CN202261358U - Information exchanger for networked medical social insurance settlement - Google Patents
Information exchanger for networked medical social insurance settlement Download PDFInfo
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- CN202261358U CN202261358U CN2011200555308U CN201120055530U CN202261358U CN 202261358 U CN202261358 U CN 202261358U CN 2011200555308 U CN2011200555308 U CN 2011200555308U CN 201120055530 U CN201120055530 U CN 201120055530U CN 202261358 U CN202261358 U CN 202261358U
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Abstract
The utility model relates to an information exchanger for networked medical social insurance settlement, which comprises a plurality of groups of data exchange modules that are connected with one another; each group of data exchange module comprises an input unit, an authentication unit, a processing unit, a bottom communication unit, a network segment configuration unit, a log unit and an output unit; the groups of data exchange modules are connected and perform data transmission and exchange with a data transmission network or an application server; and the exchanger is in a structure of four layers, i.e. a networked medical social insurance settlement interface, a data exchange layer configuration management device, a central data exchange and processing unit, and an information exchanger operating system. The exchanger takes real-time networked unified settlement in a larger administrative region as an objective, adopts a centralized data exchange application mode, achieves the networked medical social insurance settlement transaction in the region, provides a reliable data exchange mechanism for the real-time networked social insurance fund settlement, can ensure the high efficiency of the networked settlement data exchange, and has good interface expansibility.
Description
Technical field
The utility model relates to the computer data switching system, especially a kind of message switching equipment that carries out real time medical treatment capital settlement about Social Security Fund Mangt Center and each medical institutions.
Background technology
Social security medical insurance networking clearing are one of emphasis development projects of China gold guarantor engineering social insurance funds payment system, and it belongs to accurate financial sector.Early stage medical insurance reimbursement is main with large hospital; Carry out inner special line networking mode, mainly carry out exchanges data, this type of data exchange ways through EJB or Socket mode; Development technique is complicated; Exchanges data efficient is low, and shortcoming network security monitoring management is had relatively high expectations and medical institutions' network cost has high input to the software developer.
On the other hand, the clearing detail that medical institutions upload is null, and when medical insurance treatment dispute occurring, settlement data can not be as effective legal argument, and its Information Security is relatively poor.Along with medical insurance reimbursement scope constantly enlarges; General out patient service is planned as a whole the implementation of reimbursement, and community medicine mechanism can't bear the software development expense and the networking expense of great number, therefore; Early stage technology can not satisfy the business development demand of medical insurance reimbursement, has influence on the development of medical insurance cause.
The utility model content
The purpose of the utility model is to utilize existing computer information management system; Computer network security technology and computer hardware technology; A kind of social security medical treatment networking settlement information switch of managing formula concentratedly is provided; Solve the networking difficulty that present social security medical insurance networking clearing run into, networking is slow, the problem that cost is high.
The purpose of the utility model realizes through adopting following technical scheme:
Social security medical treatment networking settlement information switch; Said message switching equipment comprises body and many groups of interconnective data exchange modules that are located in the body, and said every group of data exchange module comprises interconnective input unit, authentication ' unit, processing unit, bottom communication unit, network segment dispensing unit, log unit and output unit respectively; Said every group of data exchange module is connected and carries out the transmission and the exchange of settlement data with data transmission network or application server according to specific format and security configuration.
As the optimal technical scheme of the utility model, said message switching equipment comprises four-layer structure, and wherein, the ground floor structure is social security medical treatment networking clearing interfaces, and this layer carries out the configuration of settlement data organization definition according to national social security medical insurance data standard;
Second layer structure is an exchanges data layer configuration management device, and this device comprises input unit, processing unit, output unit and the log unit of every group of exchanges data layer;
Three-decker is the central data switch processing unit, and this unit comprises data transmission device, safety certification device, DEU data exchange unit and the network segment spacer assembly of every group of exchanges data interlayer;
Four-layer structure is a message switching equipment operating system, and this system comprises the computer hardware resource control device.
