WO2019091001A1 - Medical insurance settlement method and system, insurance terminal, and computer-readable storage medium - Google Patents

Medical insurance settlement method and system, insurance terminal, and computer-readable storage medium Download PDF

Info

Publication number
WO2019091001A1
WO2019091001A1 PCT/CN2018/075165 CN2018075165W WO2019091001A1 WO 2019091001 A1 WO2019091001 A1 WO 2019091001A1 CN 2018075165 W CN2018075165 W CN 2018075165W WO 2019091001 A1 WO2019091001 A1 WO 2019091001A1
Authority
WO
WIPO (PCT)
Prior art keywords
information
insurance
medical
settlement
medical information
Prior art date
Application number
PCT/CN2018/075165
Other languages
French (fr)
Chinese (zh)
Inventor
和婷
Original Assignee
平安科技（深圳）有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 平安科技（深圳）有限公司 filed Critical 平安科技（深圳）有限公司
Publication of WO2019091001A1 publication Critical patent/WO2019091001A1/en

Links

Classifications

    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance

Definitions

  • the present application relates to the field of insurance settlement technologies, and in particular, to a medical insurance settlement method and system, an insurance terminal, and a computer readable storage medium.
  • the main purpose of the present application is to provide a medical insurance settlement method, which aims to solve the cumbersome and complicated technical problems of the above settlement process, improve the efficiency of medical insurance settlement, and shorten the processing cycle.
  • the present application provides a medical insurance settlement method for an insurance terminal, the medical insurance settlement method comprising the steps of: acquiring insurance information of a patient; comparing the insurance information with a preset settlement condition; When the insurance information satisfies the settlement condition, the medical information of the patient is received in real time; and the insurance information is settled according to the insurance information.
  • the present application also provides an insurance terminal including a memory, a processor, and a medical insurance settlement program stored on the memory and operable on the processor, the medical insurance settlement program being executed by the processor
  • the step of realizing the medical insurance settlement method, the medical insurance settlement method comprising the steps of: acquiring insurance information of the patient; comparing the insurance information with a preset settlement condition; and receiving the real-time receiving when the insurance information satisfies the settlement condition Medical information of the patient; settled according to the insurance information and the medical information.
  • the present application further provides an insurance terminal, which includes an acquisition module, a comparison module, a receiving module, and a settlement module, wherein the acquisition module is configured to acquire insurance information of the patient; and the comparison module is configured to compare the The insurance information and the preset settlement condition; the receiving module is configured to receive medical information of the patient in real time when the insurance information satisfies the settlement condition; the settlement module is configured to use the insurance information and the medical information according to the insurance information Settlement.
  • an insurance terminal which includes an acquisition module, a comparison module, a receiving module, and a settlement module, wherein the acquisition module is configured to acquire insurance information of the patient; and the comparison module is configured to compare the The insurance information and the preset settlement condition; the receiving module is configured to receive medical information of the patient in real time when the insurance information satisfies the settlement condition; the settlement module is configured to use the insurance information and the medical information according to the insurance information Settlement.
  • the present application further provides a medical insurance settlement system, including a hospital terminal, an insurance terminal, a signal transmission channel disposed between the hospital terminal and the insurance terminal, a memory, a processor, and a memory stored in the memory And a medical insurance settlement program operable on the processor, wherein the medical insurance settlement program is executed by the processor to implement a medical insurance settlement method, the medical insurance settlement method comprising the steps of: acquiring insurance information of the patient; And the insurance information and the preset settlement condition; when the insurance information satisfies the settlement condition, the medical information of the patient is received in real time; and the insurance information is settled according to the insurance information.
  • the present application further provides a computer readable storage medium having stored thereon a medical insurance settlement program, wherein the medical insurance settlement program is executed by a processor to implement a medical insurance settlement method, and the medical insurance settlement method includes the following Step: acquiring insurance information of the patient; comparing the insurance information with a preset settlement condition; receiving the medical information of the patient in real time when the insurance information satisfies the settlement condition; and according to the insurance information and the medical information Settlement.
  • the time for waiting for the relevant information to be regularly transferred from the hospital to the insurance company is omitted, thereby improving the time.
  • FIG. 1 is a schematic flow chart of a first embodiment of a medical insurance settlement method of the present application
  • step S100 is a schematic flowchart of the refinement of step S100 in the second embodiment of the medical insurance settlement method of the present application
  • step S300 is a schematic flowchart of the refinement of step S300 in the third embodiment of the medical insurance settlement method of the present application
  • step S300 is a schematic flowchart of the refinement of step S300 in the fourth embodiment of the medical insurance settlement method of the present application.
  • step S400 is a schematic flowchart of the refinement of step S400 in the fifth embodiment of the medical insurance settlement method of the present application
  • step S420 is a schematic flowchart of the refinement of step S420 in the sixth embodiment of the medical insurance settlement method of the present application.
  • FIG. 7 is a schematic flow chart of a seventh embodiment of the medical insurance settlement method of the present application.
  • FIG. 8 is a schematic structural diagram of an embodiment of an insurance terminal of the present application.
  • FIG. 9 is a schematic structural view of an embodiment of the medical insurance settlement system of the present application.
  • the main solution of the embodiment of the present application is to simplify the settlement process of medical insurance by transmitting relevant information generated during the patient visit in real time.
  • the present application provides a solution for real-time transmission of medical information, thereby improving settlement efficiency and shortening processing cycles.
  • FIG. 1 is a schematic flowchart diagram of a first embodiment of a medical insurance settlement method according to the present application.
  • the medical insurance settlement method is used for the insurance terminal, and the insurance terminal is located at the insurance company side, and the medical insurance settlement method includes the following steps:
  • Step S100 Obtaining insurance information of the patient
  • the patient's insurance information includes information on whether the patient is insured, insurance coverage, insurance time, etc. at the corresponding insurance company.
  • the insurance coverage includes the scope of the department covered by the insurance covered, the scope of the disease, the scope of the fee, etc.
  • the insurance time is the time when the insurance takes effect.
  • the acquisition of the insurance information can read the identity information of the patient's ID card, settlement card, bank card, etc. through the hospital terminal located at the hospital side, or receive the biometric features such as the fingerprint feature, facial features, and iris characteristics of the patient.
  • the patient's insurance information is further searched in the database of the hospital terminal or the insurance terminal according to the identity of the patient, which will be elaborated later.
  • the patient's insurance information can also be provided directly by the patient and verified by the hospital terminal or insurance terminal, and finally obtained by the insurance terminal for further settlement.
  • Step S200 comparing insurance information and preset settlement conditions
  • the budget settlement condition refers to the condition that can participate in direct settlement, and is related to whether the patient participates in medical insurance, and the insurance coverage, insurance time, settlement type and other parameters covered by the medical insurance.
  • the insurance coverage of the participating medical insurance covers the scope of the medical treatment, and the medical insurance is still in the valid period, and the medical insurance belongs to the direct settlement type insurance.
  • the party meets the preset settlement conditions, and as long as one of the above conditions is not satisfied, the patient's current visit cannot be directly settled.
  • Step S300 receiving the medical information of the patient in real time when the insurance information satisfies the settlement condition
  • the insurance information When the insurance information satisfies the settlement condition, it indicates that the patient's current visit can participate in direct settlement, in which case the patient's medical information is received in real time.
  • the medical information of the patient includes information such as the time of the patient's visit, the department visited, the disease, the treatment plan for the disease, the corresponding expenses, and the documents corresponding to the expenses.
  • the insurance terminal receives the patient's medical information in real time, thereby eliminating the time for waiting for the medical information to be transferred from the hospital to the insurance company.
  • only one patient and his corresponding medical information are often involved. The correspondence relationship is clear, and the amount of data involved in the information is also small, thereby facilitating the reduction of the probability of occurrence of errors and omissions during processing, and improving the processing efficiency.
  • the insurance terminal may choose not to receive the medical information of the patient, so as to reduce the data amount of the medical information to be transmitted and processed, and improve the processing efficiency.
  • Step S400 settlement according to the insurance information and the medical information.
  • the settlement is based on the patient's insurance information and medical information, wherein the settlement process can be performed in real time.
  • the patient may also be at the patient's current visit or at a certain stage.
  • centralized settlement for each patient to improve the efficiency of settlement will be elaborated in the following.
  • the medical insurance settlement method includes the following steps: acquiring insurance information of the patient; comparing the insurance information with the preset settlement condition; and receiving the medical information of the patient in real time when the insurance information satisfies the settlement condition; according to the insurance information and the medical Information settlement.
  • the patient's insurance information is received in real time, thereby eliminating the time for waiting for the periodic handover of the relevant data, thereby improving the efficiency of settlement, and at the same time, compared with the centralized handover.
  • Data the amount of data involved in the real-time transmission process is usually small.
