements for the differentiated policies; and the method has the defects of incapability of configuration and reuse of a publisher of the medical insurance policy, invisible and traceable calculation process and the like.
Generally, medical insurance institutions pay payment including DRG (diagnostic Related Groups), DIP (Big Data Diagnosis-Intervention Packet), and the like, and in order to satisfy settlement policies of medical institutions with diversified medical insurance in various regions, corresponding policy judgment and calculation need to be implemented as required, and policies in various regions are very different, and how many policy logics need to be developed for how many regions of the market are often required to implement the policies. Therefore, there is a need to develop a medical insurance information platform compatible with local medical insurance policy differences and a method for configuring a medical insurance policy thereof, so as to facilitate independent and controllable issuing party of the medical insurance policy and visually implement daily management and maintenance such as formulation, issuing and updating of the medical insurance policy.
Disclosure of Invention
The invention mainly aims to disclose a medical insurance information platform and a method for configuring a medical insurance policy based on a planning tree, so that a publisher of the medical insurance policy can conveniently and independently control and visually realize daily management and maintenance such as formulation, publication and update of the medical insurance policy under the condition of being compatible with local medical insurance policy differences.
In order to achieve the above object, the method for configuring a medical insurance policy based on a planning tree disclosed by the present invention is applied to a medical insurance information platform, wherein the medical insurance information platform is provided with a local policy maintenance module and a policy parameter management module, the policy parameter management module is provided with a calculation rule maintenance unit, and the method comprises:
the calculation rule maintenance unit acquires attribute information of a calculation rule created by a user at present, wherein the attribute information at least comprises a calculation rule name and a corresponding medical insurance zoning range;
after the calculation rule maintenance unit obtains a maintenance request of a user, the calculation rule maintenance unit screens associable dynamic parameters according to the type corresponding to the name of the calculation rule for the user to select so as to establish an association relation with the currently maintained calculation rule;
after acquiring a request of a user for modifying service parameters, the calculation rule maintenance unit loads an information list which can be retrieved by retrieving at least one dynamic parameter associated with the user in an editing process, so that the user combines a calculation formula list, a calculation symbol list and condition option information to complete the configuration of a planning tree of which the dynamic parameter conforms to a local medical insurance policy; the configured planning tree displays the assignment formulas corresponding to the dynamic parameters finally and respectively under various conditions in the form of a mind map, and in the configuration process: synchronously displaying the information of the codes mapped one by one with the objects operated by the user, and converting the operation of the user on the planning tree into the operation of the corresponding codes in real time;
the calculation rule maintenance unit brings the calculation rules of the configured planning tree into the corresponding calculation rule group according to the user operation, and then the local policy maintenance module executes corresponding issuing processing according to the issuing attribute of the calculation rule group, so that the medical insurance information platform executes medical insurance settlement of medical insurance users managed in the corresponding medical insurance zone range according to the planning tree in the effective time after issuing;
wherein the user comprises a user originating from a medical insurance policy issuer.
In order to achieve the above object, the present invention further discloses a medical insurance information platform for configuring medical insurance policies based on a planning tree, which includes a memory, a processor, and a computer program stored in the memory and operable on the processor, wherein the processor implements the steps of the above method when executing the computer program.
The invention has the following beneficial effects:
1. the planning tree meets visualization in a form of a mind map, in the configuration process of the planning tree, a user can complete the configuration of the planning tree by selecting corresponding information from a corresponding information list, a calculation formula list, a calculation symbol list and condition option information and then operating according to requirements, and because the selected and operated information has a mapping relation with background codes, the operation of the user on the planning tree can be converted into the operation on the corresponding codes in real time in the configuration process.
2. In the process of configuring the planning tree, the information of the codes which are mapped one by one with the operation objects of the user is synchronously displayed, so that the information is convenient for professional technical developers to use and common users to use, and the fault reasons can be conveniently located by analyzing the synchronous condition between the operation objects and the codes when the system has faults.