As the optimal technical scheme of the utility model, said message switching equipment one end is connected with data transmission network through Switching Module 2, outer net fire compartment wall; The said message switching equipment other end is connected with application server through Switching Module 1.
As the optimal technical scheme of the utility model, said application server connects database server respectively and calamity is equipped with server, and said database server is equipped with server with calamity and is connected.
As the optimal technical scheme of the utility model, said database server is equipped with server with calamity and is connected disk array and magnetic tape station respectively.
As the optimal technical scheme of the utility model, said data transmission network comprises bank's private network, government affairs outer net, health private network and public internet.
As the optimal technical scheme of the utility model, said message switching equipment comprises CPU, disk, network adapter.
The beneficial effect of the utility model is: with respect to prior art; The utility model is to realize that the unified clearing of networking in real time of bigger administrative region are target; With centralized exchanges data application model; Realize regional social security medical insurance networking account settlement business, have following characteristics: 1, have outer net and Intranet physics network segment isolation features; 2, set up unified social security medical insurance networking data structure, guarantee that data qualification meets national medical insurance data standard; 3, adopt the standard XML markup language to describe settlement data structure, 4, realize interconnecting of outer net and Intranet through the WebServic technology; 5, all data exchange processes are all noted through the journal file mode.
The utility model is that the social insurance funds clearing of networking in real time provide reliable data exchange mechanism, can ensure the high efficiency of networking settlement data exchange, has the excellent interface autgmentability simultaneously, can adapt to the professional continuous expansion of medical insurance.
Description of drawings
Below in conjunction with accompanying drawing and specific embodiment the utility model is described further:
Fig. 1 is the structural representation of the utility model;
Fig. 2 is the workflow sketch map of the utility model;
Fig. 3 is the operation principle sketch map of the utility model.
Embodiment
Social security medical treatment networking settlement information switch; Comprise body and many groups of interconnective data exchange modules that are located in the body, said every group of data exchange module comprises interconnective input unit, authentication ' unit, processing unit, bottom communication unit, network segment dispensing unit, log unit and output unit respectively; Said every group of data exchange module is connected and carries out the transmission and the exchange of settlement data with data transmission network or application server according to specific format and security configuration.
The present embodiment message switching equipment comprises four-layer structure, and wherein, the ground floor structure is social security medical treatment networking clearing interfaces, and this layer carries out the configuration of settlement data organization definition according to national social security medical insurance data standard; Second layer structure is an exchanges data layer configuration management device, and this device comprises input unit, processing unit, output unit and the log unit of every group of exchanges data layer; Three-decker is the central data switch processing unit, and this unit comprises data transmission device, safety certification device, DEU data exchange unit and the network segment spacer assembly of every group of exchanges data interlayer; Four-layer structure is a message switching equipment operating system, and this system comprises the computer hardware resource control device.
Said message switching equipment one end of present embodiment is connected with data transmission network through Switching Module 2, outer net fire compartment wall, and the other end is connected with application server through Switching Module 1.Said application server connects database server respectively and calamity is equipped with server, and database server is equipped with server with calamity and is connected, and database server is equipped with server with calamity and is connected disk array and magnetic tape station respectively.The said data transmission network of present embodiment comprises bank's private network, government affairs outer net, health private network and public internet; Said message switching equipment comprises CPU, disk, network adapter.
As shown in Figure 1, in the present embodiment, said social security medical treatment networking settlement information switch; Be to be deployed among the application service network segment VLAN_2; Application server is connected to the network interface of the Switching Module 1 of message switching equipment, and the outer net network segment is used the network interface of the Switching Module 2 that is linked into message switching equipment, and application server is connected to data center's network segment through Intranet again; Carry out data access, and network segment access information switch of living in is separately passed through in the outer net application.
The said transfer of data of present embodiment comprises bank's private network, government affairs outer net, health private network and public internet etc.Said message switching equipment comprises CPU, disk, network adapter etc.