  • the settlement information is processed according to the insurance information and the medical information in time, which is beneficial to simplify the settlement process and reduce the occurrence of errors and omissions, thereby further improving the settlement efficiency. , shorten the processing cycle.
  • step S100 includes: step S110, receiving identity information of a patient from a hospital terminal; step S120, searching for identity information in pre-stored data; step S130, when finding In the case of the identity information, the insurance information corresponding to the identity information in the pre-stored data is read; in step S140, when the identity information is not found, the uninsured information is generated as the corresponding insurance information.
  • the hospital terminal can obtain the identity information of the patient by reading the identity card of the patient, the bank card, the settlement card, etc.; or receiving the biological characteristics such as the fingerprint feature, the facial feature or the iris feature of the patient, and obtaining the identity of the patient. information.
  • the identity information of the patient can be pre-processed by the hospital terminal, so that the format and the like meet the requirements of the preset format of the insurance terminal, so that when the insurance terminal receives the identity information from the hospital terminal, the subsequent processing can be directly performed.
  • the insurance terminal can also directly receive the unprocessed identity information, and process it to conform to the preset format, and then perform the subsequent steps.
  • the pre-stored data is usually stored in the insurance terminal, including the identity information of the insured person and the corresponding insurance information, and the identity information is found in the pre-stored data.
  • the corresponding data can be found in the pre-stored data.
  • the identity information is read, and the insurance information corresponding to the identity information is read for subsequent operations; when the patient is not insured in advance, the corresponding identity information cannot be found in the pre-stored data, and at this time, the unencumbered information is generated.
  • the insurance information corresponding to the patient in the subsequent step, according to the generated uninsured information, it can be determined that the patient does not satisfy the condition of direct settlement, so that the insurance terminal does not need to receive the medical information of the patient, and does not need to perform the fee. Settlement, etc., to reduce the amount of data processing of insurance terminals and improve settlement efficiency.
  • step S300 includes: step S310, generating an authorization signal when the insurance information satisfies the settlement condition; step S320, transmitting an authorization signal to the hospital terminal; and step S330, receiving the hospital Medical information sent by the terminal according to the authorization signal.
  • an authorization signal is generated and sent to the hospital terminal to prompt the hospital terminal to transmit the patient's medical information to the insurance terminal in real time.
  • the hospital terminal sends the medical information and the insurance terminal receives the medical information according to the Real-Time Transport Protocol (RTP).
  • RTP Real-Time Transport Protocol
  • the medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information conforms to the preset rules of the insurance terminal.
  • the patient's medical information includes the patient's visit time, the department visited, the disease, the treatment plan for the disease, the corresponding expenses incurred, and the documents corresponding to the expenses, and pass the medical record (including the outpatient medical record). , inpatient medical records, hospitalization summary, etc.), bills (including fee types, invoice content) and other forms.
  • Unprocessed medical information is messy, and may include content that is not needed during partial settlement, such as the patient's self-reported symptoms in the medical record, the doctor's diagnosis process, and so on.
  • the above medical information is standardized in the hospital terminal, the unnecessary content in the settlement process is removed, and the medical information is converted according to the preset format of the insurance terminal, and the collated standardized medical information is transmitted to the insurance terminal in real time, eliminating the need for
  • the manual input process of medical information reduces the amount of data transmitted in real time, which is beneficial to improve transmission efficiency and reduce the hardware or bandwidth cost required for transmission. It is also convenient for the insurance terminal to directly process the subsequent steps according to the received medical information. By using the computing power of the hospital terminal, the settlement pressure of the insurance terminal is reduced, thereby further improving the settlement efficiency.
  • the type of cost of each patient such as dividing the cost into a drug fee, an examination fee, a medical treatment fee, etc., that is, in the process of processing the patient's medical information.
  • the cost type is differentiated in advance, so that it is not necessary to classify the case first and then settle the settlement of a certain type of case to further improve the settlement efficiency.
  • the hospital terminal may directly send the obtained medical information to the insurance terminal, and after receiving the medical information, the insurance terminal processes the medical information according to a preset content and/or format to satisfy Settlement needs.
  • This processing method is advantageous for simplifying the structure of the hospital terminal, reducing the cost of the hospital terminal, and making the hospital terminal more portable to meet the requirements of receiving medical information in various environments, such as in a remote environment.
  • step S300 further includes: step S340, verifying whether the received medical information is complete and correct; when the received medical information is complete and correct Step S351, executing an acknowledgment signal and transmitting to the hospital terminal; when the received medical information is incomplete or incorrect, step S352 is executed, a retransmission signal is generated and sent to the hospital terminal; and step S353, the receiving hospital terminal is retransmitted according to The medical information that the signal is resent.
  • the received medical information is verified.
  • an acknowledgement signal is generated and sent to the hospital terminal to enable the hospital terminal.
  • Defining the transmission of medical information when it is verified that the received medical information is incomplete or incorrect, a retransmission signal is generated and sent to the hospital terminal, and the hospital terminal resends the medical information according to the retransmission signal, so that the insurance terminal can promptly correct Mistakes and omissions in the process of medical information transmission, improve the correct rate and efficiency of settlement, and avoid the situation where medical information may be missing when there is a need to supplement medical information after a long period of time.
  • step S400 includes: step S410, classifying medical information received in the first preset time period; and step S420, setting up an insurance case according to the type of medical information.
  • step S430 settlement according to the insurance case.
  • the settlement is performed in units of insurance cases to improve settlement efficiency and avoid settlement errors.
  • the first preset time period is the time period involved in the current settlement. In order to improve the settlement efficiency, the first preset time period may be set to one to seven days, and may be selected according to the amount of data generated every day, so that the data involved in each settlement is performed. The amount is appropriate, avoiding too much to cause settlement difficulties, or too little to lead to waste of settlement resources.
  • There are many ways to classify medical information For example, each patient is classified into a classification standard, and all medical expenses generated by the same patient in the first preset time period are settled. Alternatively, it is also possible to combine the type of treatment of the patient and the patient, for example, whether the patient's visit is an outpatient or hospitalization, classify the medical information, set up an insurance case, and settle the payment according to the insurance case.
  • the medical information is divided into the outpatient information and the hospitalization information
  • the step S420 includes: in step S421, when the medical information is the outpatient information, the same in the second preset time period is summarized.
  • the patient's insurance information and outpatient information are set up for outpatient cases; step S422, when the medical information is hospitalization information, and the hospitalization information includes the hospitalization summary, the insurance information and hospitalization information of the same patient in the third predetermined time period are summarized, and the hospitalization case is established.
  • the second preset time period may be the same as the first preset time period, considering that the clinic usually ends in one day, and the second preset time period may also be set to one day, then, on the day or the second day when the patient ends the clinic , the patient's fee can be settled.
  • the insurance information and outpatient information of the same patient are summarized, and an outpatient case is set up for subsequent operations.
  • the third preset time period is usually the entire period of the patient's hospitalization.
  • the patient's hospitalization information includes the hospitalization summary, it indicates that the hospitalization has ended, and the expenses incurred during the hospitalization period can be settled, and the insurance information of the same patient and
  • the hospitalization information is summarized, and the inpatient case is set up for subsequent operations. Otherwise, the hospitalization case is suspended, so as to avoid the low settlement efficiency caused by frequent settlement, and avoid the occurrence of errors such as repeated settlement or missing settlement.
  • the medical insurance settlement method further includes the following steps: step S500, verifying whether the settlement is correct; when the settlement is correct, performing step S610, paying according to the settlement result.
  • step S620 is performed to determine whether it is necessary to supplement the medical information of the patient: if yes, step S631 is performed, a supplementary signal is generated, and a supplementary signal is sent to the hospital terminal; and step S632, receiving supplementary medical treatment generated by the hospital terminal according to the supplementary signal Information; step S633, re-settlement according to the insurance information, the medical information and the supplementary medical information; if not, executing step S634, and re-settlement according to the insurance information and the medical information.
  • the settlement result is verified to further improve the reliability of the settlement and avoid the occurrence of errors and omissions.
  • the hospital terminal sends the supplementary medical information according to the supplementary signal by receiving the supplementary signal to the hospital terminal, and receives the supplementary medical information without Wait for the next centralized transfer of data to improve the efficiency of re-settlement.
  • the supplemental signal may include a specific type of medical information that needs to be supplemented, so that the hospital terminal does not need to send all the medical information at each supplement to reduce the amount of data supplemented with the medical information, and the correspondence with the patient is good. It is good for dealing with problems quickly and accurately.
  • the settlement is directly based on the existing insurance information and medical information to correct the error in the settlement.
  • the present application also provides an insurance terminal.
  • the insurance terminal includes a memory 110, a processor 120, and a medical insurance settlement program stored on the memory 110 and operable on the processor 120.