3. In the invention, dynamic parameters related to local medical insurance policies can be flexibly configured through the planning tree, so that the compatibility of the medical insurance information platform on the differences of the local medical insurance policies is greatly improved, the medical insurance information platform can serve regions with the differences of a plurality of medical insurance policies, the utilization rate of resources is improved, and unified supervision is facilitated. In the operation process, ordinary users of non-professional technical developers, including users from medical insurance policy issuing parties, can search and complete configuration of the planning tree based on industry and phrase habits, so that the medical insurance policy issuing parties can conveniently and independently control and visually realize daily management and maintenance of making, issuing, updating and the like of the medical insurance policy.
The present invention will be described in further detail below with reference to the accompanying drawings.
Drawings
The accompanying drawings, which are incorporated in and constitute a part of this application, illustrate embodiments of the invention and, together with the description, serve to explain the invention and not to limit the invention. In the drawings:
fig. 1 is a flowchart illustrating a method for configuring a medical insurance policy based on a planning tree according to an embodiment of the present invention.
Detailed Description
The embodiments of the invention will be described in detail below with reference to the drawings, but the invention can be implemented in many different ways as defined and covered by the claims.
Example 1
The embodiment discloses a method for configuring a medical insurance policy based on a planning tree, which is applied to a medical insurance information platform, wherein the medical insurance information platform is provided with a local policy maintenance module and a policy parameter management module, and the policy parameter management module is provided with a calculation rule maintenance unit.
As shown in fig. 1, the method of this embodiment specifically includes:
step S1, the calculation rule maintenance unit obtains attribute information of the calculation rule currently created by the user, where the attribute information at least includes a name of the calculation rule and a corresponding medical insurance zone range.
In this step, the calculation rule name should be named according to the specification to embody the type information required for the subsequent step S2. Related names are exemplary such as: 2022-BB market value calculation rule, 2022-BB market group division rule, wherein the value calculation rule and the group division rule are regarded as two different types. As an equivalent alternative, the corresponding type information may be specified in the attribute information for relaxing the name requirement, and such variations are all within the scope of the present invention.
Step S2, after obtaining the maintenance request of the user, the calculation rule maintenance unit screens the associable dynamic parameters according to the type corresponding to the calculation rule name for the user to select to establish the association relationship with the currently maintained calculation rule.
In this step, the matching relationship between each calculation rule type and the associable dynamic parameter is configured in advance by the background. Generally, the calculation rule names correspond to different types, and the dynamic parameters that can be associated with each type often differ. The "dynamic parameter" is an object for performing condition judgment according to different attributes, and related attribute information includes, but is not limited to: "is medical insurance user", "is town employee, urban and rural resident or official", "number of hospitalization days", "type of disease" and so on.
It is worth mentioning that: the maintenance request is the first maintenance request of the user following the step S1, and is mainly used for building the content of the new calculation rule. Alternatively, in parallel with the maintenance request of this step, the user may also perform processing of deletion, copy, and the like of the selected calculation rule as necessary.
Step S3, after obtaining the request of user to modify the service parameter, the calculation rule maintenance unit loads at least one information list which can be retrieved and taken by the user in the editing process of the dynamic parameter associated with the user, so that the user combines the calculation formula list, the calculation symbol list and the condition option information to complete the planning tree configuration of the dynamic parameter according with the local medical insurance policy; the configured planning tree displays the final corresponding assignment formulas of the corresponding dynamic parameters under various conditions in a thinking guide diagram form, and in the configuration process: and synchronously displaying the information of the codes mapped one by one with the objects operated by the user, and converting the operation of the user on the planning tree into the operation on the corresponding codes in real time. And the dynamic parameters are respectively configured with at least two condition numbers corresponding to the assignment formulas.