As shown in Figure 2, be the workflow of the utility model, medical institutions will transform the charge client of HIS system according to social security medical treatment networking clearing interface specification; The patient is when the payment medical expense, and medical institutions can send solicited messages such as insured people's ID card No., name and insured insurance kind to message switching equipment, and the outer net data exchange module of message switching equipment is after receiving solicited message; Data are carried out the grammer verification in meeting and request permissions is checked, if request is correct, the information exchange chance is transmitted to request the data exchange module of Intranet; After the data exchange module of Intranet is received request, can carry out data structure and decompose, call the relevant interface at social security center; Return to the outer net Switching Module to request results; The outer net Switching Module is passed the client to medical institutions back, at this time again after receiving the result; Client will show insured personnel's basic document, enjoys relevant treatment information such as reimbursement amount and reimbursement ratio.
Medical institutions are combined into request msg to the charge detail according to interface specification according to insured people's data, send to message switching equipment; The same with above-mentioned process, after the data exchange module of outer net receives request, can hand to the data exchange module of Intranet; Analyze the data that clearing are detailed, calculate social security check and approve the amount of money, individual at one's own expense the amount of money, the disbursement from fund amount of money and individual pay results such as the amount of money for oneself, and settle accounts operation such as flowing water book keeping operation; At last pass client by the data exchange module of Intranet back through the data exchange module of outer net again to medical institutions; After client receives the result, only collect the individual and use expense at one's own expense at one's own expense, do not collect the disbursement from fund amount of money with the individual; Thereby accomplish networking settlement function in real time, the patient only need pay the expense that oneself should give.
As shown in Figure 3; The HIS system of the medical institutions of outer net all must unifiedly insert the social security core system through message switching equipment; The data of all requests are all described with the XML form; With the data transfer mode of WebService, send to the outer net data exchange module of message switching equipment to request, the input unit of outer net data exchange module can be received the request from medical institutions.
The outer net data exchange module of message switching equipment receives request at every turn; At first input unit carries out log record, collects critical datas such as request IP, request text, medical institutions' numbering and request time, and processing unit can be asked all must be through the certificate server verification; After if data check passes through; The processing unit of outer net data exchange module just is transmitted to the intranet data Switching Module, otherwise, directly return the client that medical institutions are given in error message.
The processing unit of outer net and intranet data Switching Module are to carry out packet exchange through the bottom communication unit; Outer net the bottom communication unit can be split as several packets to the XML text; Send to the intranet data Switching Module then; The bottom communication unit of intranet data Switching Module reduces the XML text again after receiving packet.
During the request of intranet data Switching Module after receiving reduction; At first input unit also is to carry out log record, and processing unit can be explained appealing structure then, and major key, the medical institutions that isolate the clearing personnel number, the data such as medical technologies project, medicine catalogue and settlement amounts of clearing; Then processing unit can inquire insured people's the account of paying the fees through the data center of social security through SQL statement; Judged whether the arrearage record, whether the medical allowable amount of money has reached information such as the line that binds, and processing unit can be according to the Policy Conditions after being provided with; The reimbursement ratio that comprises corresponding insurance kind; Conditions such as reimbursement accumulative total total amount and reimbursement time period, calculate social security check and approve the amount of money, individual at one's own expense the amount of money, the disbursement from fund amount of money and individual pay results such as the amount of money for oneself, and be accessed in the data center of social security to clearing flowing water.
At last; By the output unit of intranet data Switching Module the clearing serial number, the amount of money, the disbursement from fund amount of money and individual pay the packet that result such as the amount of money is packaged into the XML structure for oneself at one's own expense to check and approve the amount of money, individual; Pass processing unit back by the bottom communication module again, return to the result through the mode of WebService the client of medical institutions again by the output unit of outer net to outer net.