  • the medical insurance settlement program is The steps of implementing the medical insurance settlement method as described above when the processor 120 is executed.
  • the method implemented when the medical insurance settlement program running on the processor 120 is executed may refer to various embodiments of the medical insurance settlement method of the present application, and details are not described herein again.
  • the processor 120 in the insurance terminal may be a CPU or the like, and may further include a network interface 130, a user interface 140, and a communication bus 150.
  • An operating system, a network communication module, a user interface module, and a medical insurance settlement program may be included in the memory 110 as a computer storage medium.
  • the network interface 130 is mainly used to connect to the background server for data communication with the background server.
  • the user interface 140 is mainly used for connecting the client (user end) to perform data communication with the client.
  • the medical insurance settlement system includes a hospital terminal 200, an insurance terminal 100, a signal transmission channel 300 disposed between the hospital terminal 200 and the insurance terminal 100, a memory 400, and a processor. 500 and a medical insurance settlement program stored on the memory 400 and operable on the processor 500.
  • the memory 400 and the processor 500 may be disposed inside the insurance terminal 200, and the medical insurance settlement program is executed by the processor 500 to implement the steps of the medical insurance settlement method as described above.
  • the medical insurance settlement program running on the processor 500 refer to various embodiments of the medical insurance settlement method of the present application, and details are not described herein again.
  • the embodiment of the present application further provides a computer readable storage medium, where the medical insurance settlement program is stored, and the medical insurance settlement program is executed by the processor to implement the steps of the medical insurance settlement method as described above.
  • the method implemented when the medical insurance settlement method running on the processor is executed may refer to various embodiments of the medical insurance settlement program of the present application. I will not repeat them here.
  • the embodiment of the present application further provides an insurance terminal, where the insurance terminal includes: an acquisition module, configured to acquire insurance information of the patient; a comparison module, configured to compare the insurance information with a preset settlement condition; and receive And a module, configured to receive medical information of the patient in real time when the insurance information satisfies the settlement condition; and a settlement module, configured to settle according to the insurance information and the medical information.
  • the insurance terminal includes: an acquisition module, configured to acquire insurance information of the patient; a comparison module, configured to compare the insurance information with a preset settlement condition; and receive And a module, configured to receive medical information of the patient in real time when the insurance information satisfies the settlement condition; and a settlement module, configured to settle according to the insurance information and the medical information.
  • the acquiring module includes: a first receiving unit, configured to receive identity information of a patient from the hospital terminal; a searching unit, configured to search the identity information in the pre-stored data; and a reading unit, configured to find In the case of the identity information, the insurance information corresponding to the identity information in the pre-stored data is read; the information generating unit is configured to generate the uninsured information as the corresponding insurance information when the identity information is not found.
  • the receiving module includes: a signal generating unit, configured to generate an authorization signal when the insurance information satisfies the settlement condition; a sending unit, configured to send the authorization signal to a hospital terminal; and a second receiving unit, Receiving medical information transmitted by the hospital terminal according to the authorization signal; wherein the medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information is consistent The preset rule of the insurance terminal.
  • the receiving module further includes: a verification unit, configured to verify whether the received medical information is complete and correct; and the signal generating unit is further configured to: when the received medical information is complete and correct, generate a confirmation signal; the sending unit is further configured to send the confirmation signal to the hospital terminal; the signal generating unit is further configured to generate a retransmission signal when the received medical information is incomplete or incorrect; The transmitting unit is further configured to send the retransmission signal to the hospital terminal; the second receiving unit is further configured to receive the medical information that is retransmitted by the hospital terminal according to the retransmission signal.
  • a verification unit configured to verify whether the received medical information is complete and correct
  • the signal generating unit is further configured to: when the received medical information is complete and correct, generate a confirmation signal
  • the sending unit is further configured to send the confirmation signal to the hospital terminal
  • the signal generating unit is further configured to generate a retransmission signal when the received medical information is incomplete or incorrect
  • the transmitting unit is further configured to send the retransmission signal to the
  • the settlement module includes: a classification unit, configured to classify the medical information received in the first preset time period; and a filing unit configured to set an insurance case according to the type of the medical information; Used to settle the insurance case.
  • the category of the medical information includes the outpatient information and the hospitalization information;
  • the filing unit includes: an outpatient filing unit, configured to summarize the same patient in the second preset time period when the medical information is the outpatient information The insurance information and the outpatient information, setting up an outpatient case;
  • the inpatient filing unit is configured to summarize the insurance of the same patient in the third preset time period when the medical information is hospitalization information, and the hospitalization information includes a hospitalization summary Information and the hospitalization information, and establish an inpatient case.
  • the insurance terminal further includes: a verification module, configured to verify whether the settlement is correct; a compensation module, configured to pay according to the settlement result when the settlement is correct; and a judgment module, configured to determine whether the supplementary is needed when the settlement is incorrect
  • the medical information of the patient a supplemental module, configured to generate a supplemental signal and send the supplemental signal to the hospital terminal if the medical information of the patient needs to be supplemented; the receiving module is further configured to receive the generated by the hospital terminal according to the supplementary signal Supplementing medical information; the settlement module is further configured to re-settlement according to the insurance information, the medical information, and the supplementary medical information; the settlement module is further configured to: if the medical information of the patient is not needed to be supplemented, according to the insurance The information and the medical information are re-cleared.

Abstract

Disclosed in the present application is a medical insurance settlement method, used on an insurance terminal. The medical insurance settlement method comprises the following steps: acquiring patient insurance information; comparing the insurance information and a pre-determined settlement condition; when the insurance information satisfies the settlement condition, receiving medical information of a patient in real time; settling according to the insurance information and the medical information. Also disclosed in the present application are an insurance terminal, a medical insurance settlement system and a computer-readable storage medium. The present application improves medical insurance settlement efficiency.

Description

医保结算方法及系统、保险终端、计算机可读存储介质  Medical insurance settlement method and system, insurance terminal, computer readable storage medium
本申请要求于2017年11月10日提交中国专利局，申请号为201711110994.2、发明名称为“医保结算方法及系统、保险终端、计算机可读存储介质”的中国专利申请的优先权，其全部内容通过引用结合在申请中。This application claims the priority of the Chinese patent application filed on November 10, 2017, the Chinese Patent Office, the application number is 20171110994.2, and the invention name is "medical insurance settlement method and system, insurance terminal, computer readable storage medium", all contents thereof It is incorporated in the application by reference.
技术领域Technical field
本申请涉及保险结算技术领域，尤其涉及一种医保结算方法及系统、保险终端、计算机可读存储介质。The present application relates to the field of insurance settlement technologies, and in particular, to a medical insurance settlement method and system, an insurance terminal, and a computer readable storage medium.
背景技术Background technique
现有一种具有直接结算功能的医疗保险，以覆盖参保患者在就诊过程中产生的费用，并简化费用结算的手续，具体的，在理赔过程中，由医院与保险公司直接结算患者的费用，无需患者先行垫付。然而，在医院与保险公司结算费用的过程中，医院需要将参保患者的就诊数据等相关资料打包，移交给保险公司，为了简化流程，降低移交成本，通常该移交过程是定期进行的，如每三个月移交一次相关资料。保险公司收到相关资料后，根据医院提交的相关材料填写信息，录入账单并结算。这种结算方式中，等待移交相关资料的时间较长，且每次移交的相关资料的总数据量较大，导致结算过程繁琐复杂，结算的效率低下，处理周期长。There is a medical insurance with direct settlement function to cover the expenses incurred by the insured patients during the treatment process, and to simplify the procedures for settlement of expenses. Specifically, in the process of claim settlement, the hospital and the insurance company directly settle the expenses of the patient. No need for patients to advance. However, in the process of settlement fees between the hospital and the insurance company, the hospital needs to package the relevant data of the insured patient's medical treatment data and hand it over to the insurance company. In order to simplify the process and reduce the handover cost, the handover process is usually carried out regularly, such as The relevant information is handed over every three months. After receiving the relevant information, the insurance company fills in the information according to the relevant materials submitted by the hospital, enters the bill and settles the bill. In this settlement method, the time for waiting for the transfer of relevant materials is long, and the total amount of data of the related materials transferred each time is large, which results in a complicated and complicated settlement process, low settlement efficiency, and long processing period.
发明内容Summary of the invention
本申请的主要目的在于提供一种医保结算方法，旨在解决上述结算过程繁琐复杂的技术问题，提高医保结算的效率，缩短处理周期。The main purpose of the present application is to provide a medical insurance settlement method, which aims to solve the cumbersome and complicated technical problems of the above settlement process, improve the efficiency of medical insurance settlement, and shorten the processing cycle.