In this step, the condition option information is used to construct a path distribution condition in the planning tree, for example, in the inspection process, if the overall situation is greater than 0 and corresponds to the path a, and if the overall situation is less than or equal to 0, corresponds to another path B; or the grouping is successful and corresponds to the branch C, and the grouping is unsuccessful and corresponds to the other branch D. The calculation symbol list is mainly used for providing calculation symbols required by configuration, such as: adding, subtracting, multiplying, dividing, deducting, and the like; the calculation formula list is mainly used for providing calculation functions required by configuration. The information list is mainly used to provide other information required for planning tree configuration, including but not limited to: for configuring the attributes of each node in the planning tree. Typically, a partial sub-node corresponds to two or more conditional states, such as: the leg over which the packet status (which may be considered a child node) extends includes both a packet successful leg and a packet unsuccessful leg.
Optionally, the retrieval mode of this step may specifically be based on a keyword or a keyword to perform retrieval. The keywords or keywords should conform to industry usage habits.
In this step, the request for modifying the service parameters is mainly used to identify the specific dynamic parameters modified by the user to perform the corresponding processing. For example: if the DIP score result and the DIP point value calculation two dynamic parameters are correlated in the score calculation rule, the user can enter a rule tree configuration interface of the DIP score result by clicking a menu area where the DIP score result is located; and if the area selected and clicked by the user is the menu area where the DIP point value is calculated, entering a rule tree configuration interface for calculating the DIP point value.
Similarly to the above step S2, this step is the same: if the dynamic parameters are different, the associated information list, calculation formula list, calculation symbol list and condition option information are often different. The essence is that the background classifies specific items in the information list, the calculation formula list, the calculation symbol list and the condition option information which can be associated with each dynamic parameter one by one in advance, and invalid items are filtered out, so that the items among a plurality of dynamic parameters are prevented from being mixed, a user can conveniently and quickly select an operation object, the probability of mismatching of the user is further reduced, and the reliability of the platform is improved.
Preferably, in the process of configuring the planning tree for any dynamic parameter, the information list is a union of all information related to the dynamic parameter in the settlement information tables nationwide; the calculation formula list is a union of all calculation functions related to the dynamic parameter in the national range; the calculation symbol list is a union of all calculation symbols related to the dynamic parameter in the national range; the condition option information is a union of all condition option information related to the dynamic parameter in the national range; and all retrieval contents in the list (namely, descriptive contents of the selectable objects conforming to the industry habits of common users of the medical insurance policy issuer, usually names of function and variable parameters, such as a DIP value result, a personal self-payment amount, a DIP value result and a total self-payment amount, which also belong to the node attributes of the planning tree) and codes are displayed in the information list and the calculation formula list in a one-to-one mapping relation which is common all over the country (for example, the descriptive names of all the operation objects and the parameter values in the corresponding codes can be displayed in a one-to-one correspondence manner). Therefore, flexible configuration based on local medical insurance policies in all parts of the country can be met.
And step S4, the calculation rule maintenance unit brings the calculation rules configured with the planning tree into the corresponding calculation rule group according to the user operation, and then the local policy maintenance module executes corresponding release processing according to the release attribute of the calculation rule group, so that the medical insurance information platform executes medical insurance settlement of medical insurance users managed in the corresponding medical insurance division range according to the planning tree in the effective time after release.
In this step, the medical insurance policies of different places are generally complex and often need to be broken down into a plurality of calculation rules. One calculation rule group can be regarded as a minimum medical insurance policy settlement unit which can be independently issued. The relevant medical insurance policy may be DIP, DRG, etc. When the calculation rule is a score calculation rule, the dynamic parameters which can be associated comprise a DIP score result, a DIP score value calculation and a settlement information table, and at least the DIP score result and the DIP score value calculation are configured through a planning tree.
And step S5, after the planning tree is configured, when the calculation rule maintenance unit acquires the maintenance request of the user again, directly displaying the corresponding planning tree for the user to execute the corresponding maintenance processing. Optionally, after selecting a corresponding dynamic parameter from the dynamic parameter maintenance unit that performs centralized maintenance management on the dynamic parameter, the user may perform routine maintenance such as addition, deletion, or modification of branches on the planning tree.