Claims (3)
1. social security medical treatment networking settlement information switch; Comprise body and many groups of interconnective data exchange modules that are located in the body, said every group of data exchange module comprises interconnective input unit, authentication ' unit, processing unit, bottom communication unit, network segment dispensing unit, log unit and output unit respectively; Said every group of data exchange module is connected and carries out the transmission and the exchange of settlement data with data transmission network or application server according to specific format and security configuration; Said message switching equipment comprises four-layer structure, and wherein, the ground floor structure is social security medical treatment networking clearing interfaces; Second layer structure is an exchanges data layer configuration management device, and this device comprises input unit, processing unit, output unit and the log unit of every group of exchanges data layer; Three-decker is the central data switch processing unit, and this unit comprises data transmission device, safety certification device, DEU data exchange unit and the network segment spacer assembly of every group of exchanges data interlayer; Four-layer structure is a message switching equipment operating system, and this system comprises the computer hardware resource control device; It is characterized in that: said message switching equipment one end is connected with data transmission network through Switching Module 2, outer net fire compartment wall; The said message switching equipment other end is connected with application server through Switching Module 1; Said application server connects database server respectively and calamity is equipped with server, and said database server is equipped with server with calamity and is connected; Said database server is equipped with server with calamity and is connected disk array and magnetic tape station respectively.
2. social security medical treatment networking settlement information switch according to claim 1, it is characterized in that: said data transmission network comprises bank's private network, government affairs outer net, health private network and public internet.
3. social security medical treatment networking settlement information switch according to claim 1, it is characterized in that: said message switching equipment comprises CPU, disk, network adapter.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2011200555308U CN202261358U (en) | 2011-03-04 | 2011-03-04 | Information exchanger for networked medical social insurance settlement |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN2011200555308U CN202261358U (en) | 2011-03-04 | 2011-03-04 | Information exchanger for networked medical social insurance settlement |
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| Publication Number | Publication Date |
|---|---|
| CN202261358U true CN202261358U (en) | 2012-05-30 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN2011200555308U Expired - Fee Related CN202261358U (en) | 2011-03-04 | 2011-03-04 | Information exchanger for networked medical social insurance settlement |
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| Country | Link |
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| CN (1) | CN202261358U (en) |
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104484824A (en) * | 2014-12-25 | 2015-04-01 | 上海亿保健康管理有限公司 | System and method for automatically converting consumption data into claim settlement information |
| CN107463767A (en) * | 2017-07-06 | 2017-12-12 | 深圳市坐标软件开发有限公司 | Cloud HIS medical insurances data processing method and system |
-
2011
- 2011-03-04 CN CN2011200555308U patent/CN202261358U/en not_active Expired - Fee Related
Cited By (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN104484824A (en) * | 2014-12-25 | 2015-04-01 | 上海亿保健康管理有限公司 | System and method for automatically converting consumption data into claim settlement information |
| CN107463767A (en) * | 2017-07-06 | 2017-12-12 | 深圳市坐标软件开发有限公司 | Cloud HIS medical insurances data processing method and system |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| C14 | Grant of patent or utility model | ||
| GR01 | Patent grant | ||
| C56 | Change in the name or address of the patentee |
Owner name: GUANGDONG ZONNY HEALTHCARE TECHNOLOGY CO., LTD. Free format text: FORMER NAME: ZHUHAI ZHONGYI SOFTWARE TECHNOLOGY CO., LTD. |
|
| CP03 | Change of name, title or address |
Address after: 519015 Guangdong province Zhuhai Jida Approach Road 333 Building No. 12 Patentee after: GUANGDONG ZONNY HEALTHCARE TECHNOLOGY CO., LTD. Address before: 519000 Guangdong province Zhuhai Jida approach road No. 333 building 11-12 Patentee before: Zhuhai Zhongyi Software Technology Co., Ltd. |
|
| CF01 | Termination of patent right due to non-payment of annual fee | ||
| CF01 | Termination of patent right due to non-payment of annual fee |
Granted publication date: 20120530 Termination date: 20170304 |