为实现上述目的，本申请提供一种医保结算方法，用于保险终端，所述医保结算方法包括以下步骤：获取患者的保险信息；比对所述保险信息和预设的结算条件；当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；根据所述保险信息和所述医疗信息结算。To achieve the above object, the present application provides a medical insurance settlement method for an insurance terminal, the medical insurance settlement method comprising the steps of: acquiring insurance information of a patient; comparing the insurance information with a preset settlement condition; When the insurance information satisfies the settlement condition, the medical information of the patient is received in real time; and the insurance information is settled according to the insurance information.
本申请还提出一种保险终端，所述保险终端包括存储器、处理器及存储在所述存储器上并可在所述处理器上运行的医保结算程序，所述医保结算程序被所述处理器执行时实现医保结算方法的步骤，所述医保结算方法包括以下步骤：获取患者的保险信息；比对所述保险信息和预设的结算条件；当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；根据所述保险信息和所述医疗信息结算。The present application also provides an insurance terminal including a memory, a processor, and a medical insurance settlement program stored on the memory and operable on the processor, the medical insurance settlement program being executed by the processor The step of realizing the medical insurance settlement method, the medical insurance settlement method comprising the steps of: acquiring insurance information of the patient; comparing the insurance information with a preset settlement condition; and receiving the real-time receiving when the insurance information satisfies the settlement condition Medical information of the patient; settled according to the insurance information and the medical information.
本申请还提出一种保险终端，所述保险终端包括获取模块，比对模块，接收模块和结算模块，所述获取模块用于获取患者的保险信息；所述比对模块用于比对所述保险信息和预设的结算条件；所述接收模块用于当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；所述结算模块用于根据所述保险信息和所述医疗信息结算。The present application further provides an insurance terminal, which includes an acquisition module, a comparison module, a receiving module, and a settlement module, wherein the acquisition module is configured to acquire insurance information of the patient; and the comparison module is configured to compare the The insurance information and the preset settlement condition; the receiving module is configured to receive medical information of the patient in real time when the insurance information satisfies the settlement condition; the settlement module is configured to use the insurance information and the medical information according to the insurance information Settlement.
本申请还提出一种医保结算系统，所述医保结算系统包括医院终端、保险终端、设于所述医院终端和所述保险终端之间的信号传输通道、存储器、处理器及存储在所述存储器上并可在所述处理器上运行的医保结算程序，所述医保结算程序被所述处理器执行时实现医保结算方法的步骤，所述医保结算方法包括以下步骤：获取患者的保险信息；比对所述保险信息和预设的结算条件；当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；根据所述保险信息和所述医疗信息结算。The present application further provides a medical insurance settlement system, including a hospital terminal, an insurance terminal, a signal transmission channel disposed between the hospital terminal and the insurance terminal, a memory, a processor, and a memory stored in the memory And a medical insurance settlement program operable on the processor, wherein the medical insurance settlement program is executed by the processor to implement a medical insurance settlement method, the medical insurance settlement method comprising the steps of: acquiring insurance information of the patient; And the insurance information and the preset settlement condition; when the insurance information satisfies the settlement condition, the medical information of the patient is received in real time; and the insurance information is settled according to the insurance information.
本申请还提出一种计算机可读存储介质，所述计算机可读存储介质上存储有医保结算程序，所述医保结算程序被处理器执行时实现医保结算方法的步骤，所述医保结算方法包括以下步骤：获取患者的保险信息；比对所述保险信息和预设的结算条件；当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；根据所述保险信息和所述医疗信息结算。The present application further provides a computer readable storage medium having stored thereon a medical insurance settlement program, wherein the medical insurance settlement program is executed by a processor to implement a medical insurance settlement method, and the medical insurance settlement method includes the following Step: acquiring insurance information of the patient; comparing the insurance information with a preset settlement condition; receiving the medical information of the patient in real time when the insurance information satisfies the settlement condition; and according to the insurance information and the medical information Settlement.
在本申请技术方案中，当根据患者的保险信息确定患者满足预设的结算条件时，通过实时接收患者的医疗信息，省去了等待相关资料定期从医院移交到保险公司的时间，从而提高了结算的效率，同时，相比集中移交相关资料，实时传输过程中涉及资料或信息的数据量通常较小，在接收到患者的医疗信息后，及时根据保险信息和医疗信息进行结算处理，有利于简化结算过程，减少错漏的发生，从而进一步提高结算效率，缩短处理周期。In the technical solution of the present application, when the patient meets the preset settlement condition according to the patient's insurance information, by receiving the medical information of the patient in real time, the time for waiting for the relevant information to be regularly transferred from the hospital to the insurance company is omitted, thereby improving the time. The efficiency of settlement, at the same time, compared to the centralized transfer of relevant data, the amount of data involved in the real-time transmission process of data or information is usually small, after receiving the patient's medical information, timely settlement according to insurance information and medical information, is conducive to Simplify the settlement process and reduce the occurrence of errors and omissions, thereby further improving settlement efficiency and shortening the processing cycle.
附图说明DRAWINGS
图1是本申请医保结算方法第一实施例的流程示意图；1 is a schematic flow chart of a first embodiment of a medical insurance settlement method of the present application;
图2是本申请医保结算方法第二实施例中步骤S100的细化流程示意图；2 is a schematic flowchart of the refinement of step S100 in the second embodiment of the medical insurance settlement method of the present application;
图3是本申请医保结算方法第三实施例中步骤S300的细化流程示意图；3 is a schematic flowchart of the refinement of step S300 in the third embodiment of the medical insurance settlement method of the present application;
图4是本申请医保结算方法第四实施例中步骤S300的细化流程示意图；4 is a schematic flowchart of the refinement of step S300 in the fourth embodiment of the medical insurance settlement method of the present application;
图5是本申请医保结算方法第五实施例中步骤S400的细化流程示意图；5 is a schematic flowchart of the refinement of step S400 in the fifth embodiment of the medical insurance settlement method of the present application;
图6是本申请医保结算方法第六实施例中步骤S420的细化流程示意图；6 is a schematic flowchart of the refinement of step S420 in the sixth embodiment of the medical insurance settlement method of the present application;
图7是本申请医保结算方法第七实施例的流程示意图；7 is a schematic flow chart of a seventh embodiment of the medical insurance settlement method of the present application;
图8是本申请保险终端一实施例的结构示意图；8 is a schematic structural diagram of an embodiment of an insurance terminal of the present application;
图9是本申请医保结算系统一实施例的结构示意图。9 is a schematic structural view of an embodiment of the medical insurance settlement system of the present application.
本申请目的的实现、功能特点及优点将结合实施例，参照附图做进一步说明。The implementation, functional features and advantages of the present application will be further described with reference to the accompanying drawings.
具体实施方式Detailed ways
应当理解，此处所描述的具体实施例仅仅用以解释本申请，并不用于限定本申请。It is understood that the specific embodiments described herein are merely illustrative of the application and are not intended to be limiting.
本申请实施例的主要解决方案是：通过实时传输患者就诊过程中产生的相关信息，简化医疗保险的结算流程。The main solution of the embodiment of the present application is to simplify the settlement process of medical insurance by transmitting relevant information generated during the patient visit in real time.
由于现有技术中患者的医疗信息是集中定期移交的，等待移交所需的时间较长，且每次移交涉及的数据量庞大，导致结算效率低下，处理周期长。Since the medical information of the patients in the prior art is periodically and periodically transferred, the time required for the handover is long, and the amount of data involved in each handover is large, resulting in low settlement efficiency and long processing period.
本申请提供一种解决方案，使医疗信息实时传输，从而提高结算效率，缩短处理周期。The present application provides a solution for real-time transmission of medical information, thereby improving settlement efficiency and shortening processing cycles.
如图1所示，为本申请医保结算方法的第一实施例的流程示意图。在本实施例中，医保结算方法用于保险终端，保险终端设于保险公司侧，医保结算方法包括以下步骤：FIG. 1 is a schematic flowchart diagram of a first embodiment of a medical insurance settlement method according to the present application. In this embodiment, the medical insurance settlement method is used for the insurance terminal, and the insurance terminal is located at the insurance company side, and the medical insurance settlement method includes the following steps:
步骤S100、获取患者的保险信息；Step S100: Obtaining insurance information of the patient;
患者的保险信息包括患者是否在相应的保险公司投保，保险范围，保险时间等信息。其中，保险范围包括所投保险覆盖的科室范围、疾病范围、费用范围等，保险时间即保险生效的时间。具体的，保险信息的获取可通过设于医院侧的医院终端读取患者的身份证、结算卡、银行卡等上的身份信息，或接收患者的指纹特征、脸部特征、虹膜特征等生物特征，以识别患者的身份，进一步根据患者的身份在设于医院终端或保险终端的数据库中查找患者的保险信息，后文中还将详细阐述。当然，患者的保险信息也可以由患者直接提供，并通过医院终端或保险终端进行核实，并最终由保险终端获取，以待进一步的结算。The patient's insurance information includes information on whether the patient is insured, insurance coverage, insurance time, etc. at the corresponding insurance company. Among them, the insurance coverage includes the scope of the department covered by the insurance covered, the scope of the disease, the scope of the fee, etc., and the insurance time is the time when the insurance takes effect. Specifically, the acquisition of the insurance information can read the identity information of the patient's ID card, settlement card, bank card, etc. through the hospital terminal located at the hospital side, or receive the biometric features such as the fingerprint feature, facial features, and iris characteristics of the patient. In order to identify the patient's identity, the patient's insurance information is further searched in the database of the hospital terminal or the insurance terminal according to the identity of the patient, which will be elaborated later. Of course, the patient's insurance information can also be provided directly by the patient and verified by the hospital terminal or insurance terminal, and finally obtained by the insurance terminal for further settlement.