Preferably, this embodiment further includes: in the configuration process of the planning tree, all expansion parameters which are added in a matching way with the local medical insurance policy are loaded into an expansion parameter list for a user to take, and the expansion parameter list, the information list, the calculation formula list and the calculation symbol list are arranged in a same display interface side by side. In other words, the extended parameters may be defined parameters in other functional modules in the medical insurance information platform, including parameters in other calculation rules in the same calculation rule group, such as "average cost of disease category", and the like.
Preferably, this embodiment further includes: a static parameter maintenance unit is arranged in the policy parameter management module to realize the unified management of the reusable fixed data. The "static parameters" are fixed and unchangeable parameters, for example, the numerical label corresponding to "employee planning fund calculation" is "301101"; typically, the static parameters may be incorporated into the above-described information list to facilitate user configuration of the planning tree. Therefore, when the user modifies the digital label corresponding to the employee planning fund calculation to 301001 again in the static parameter management module, the original corresponding digital label 301101 can be synchronously updated to 301001 in each planning tree configured locally by the user. Optionally, the static parameter unit and the dynamic parameter maintenance unit are provided in the policy parameter management module together with the calculation rule unit, and preferably, a functional unit for performing centralized management on the calculation rule group may be further included in the policy parameter management module so as to facilitate quick switching among associated series of operations by a user.
Preferably, the method of this embodiment further includes: after the user edits the assignment formula corresponding to the first leaf node in the planning tree, the calculation rule maintenance unit detects whether the second leaf node and the first leaf node have a common father node or not when the user edits the assignment formula, and if so, the assignment formula edited by the first leaf node is filled into a corresponding editing column to be used as a modified prototype. Generally, the assignment formulas of most leaf nodes are relatively complex, the difference of the assignment formulas corresponding to adjacent leaf nodes is relatively small, and compared with the situation that a user selects repeated objects from an information list, a calculation formula list and a calculation symbol list again, the method greatly reduces invalid work and lowers the error probability; further, the embodiment may also detect, in a traversal manner, whether there are at least two leaf nodes in the planning tree that have the same non-constant assignment formula before incorporating the calculation rule configured with the planning tree into the corresponding calculation rule group, and if there are at least two leaf nodes in the planning tree, output corresponding alarm information to prompt the user to correct the error; and further, on the premise of improving the configuration efficiency of the planning tree, the reliability of configuration is ensured, and meanwhile, the logic optimization of each conditional branch in the planning tree is facilitated (in the embodiment, two leaf nodes with the same assignment formula are not allowed to appear in the same planning tree, and if the two leaf nodes exist, the two leaf nodes are regarded as the classification errors of the conditional branch, wherein the assignment formula is limited to the assignment formula which is calculated according to variables, and the conditions that the assignment is constant 0 and the like are not included), so that the overall performance of the platform is improved.
Example 2
Corresponding to the above method embodiments, this embodiment discloses a medical insurance information platform for configuring medical insurance policies based on a planning tree, which includes a memory, a processor, and a computer program stored in the memory and operable on the processor, wherein the processor implements the steps corresponding to the above method embodiments when executing the computer program.
In summary, the medical insurance information platform and the method for configuring the medical insurance policy based on the planning tree disclosed in the embodiments of the present invention have at least the following beneficial effects:
1. the planning tree meets visualization in a form of a mind map, in the configuration process of the planning tree, a user can complete the configuration of the planning tree by selecting corresponding information from a corresponding information list, a calculation formula list, a calculation symbol list and condition option information and then operating according to requirements, and because the selected and operated information has a mapping relation with background codes, the operation of the user on the planning tree can be converted into the operation on the corresponding codes in real time in the configuration process.
2. In the process of configuring the planning tree, the information of the codes which are mapped one by one with the operation objects of the user is synchronously displayed, so that the information is convenient for professional technical developers to use and common users to use, and the fault reasons can be conveniently located by analyzing the synchronous condition between the operation objects and the codes when the system has faults.