步骤S200、比对保险信息和预设的结算条件；Step S200, comparing insurance information and preset settlement conditions;
其中，预算的结算条件是指能够参与直接结算的条件，与患者是否参与了医疗保险，以及该医疗保险所覆盖的保险范围、保险时间、结算种类等参数相关。通常，只有当患者同时满足以下条件，即参与了医疗保险，所参与医疗保险的保险范围覆盖了本次就诊的范围，该医疗保险尚处于有效期内，该医疗保险属于直接结算类型的保险时，方符合预设的结算条件，只要上述条件中有一项不满足，则患者的此次就诊不能进行直接结算。Among them, the budget settlement condition refers to the condition that can participate in direct settlement, and is related to whether the patient participates in medical insurance, and the insurance coverage, insurance time, settlement type and other parameters covered by the medical insurance. Usually, only when the patient meets the following conditions, that is, participates in medical insurance, the insurance coverage of the participating medical insurance covers the scope of the medical treatment, and the medical insurance is still in the valid period, and the medical insurance belongs to the direct settlement type insurance. The party meets the preset settlement conditions, and as long as one of the above conditions is not satisfied, the patient's current visit cannot be directly settled.
步骤S300、当保险信息满足结算条件时，实时接收患者的医疗信息；Step S300, receiving the medical information of the patient in real time when the insurance information satisfies the settlement condition;
当保险信息满足结算条件时，表明该患者的此次就诊可以参与直接结算，在这种情况下，实时接收患者的医疗信息。具体的，患者的医疗信息包括患者的就诊时间、就诊的科室、所患的疾病、针对该疾病采用的治疗方案、相应产生的费用以及与费用相对应的单据等信息。保险终端实时接收患者的医疗信息，从而省去了等待医疗信息从医院移交到保险公司的时间，同时，在每一次实时传输过程中，往往只涉及一个患者和他对应的医疗信息，信息之间的对应关系明确，并且该信息涉及的数据量也较少，从而有利于减小处理过程中发生错漏的概率，且提高了处理效率。When the insurance information satisfies the settlement condition, it indicates that the patient's current visit can participate in direct settlement, in which case the patient's medical information is received in real time. Specifically, the medical information of the patient includes information such as the time of the patient's visit, the department visited, the disease, the treatment plan for the disease, the corresponding expenses, and the documents corresponding to the expenses. The insurance terminal receives the patient's medical information in real time, thereby eliminating the time for waiting for the medical information to be transferred from the hospital to the insurance company. At the same time, in each real-time transmission process, only one patient and his corresponding medical information are often involved. The correspondence relationship is clear, and the amount of data involved in the information is also small, thereby facilitating the reduction of the probability of occurrence of errors and omissions during processing, and improving the processing efficiency.
进一步的，当保险信息不满足预设的结算条件时，保险终端可以选择不接收该患者的医疗信息，以减少待传输和处理的医疗信息的数据量，提高处理效率。Further, when the insurance information does not meet the preset settlement condition, the insurance terminal may choose not to receive the medical information of the patient, so as to reduce the data amount of the medical information to be transmitted and processed, and improve the processing efficiency.
步骤S400、根据保险信息和医疗信息结算。Step S400, settlement according to the insurance information and the medical information.
根据患者的保险信息和医疗信息进行结算，其中，结算过程可以是实时进行的，当然，若患者在单次就诊过程中产生费用的次数较多，也可以在患者的本次就诊或某一阶段的就诊结束后，针对每个患者集中结算，以提高结算效率，后文中还将详细阐述。The settlement is based on the patient's insurance information and medical information, wherein the settlement process can be performed in real time. Of course, if the patient has incurred more expenses in a single visit, it may also be at the patient's current visit or at a certain stage. After the end of the visit, centralized settlement for each patient to improve the efficiency of settlement, will be elaborated in the following.
在本实施例中，医保结算方法包括以下步骤：获取患者的保险信息；比对保险信息和预设的结算条件；当保险信息满足结算条件时，实时接收患者的医疗信息；根据保险信息和医疗信息结算。当根据患者的保险信息确定患者满足预设的结算条件时，即实时接收患者的医疗信息，从而省去了等待相关资料定期移交的时间，从而提高了结算的效率，同时，相比集中移交相关资料，实时传输过程中涉及的数据量通常较少，在接收到患者的医疗信息后，及时根据保险信息和医疗信息进行结算处理，有利于简化结算过程，减少错漏的发生，从而进一步提高结算效率，缩短处理周期。In this embodiment, the medical insurance settlement method includes the following steps: acquiring insurance information of the patient; comparing the insurance information with the preset settlement condition; and receiving the medical information of the patient in real time when the insurance information satisfies the settlement condition; according to the insurance information and the medical Information settlement. When it is determined according to the patient's insurance information that the patient meets the preset settlement condition, the patient's medical information is received in real time, thereby eliminating the time for waiting for the periodic handover of the relevant data, thereby improving the efficiency of settlement, and at the same time, compared with the centralized handover. Data, the amount of data involved in the real-time transmission process is usually small. After receiving the medical information of the patient, the settlement information is processed according to the insurance information and the medical information in time, which is beneficial to simplify the settlement process and reduce the occurrence of errors and omissions, thereby further improving the settlement efficiency. , shorten the processing cycle.
如图2所示，在本申请的第二实施例中，步骤S100包括：步骤S110、接收来自医院终端的患者的身份信息；步骤S120、在预存数据中查找身份信息；步骤S130、当查找到身份信息时，读取预存数据中与身份信息对应的保险信息；步骤S140、当未查找到身份信息时，生成未参保信息作为对应的保险信息。As shown in FIG. 2, in the second embodiment of the present application, step S100 includes: step S110, receiving identity information of a patient from a hospital terminal; step S120, searching for identity information in pre-stored data; step S130, when finding In the case of the identity information, the insurance information corresponding to the identity information in the pre-stored data is read; in step S140, when the identity information is not found, the uninsured information is generated as the corresponding insurance information.
考虑到患者在医院就诊，因此，其身份信息通常是由设置在医院侧的医院终端直接获取的。具体的，医院终端可通过读取患者的身份证、银行卡、结算卡等身份证件，获取患者的身份信息；或者，接收患者的指纹特征、脸部特征或虹膜特征等生物特征，获取其身份信息。患者的身份信息可以由医院终端进行一定的预处理，使其格式等符合保险终端预设格式的要求，这样，当保险终端接收到来自医院终端的身份信息时，可直接进行后续处理。当然，保险终端也可以直接接收未经处理的身份信息，并自行进行处理使其符合预设格式，再执行后续的步骤。预存数据通常保存在保险终端中，包括参保人员的身份信息和对应的保险信息，在预存数据中查找身份信息，当该患者事先参加了医疗保险时，在预存数据中将能够查找到对应的身份信息，读取与身份信息对应的保险信息，以待后续的操作；当该患者事先并未参保时，在预存数据中将无法查找到对应的身份信息，此时，生成未参保信息，作为该患者对应的保险信息，在后续的步骤中，根据生成的未参保信息，可判定该患者不满足直接结算的条件，从而保险终端无需接收该患者的医疗信息，也无需对费用进行结算等，以减少保险终端的数据处理量，提高结算效率。Considering that the patient is visiting the hospital, his identity information is usually obtained directly from the hospital terminal located at the hospital side. Specifically, the hospital terminal can obtain the identity information of the patient by reading the identity card of the patient, the bank card, the settlement card, etc.; or receiving the biological characteristics such as the fingerprint feature, the facial feature or the iris feature of the patient, and obtaining the identity of the patient. information. The identity information of the patient can be pre-processed by the hospital terminal, so that the format and the like meet the requirements of the preset format of the insurance terminal, so that when the insurance terminal receives the identity information from the hospital terminal, the subsequent processing can be directly performed. Of course, the insurance terminal can also directly receive the unprocessed identity information, and process it to conform to the preset format, and then perform the subsequent steps. The pre-stored data is usually stored in the insurance terminal, including the identity information of the insured person and the corresponding insurance information, and the identity information is found in the pre-stored data. When the patient participates in the medical insurance in advance, the corresponding data can be found in the pre-stored data. The identity information is read, and the insurance information corresponding to the identity information is read for subsequent operations; when the patient is not insured in advance, the corresponding identity information cannot be found in the pre-stored data, and at this time, the unencumbered information is generated. As the insurance information corresponding to the patient, in the subsequent step, according to the generated uninsured information, it can be determined that the patient does not satisfy the condition of direct settlement, so that the insurance terminal does not need to receive the medical information of the patient, and does not need to perform the fee. Settlement, etc., to reduce the amount of data processing of insurance terminals and improve settlement efficiency.
如图3所示，在本申请的第三实施例中，步骤S300包括：步骤S310、当保险信息满足结算条件时，生成授权信号；步骤S320、发送授权信号至医院终端；步骤S330、接收医院终端根据授权信号发送的医疗信息。As shown in FIG. 3, in the third embodiment of the present application, step S300 includes: step S310, generating an authorization signal when the insurance information satisfies the settlement condition; step S320, transmitting an authorization signal to the hospital terminal; and step S330, receiving the hospital Medical information sent by the terminal according to the authorization signal.
当患者的保险信息满足结算条件时，生成授权信号并发送至医院终端，以提示医院终端可以将该患者的医疗信息实时传输给保险终端。医院终端发送医疗信息和保险终端接收该医疗信息可根据实时传输协议（RTP）进行，实时接收医疗信息时，患者和其医疗信息之间的对应关系简明清晰，且数据量较少，因此传输过程中的错漏率较小，且节约了等待集中移交所需的大量时间，提高了处理效率。When the patient's insurance information satisfies the settlement condition, an authorization signal is generated and sent to the hospital terminal to prompt the hospital terminal to transmit the patient's medical information to the insurance terminal in real time. The hospital terminal sends the medical information and the insurance terminal receives the medical information according to the Real-Time Transport Protocol (RTP). When the medical information is received in real time, the correspondence between the patient and the medical information is concise and clear, and the amount of data is small, so the transmission process The error rate is small, and saves a lot of time waiting for centralized handover, which improves processing efficiency.
进一步的，在一具体示例中，医疗信息由医院终端根据授权信号进行标准化处理，以使医疗信息的内容和/或格式符合保险终端的预设规则。通常，患者的医疗信息包括患者的就诊时间、就诊的科室、所患的疾病、针对该疾病采用的治疗方案、相应产生的费用以及与费用相对应的单据等信息，并通过病历（包括门诊病历、住院病历、住院小结等）、票据（包括费用类型、发票内容）等形式体现。未经处理的医疗信息比较杂乱，其中还可能包括部分结算过程中并不需要的内容，如病历中患者的自述症状、医生诊断的过程等内容。在医院终端中将上述医疗信息进行标准化处理，剔除结算过程中不需要的内容，并按保险终端的预设格式转换医疗信息，将整理后的标准化的医疗信息实时传输到保险终端，省去了医疗信息的人工录入流程，同时减少了实时传输的数据量，有利于提高传输效率，降低传输所需的硬件或带宽成本；也便于保险终端直接根据接收到的医疗信息进行后续步骤的处理，充分利用医院终端的计算能力，降低保险终端的结算压力，从而进一步提高结算效率。进一步的，在处理过程中，还可以对每一个患者的费用类型进行区分，如将费用分别分为药费、检查费、诊疗费等，也就是说，在处理患者的医疗信息的过程中，事先对费用类型进行区分，从而无需先对案件分类再对某一类案件集中结算，以进一步提高结算效率。Further, in a specific example, the medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information conforms to the preset rules of the insurance terminal. Usually, the patient's medical information includes the patient's visit time, the department visited, the disease, the treatment plan for the disease, the corresponding expenses incurred, and the documents corresponding to the expenses, and pass the medical record (including the outpatient medical record). , inpatient medical records, hospitalization summary, etc.), bills (including fee types, invoice content) and other forms. Unprocessed medical information is messy, and may include content that is not needed during partial settlement, such as the patient's self-reported symptoms in the medical record, the doctor's diagnosis process, and so on. The above medical information is standardized in the hospital terminal, the unnecessary content in the settlement process is removed, and the medical information is converted according to the preset format of the insurance terminal, and the collated standardized medical information is transmitted to the insurance terminal in real time, eliminating the need for The manual input process of medical information reduces the amount of data transmitted in real time, which is beneficial to improve transmission efficiency and reduce the hardware or bandwidth cost required for transmission. It is also convenient for the insurance terminal to directly process the subsequent steps according to the received medical information. By using the computing power of the hospital terminal, the settlement pressure of the insurance terminal is reduced, thereby further improving the settlement efficiency. Further, in the process of processing, it is also possible to distinguish the type of cost of each patient, such as dividing the cost into a drug fee, an examination fee, a medical treatment fee, etc., that is, in the process of processing the patient's medical information, The cost type is differentiated in advance, so that it is not necessary to classify the case first and then settle the settlement of a certain type of case to further improve the settlement efficiency.
当然，在另一具体示例中，医院终端也可以直接将获取到的医疗信息发送至保险终端，保险终端在接收到医疗信息后，按照预设的内容和/或格式对其进行处理，以满足结算的需求。这种处理方式有利于简化医院终端的结构，降低医院终端的成本，使医院终端更加便携，以满足在各种环境下，例如在偏远地区环境下接收医疗信息的要求。Of course, in another specific example, the hospital terminal may directly send the obtained medical information to the insurance terminal, and after receiving the medical information, the insurance terminal processes the medical information according to a preset content and/or format to satisfy Settlement needs. This processing method is advantageous for simplifying the structure of the hospital terminal, reducing the cost of the hospital terminal, and making the hospital terminal more portable to meet the requirements of receiving medical information in various environments, such as in a remote environment.
如图4所示，在本申请的第四实施例中，在步骤S330之后，步骤S300还包括：步骤S340、验证接收到的医疗信息是否完整且正确；当接收到的医疗信息完整且正确时，执行步骤S351、生成确认信号并发送至医院终端；当接收到的医疗信息不完整或不正确时，执行步骤S352、生成重发信号并发送至医院终端；步骤S353、接收医院终端根据重发信号重新发送的医疗信息。As shown in FIG. 4, in the fourth embodiment of the present application, after step S330, step S300 further includes: step S340, verifying whether the received medical information is complete and correct; when the received medical information is complete and correct Step S351, executing an acknowledgment signal and transmitting to the hospital terminal; when the received medical information is incomplete or incorrect, step S352 is executed, a retransmission signal is generated and sent to the hospital terminal; and step S353, the receiving hospital terminal is retransmitted according to The medical information that the signal is resent.
在本实施例中，每次实时接收医疗信息之后，均对接收到的医疗信息进行验证，当验证到接收到的医疗信息完整且正确时，生成确认信号并发送至医院终端，以使医院终端明确医疗信息的传输情况；当验证到接收到的医疗信息不完整或不正确时，生成重发信号并发送至医院终端，医院终端根据重发信号重新发送医疗信息，以使得保险终端能够及时修正医疗信息传输过程中的错漏，提高结算的正确率和效率，避免出现较长时间后再需补充医疗信息时，可能出现的医疗信息已经缺失的情况。In this embodiment, after receiving the medical information in real time, the received medical information is verified. When the received medical information is verified to be complete and correct, an acknowledgement signal is generated and sent to the hospital terminal to enable the hospital terminal. Defining the transmission of medical information; when it is verified that the received medical information is incomplete or incorrect, a retransmission signal is generated and sent to the hospital terminal, and the hospital terminal resends the medical information according to the retransmission signal, so that the insurance terminal can promptly correct Mistakes and omissions in the process of medical information transmission, improve the correct rate and efficiency of settlement, and avoid the situation where medical information may be missing when there is a need to supplement medical information after a long period of time.
如图5所示，在本申请的第五实施例中，步骤S400包括：步骤S410、对在第一预设时段内接收到的医疗信息分类；步骤S420、根据医疗信息的类别，设立保险案件；步骤S430、根据保险案件结算。As shown in FIG. 5, in the fifth embodiment of the present application, step S400 includes: step S410, classifying medical information received in the first preset time period; and step S420, setting up an insurance case according to the type of medical information. Step S430, settlement according to the insurance case.