3. In the invention, dynamic parameters related to local medical insurance policies can be flexibly configured through the planning tree, so that the compatibility of the medical insurance information platform on the differences of the local medical insurance policies is greatly improved, the medical insurance information platform can serve regions with the differences of a plurality of medical insurance policies, the utilization rate of resources is improved, and unified supervision is facilitated. In the operation process, ordinary users of non-professional technical developers, including users from medical insurance policy issuers, can search and complete the configuration of the planning tree based on industry and language habits, so that the medical insurance policy issuers can independently and controllably establish, issue and update the medical insurance policy visually and perform daily management and maintenance.
The above description is only a preferred embodiment of the present invention and is not intended to limit the present invention, and various modifications and changes may be made by those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.
Claims (8)
1. A method for configuring a medical insurance policy based on a planning tree is applied to a medical insurance information platform, and is characterized in that the medical insurance information platform is provided with a local policy maintenance module and a policy parameter management module, and a calculation rule maintenance unit is arranged in the policy parameter management module, and the method comprises the following steps:
the calculation rule maintenance unit acquires attribute information of a calculation rule created by a user at present, wherein the attribute information at least comprises a calculation rule name and a corresponding medical insurance zoning range;
after the calculation rule maintenance unit obtains a maintenance request of a user, the calculation rule maintenance unit screens associable dynamic parameters according to the type corresponding to the name of the calculation rule for the user to select so as to establish an association relation with the currently maintained calculation rule;
after acquiring a request of a user for modifying service parameters, the calculation rule maintenance unit loads an information list which can be retrieved and taken by at least one dynamic parameter associated with the user in an editing process, so that the user combines a calculation formula list, a calculation symbol list and condition option information to complete the configuration of a planning tree of which the dynamic parameter conforms to a local medical insurance policy; the configured planning tree displays the assignment formulas corresponding to the dynamic parameters finally and respectively under various conditions in the form of a mind map, and in the configuration process: synchronously displaying the information of the codes mapped one by one with the objects operated by the user, and converting the operation of the user on the planning tree into the operation of the corresponding codes in real time;
the calculation rule maintenance unit brings the calculation rules of the configured planning tree into the corresponding calculation rule group according to the user operation, and then the local policy maintenance module executes corresponding issuing processing according to the issuing attribute of the calculation rule group, so that the medical insurance information platform executes medical insurance settlement of medical insurance users managed in the corresponding medical insurance zone range according to the planning tree in the effective time after issuing;
wherein the user comprises a user originating from a medical insurance policy issuer.
2. The method of claim 1, wherein the list of information is a union of all information related to the dynamic parameter in each nationwide statement of settlement information; the calculation formula list is a union of all calculation functions related to the dynamic parameter in a nationwide range; the calculation symbol list is a union of all calculation symbols related to the dynamic parameter in a nationwide range; the condition option information is a union of all condition option information related to the dynamic parameter in the national range; and the information list and the calculation formula list both display the one-to-one mapping relation which is common nationwide between each retrieval content and the code in the list.
3. The method of claim 2, further comprising:
in the configuration process of the planning tree, all expansion parameters which are added in a matching way with a local medical insurance policy are loaded into an expansion parameter list for a user to take, and the expansion parameter list, the information list, the calculation formula list and the calculation symbol list are arranged in a same display interface side by side.
4. The method of claim 3, further comprising:
and setting a static parameter maintenance unit in the policy parameter management module to realize the unified management of the reusable fixed data.
5. The method of any of claims 1 to 4, further comprising:
after the user edits the assignment formula corresponding to the first leaf node in the planning tree, the calculation rule maintenance unit detects whether a second leaf node and the first leaf node have a common father node or not when the user edits the assignment formula, and if so, fills the assignment formula edited by the first leaf node into a corresponding editing column to serve as a modified prototype; and before the calculation rules of the configured planning tree are brought into the corresponding calculation rule groups, whether at least two leaf nodes with the same non-constant assignment formula exist in the planning tree or not is detected in a traversal mode, and if yes, corresponding warning information is output to prompt a user to correct errors.