在本实施例中，结算是以保险案件为单位进行的，以提高结算效率，避免发生结算错误的情况。第一预设时段即本次结算所涉及的时段，为了提高结算效率，第一预设时段可以设为一至七天，可根据每天所产生的数据量进行选择，以使得每次结算所涉及的数据量合适，避免过多导致结算困难，或过少导致结算资源的浪费。医疗信息的分类存在多种方式，例如，以每个患者为分类标准，对同一患者在第一预设时段内产生的所有医疗费用进行结算。或者，也可以结合患者和患者的就诊类型，例如患者的就诊是门诊还是住院，对医疗信息进行分类，设立保险案件，并根据保险案件进行结算。In the present embodiment, the settlement is performed in units of insurance cases to improve settlement efficiency and avoid settlement errors. The first preset time period is the time period involved in the current settlement. In order to improve the settlement efficiency, the first preset time period may be set to one to seven days, and may be selected according to the amount of data generated every day, so that the data involved in each settlement is performed. The amount is appropriate, avoiding too much to cause settlement difficulties, or too little to lead to waste of settlement resources. There are many ways to classify medical information. For example, each patient is classified into a classification standard, and all medical expenses generated by the same patient in the first preset time period are settled. Alternatively, it is also possible to combine the type of treatment of the patient and the patient, for example, whether the patient's visit is an outpatient or hospitalization, classify the medical information, set up an insurance case, and settle the payment according to the insurance case.
在本申请的第六实施例中，如图6所示，将医疗信息分为门诊信息和住院信息，步骤S420包括：步骤S421、当医疗信息为门诊信息时，汇总第二预设时段内同一患者的保险信息和门诊信息，设立门诊案件；步骤S422、当医疗信息为住院信息，且住院信息包括住院小结时，汇总第三预设时段内同一患者的保险信息和住院信息，设立住院案件。In the sixth embodiment of the present application, as shown in FIG. 6, the medical information is divided into the outpatient information and the hospitalization information, and the step S420 includes: in step S421, when the medical information is the outpatient information, the same in the second preset time period is summarized. The patient's insurance information and outpatient information are set up for outpatient cases; step S422, when the medical information is hospitalization information, and the hospitalization information includes the hospitalization summary, the insurance information and hospitalization information of the same patient in the third predetermined time period are summarized, and the hospitalization case is established.
其中，第二预设时段可以与第一预设时段相同，考虑到门诊通常在一天内即可结束，第二预设时段也可以设为一天，那么，在患者结束门诊的当天或第二天，即可对该患者的费用进行结算。将同一患者的保险信息和门诊信息进行汇总，设立门诊案件以待后续操作。第三预设时段通常为患者住院的整个时段，当患者的住院信息中包括住院小结时，表明此次住院已经结束，可以对此次住院期间产生的费用进行结算，将同一患者的保险信息和住院信息进行汇总，设立住院案件以待后续操作，否则，暂缓生成住院案件，以免频繁结算导致结算效率的低下，同时避免重复结算或遗漏结算等错误的发生。The second preset time period may be the same as the first preset time period, considering that the clinic usually ends in one day, and the second preset time period may also be set to one day, then, on the day or the second day when the patient ends the clinic , the patient's fee can be settled. The insurance information and outpatient information of the same patient are summarized, and an outpatient case is set up for subsequent operations. The third preset time period is usually the entire period of the patient's hospitalization. When the patient's hospitalization information includes the hospitalization summary, it indicates that the hospitalization has ended, and the expenses incurred during the hospitalization period can be settled, and the insurance information of the same patient and The hospitalization information is summarized, and the inpatient case is set up for subsequent operations. Otherwise, the hospitalization case is suspended, so as to avoid the low settlement efficiency caused by frequent settlement, and avoid the occurrence of errors such as repeated settlement or missing settlement.
如图7所示，在本申请的第七实施例中，在步骤S400之后，医保结算方法还包括以下步骤：步骤S500、验证结算是否正确；当结算正确时，执行步骤S610、按照结算结果赔付；当结算不正确时，执行步骤S620、判断是否需要补充患者的医疗信息：若是，执行步骤S631、生成补充信号并发送补充信号至医院终端；步骤S632、接收医院终端根据补充信号生成的补充医疗信息；步骤S633、根据保险信息、医疗信息和补充医疗信息重新结算；若否，执行步骤S634、根据保险信息和医疗信息重新结算。As shown in FIG. 7, in the seventh embodiment of the present application, after step S400, the medical insurance settlement method further includes the following steps: step S500, verifying whether the settlement is correct; when the settlement is correct, performing step S610, paying according to the settlement result. When the settlement is not correct, step S620 is performed to determine whether it is necessary to supplement the medical information of the patient: if yes, step S631 is performed, a supplementary signal is generated, and a supplementary signal is sent to the hospital terminal; and step S632, receiving supplementary medical treatment generated by the hospital terminal according to the supplementary signal Information; step S633, re-settlement according to the insurance information, the medical information and the supplementary medical information; if not, executing step S634, and re-settlement according to the insurance information and the medical information.
在本实施例中，在结算之后，对结算结果进行验证，以进一步提高结算的可靠性，避免发生错漏。当结算正确时，即正常赔付；当结算发生错误，且原先的医疗信息不足时，通过发送补充信号至医院终端，使医院终端根据该补充信号发送补充医疗信息，并接收补充医疗信息，而无需等待下一次集中移交数据，以提高重新结算的效率。其中，补充信号中可以包含具体的需要补充的医疗信息的类型，从而医院终端无需在每次补充时发送全部的医疗信息，以减少补充医疗信息的数据量，且与患者之间的对应性好，有利于快速准确地处理问题。当结算发生错误，但并不需要补充医疗信息时，直接根据已有的保险信息和医疗信息进行结算，以改正结算中的错误。In the present embodiment, after the settlement, the settlement result is verified to further improve the reliability of the settlement and avoid the occurrence of errors and omissions. When the settlement is correct, the payment is normal; when the settlement is wrong, and the original medical information is insufficient, the hospital terminal sends the supplementary medical information according to the supplementary signal by receiving the supplementary signal to the hospital terminal, and receives the supplementary medical information without Wait for the next centralized transfer of data to improve the efficiency of re-settlement. The supplemental signal may include a specific type of medical information that needs to be supplemented, so that the hospital terminal does not need to send all the medical information at each supplement to reduce the amount of data supplemented with the medical information, and the correspondence with the patient is good. It is good for dealing with problems quickly and accurately. When there is an error in the settlement, but it is not necessary to supplement the medical information, the settlement is directly based on the existing insurance information and medical information to correct the error in the settlement.
本申请还提出一种保险终端，如图8所示，保险终端包括存储器110、处理器120及存储在存储器110上并可在处理器120上运行的医保结算程序，所述医保结算程序被所述处理器120执行时实现如上所述的医保结算方法的步骤。其中，在所述处理器120上运行的医保结算程序被执行时所实现的方法可参照本申请医保结算方法的各个实施例，在此不再赘述，The present application also provides an insurance terminal. As shown in FIG. 8, the insurance terminal includes a memory 110, a processor 120, and a medical insurance settlement program stored on the memory 110 and operable on the processor 120. The medical insurance settlement program is The steps of implementing the medical insurance settlement method as described above when the processor 120 is executed. The method implemented when the medical insurance settlement program running on the processor 120 is executed may refer to various embodiments of the medical insurance settlement method of the present application, and details are not described herein again.
保险终端中的处理器120可以是CPU等，还可以包括网络接口130，用户接口140，通信总线150。The processor 120 in the insurance terminal may be a CPU or the like, and may further include a network interface 130, a user interface 140, and a communication bus 150.
作为一种计算机存储介质的存储器110中可以包括操作系统、网络通信模块、用户接口模块以及医保结算程序。网络接口130主要用于连接后台服务器，与后台服务器进行数据通信；用户接口140主要用于连接客户端（用户端），与客户端进行数据通信。An operating system, a network communication module, a user interface module, and a medical insurance settlement program may be included in the memory 110 as a computer storage medium. The network interface 130 is mainly used to connect to the background server for data communication with the background server. The user interface 140 is mainly used for connecting the client (user end) to perform data communication with the client.
本申请还提出一种医保结算系统，如图9所示，医保结算系统包括医院终端200、保险终端100、设于医院终端200和保险终端100之间的信号传输通道300、存储器400、处理器500及存储在存储器400上并可在处理器500上运行的医保结算程序。其中，存储器400和处理器500可设于保险终端200内部，所述医保结算程序被所述处理器500执行时实现如上所述的医保结算方法的步骤。其中，在所述处理器500上运行的医保结算程序被执行时所实现的方法可参照本申请医保结算方法的各个实施例，在此不再赘述。The present application also proposes a medical insurance settlement system. As shown in FIG. 9, the medical insurance settlement system includes a hospital terminal 200, an insurance terminal 100, a signal transmission channel 300 disposed between the hospital terminal 200 and the insurance terminal 100, a memory 400, and a processor. 500 and a medical insurance settlement program stored on the memory 400 and operable on the processor 500. The memory 400 and the processor 500 may be disposed inside the insurance terminal 200, and the medical insurance settlement program is executed by the processor 500 to implement the steps of the medical insurance settlement method as described above. For the method implemented when the medical insurance settlement program running on the processor 500 is executed, refer to various embodiments of the medical insurance settlement method of the present application, and details are not described herein again.