6. The method of any of claims 1 to 4, further comprising:
after the planning tree is configured, when the calculation rule maintenance unit acquires the maintenance request of the user again, the corresponding planning tree is directly displayed for the user to execute corresponding maintenance processing.
7. The method according to any one of claims 1 to 4, wherein when the calculation rule is a score calculation rule, the dynamic parameters that can be associated include a DIP score result, a DIP score calculation and a settlement information table, and at least the DIP score result and the DIP score calculation are configured by a planning tree.
8. A medical insurance information platform for configuring medical insurance policies based on a planning tree, comprising a memory, a processor and a computer program stored on the memory and executable on the processor, wherein the processor implements the steps of the method of any of claims 1 to 7 when executing the computer program.
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Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH10326304A (en) * | 1997-05-27 | 1998-12-08 | Daiichi Seimei Hoken Sougogaishiya | Insurance money calculation system and recording medium storing procedure for allowing computer to calculate insurance money |
| US20140142987A1 (en) * | 2012-11-16 | 2014-05-22 | Ryan Misch | System and Method for Automating Insurance Quotation Processes |
| CN107423270A (en) * | 2017-07-27 | 2017-12-01 | 国云科技股份有限公司 | The implementation method that a kind of online flow chart and code mutually turn in real time |
| CN111158656A (en) * | 2019-12-31 | 2020-05-15 | 中国银行股份有限公司 | Method and device for generating test codes based on fruit tree method |
| CN112447285A (en) * | 2019-09-04 | 2021-03-05 | 南京医渡云医学技术有限公司 | Decision logic representation method and device based on mind map |
| CN113886538A (en) * | 2021-09-28 | 2022-01-04 | 北京华彬立成科技有限公司 | Medical insurance reimbursement information query method and device, electronic equipment and storage medium |
| CN114119260A (en) * | 2021-11-22 | 2022-03-01 | 湖南和宇数字技术研究院有限公司 | Medical insurance treatment calculation method and device and electronic equipment |
| CN114529017A (en) * | 2020-11-23 | 2022-05-24 | 上海电气电站设备有限公司 | Steam turbine fault maintenance system, maintenance method and electronic equipment |
-
2022
- 2022-08-30 CN CN202211045814.8A patent/CN115131160B/en active Active
Patent Citations (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| JPH10326304A (en) * | 1997-05-27 | 1998-12-08 | Daiichi Seimei Hoken Sougogaishiya | Insurance money calculation system and recording medium storing procedure for allowing computer to calculate insurance money |
| US20140142987A1 (en) * | 2012-11-16 | 2014-05-22 | Ryan Misch | System and Method for Automating Insurance Quotation Processes |
| CN107423270A (en) * | 2017-07-27 | 2017-12-01 | 国云科技股份有限公司 | The implementation method that a kind of online flow chart and code mutually turn in real time |
| CN112447285A (en) * | 2019-09-04 | 2021-03-05 | 南京医渡云医学技术有限公司 | Decision logic representation method and device based on mind map |
| CN111158656A (en) * | 2019-12-31 | 2020-05-15 | 中国银行股份有限公司 | Method and device for generating test codes based on fruit tree method |
| CN114529017A (en) * | 2020-11-23 | 2022-05-24 | 上海电气电站设备有限公司 | Steam turbine fault maintenance system, maintenance method and electronic equipment |
| CN113886538A (en) * | 2021-09-28 | 2022-01-04 | 北京华彬立成科技有限公司 | Medical insurance reimbursement information query method and device, electronic equipment and storage medium |
| CN114119260A (en) * | 2021-11-22 | 2022-03-01 | 湖南和宇数字技术研究院有限公司 | Medical insurance treatment calculation method and device and electronic equipment |
Non-Patent Citations (2)
| Title |
|---|
| 史俊等: "河南省城乡居民医保省级即时结报平台信息管理系统设计与应用", 《智慧健康》 * |
| 彭磊等: "改进的规则引擎在医保系统中的应用", 《微计算机信息》 * |
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