此外，本申请实施例还提出一种计算机可读存储介质，计算机可读存储介质上存储有医保结算程序，医保结算程序被处理器执行时实现如上所述的医保结算方法的步骤。其中，在处理器上运行的医保结算方法被执行时实现的方法可参照本申请医保结算程序的各个实施例。在此不再赘述。In addition, the embodiment of the present application further provides a computer readable storage medium, where the medical insurance settlement program is stored, and the medical insurance settlement program is executed by the processor to implement the steps of the medical insurance settlement method as described above. The method implemented when the medical insurance settlement method running on the processor is executed may refer to various embodiments of the medical insurance settlement program of the present application. I will not repeat them here.
此外，本申请实施例还提出一种保险终端，所述保险终端包括：获取模块，用于获取患者的保险信息；比对模块，用于比对所述保险信息和预设的结算条件；接收模块，用于当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；结算模块，用于根据所述保险信息和所述医疗信息结算。In addition, the embodiment of the present application further provides an insurance terminal, where the insurance terminal includes: an acquisition module, configured to acquire insurance information of the patient; a comparison module, configured to compare the insurance information with a preset settlement condition; and receive And a module, configured to receive medical information of the patient in real time when the insurance information satisfies the settlement condition; and a settlement module, configured to settle according to the insurance information and the medical information.
进一步的，所述获取模块包括：第一接收单元，用于接收来自医院终端的患者的身份信息；查找单元，用于在预存数据中查找所述身份信息；读取单元，用于当查找到所述身份信息时，读取所述预存数据中与所述身份信息对应的保险信息；信息生成单元，用于当未查找到所述身份信息时，生成未参保信息作为对应的保险信息。Further, the acquiring module includes: a first receiving unit, configured to receive identity information of a patient from the hospital terminal; a searching unit, configured to search the identity information in the pre-stored data; and a reading unit, configured to find In the case of the identity information, the insurance information corresponding to the identity information in the pre-stored data is read; the information generating unit is configured to generate the uninsured information as the corresponding insurance information when the identity information is not found.
进一步的，所述接收模块包括：信号生成单元，用于当所述保险信息满足所述结算条件时，生成授权信号；发送单元，用于发送所述授权信号至医院终端；第二接收单元，用于接收所述医院终端根据所述授权信号发送的医疗信息；其中，所述医疗信息由所述医院终端根据所述授权信号进行标准化处理，以使所述医疗信息的内容和/或格式符合所述保险终端的预设规则。Further, the receiving module includes: a signal generating unit, configured to generate an authorization signal when the insurance information satisfies the settlement condition; a sending unit, configured to send the authorization signal to a hospital terminal; and a second receiving unit, Receiving medical information transmitted by the hospital terminal according to the authorization signal; wherein the medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information is consistent The preset rule of the insurance terminal.
进一步的，所述接收模块还包括：验证单元，用于验证接收到的所述医疗信息是否完整且正确；所述信号生成单元还用于当接收到的所述医疗信息完整且正确时，生成确认信号；所述发送单元还用于发送所述确认信号至所述医院终端；所述信号生成单元还用于当接收到的所述医疗信息不完整或不正确时，生成重发信号；所述发送单元还用于发送所述重发信号至所述医院终端；所述第二接收单元还用于接收所述医院终端根据所述重发信号重新发送的所述医疗信息。Further, the receiving module further includes: a verification unit, configured to verify whether the received medical information is complete and correct; and the signal generating unit is further configured to: when the received medical information is complete and correct, generate a confirmation signal; the sending unit is further configured to send the confirmation signal to the hospital terminal; the signal generating unit is further configured to generate a retransmission signal when the received medical information is incomplete or incorrect; The transmitting unit is further configured to send the retransmission signal to the hospital terminal; the second receiving unit is further configured to receive the medical information that is retransmitted by the hospital terminal according to the retransmission signal.
进一步的，所述结算模块包括：分类单元，用于对在第一预设时段内接收到的所述医疗信息分类；立案单元，用于根据所述医疗信息的类别，设立保险案件；结算单元，用于针对所述保险案件结算。Further, the settlement module includes: a classification unit, configured to classify the medical information received in the first preset time period; and a filing unit configured to set an insurance case according to the type of the medical information; Used to settle the insurance case.
进一步的，所述医疗信息的类别包括门诊信息和住院信息；所述立案单元包括：门诊立案单元，用于当所述医疗信息为门诊信息时，汇总第二预设时段内同一患者的所述保险信息和所述门诊信息，设立门诊案件；住院立案单元，用于当所述医疗信息为住院信息，且所述住院信息包括住院小结时，汇总第三预设时段内同一患者的所述保险信息和所述住院信息，设立住院案件。Further, the category of the medical information includes the outpatient information and the hospitalization information; the filing unit includes: an outpatient filing unit, configured to summarize the same patient in the second preset time period when the medical information is the outpatient information The insurance information and the outpatient information, setting up an outpatient case; the inpatient filing unit is configured to summarize the insurance of the same patient in the third preset time period when the medical information is hospitalization information, and the hospitalization information includes a hospitalization summary Information and the hospitalization information, and establish an inpatient case.
进一步的，所述保险终端还包括：验证模块，用于验证结算是否正确；赔付模块，用于当结算正确时，按照结算结果赔付；判断模块，用于当结算不正确时，判断是否需要补充患者的医疗信息：补充模块，用于若需要补充患者的医疗信息，生成补充信号并发送所述补充信号至医院终端；所述接收模块还用于接收所述医院终端根据所述补充信号生成的补充医疗信息；所述结算模块还用于根据所述保险信息、所述医疗信息和所述补充医疗信息重新结算；所述结算模块还用于若不需要补充患者的医疗信息，根据所述保险信息和所述医疗信息重新结算。Further, the insurance terminal further includes: a verification module, configured to verify whether the settlement is correct; a compensation module, configured to pay according to the settlement result when the settlement is correct; and a judgment module, configured to determine whether the supplementary is needed when the settlement is incorrect The medical information of the patient: a supplemental module, configured to generate a supplemental signal and send the supplemental signal to the hospital terminal if the medical information of the patient needs to be supplemented; the receiving module is further configured to receive the generated by the hospital terminal according to the supplementary signal Supplementing medical information; the settlement module is further configured to re-settlement according to the insurance information, the medical information, and the supplementary medical information; the settlement module is further configured to: if the medical information of the patient is not needed to be supplemented, according to the insurance The information and the medical information are re-cleared.
需要说明的是，在本文中，术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含，从而使得包括一系列要素的过程、方法、物品或者系统不仅包括那些要素，而且还包括没有明确列出的其他要素，或者是还包括为这种过程、方法、物品或者系统所固有的要素。在没有更多限制的情况下，由语句“包括一个……”限定的要素，并不排除在包括该要素的过程、方法、物品或者系统中还存在另外的相同要素。It is to be understood that the term "comprises", "comprising", or any other variants thereof, is intended to encompass a non-exclusive inclusion, such that a process, method, article, or It also includes other elements that are not explicitly listed, or elements that are inherent to such a process, method, item, or system. An element defined by the phrase "comprising a ..." does not exclude the presence of additional equivalent elements in a process, method, article, or system that includes the element, without further limitation.
上述本申请实施例序号仅仅为了描述，不代表实施例的优劣。The serial numbers of the embodiments of the present application are merely for the description, and do not represent the advantages and disadvantages of the embodiments.
以上仅为本申请的优选实施例，并非因此限制本申请的专利范围，凡是利用本申请说明书及附图内容所作的等效结构或等效流程变换，或直接或间接运用在其他相关的技术领域，均同理包括在本申请的专利保护范围内。The above is only a preferred embodiment of the present application, and is not intended to limit the scope of the patent application, and the equivalent structure or equivalent process transformations made by the specification and the drawings of the present application, or directly or indirectly applied to other related technical fields. The same is included in the scope of patent protection of this application.

Claims (35)

  1. 一种医保结算方法，用于保险终端，其特征在于，所述医保结算方法包括以下步骤： A medical insurance settlement method for an insurance terminal, characterized in that the medical insurance settlement method comprises the following steps:
    获取患者的保险信息；Obtain the patient's insurance information;
    比对所述保险信息和预设的结算条件；Comparing the insurance information with preset settlement conditions;
    当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；Receiving medical information of the patient in real time when the insurance information satisfies the settlement condition;
    根据所述保险信息和所述医疗信息结算。The settlement is based on the insurance information and the medical information.
  2. 如权利要求1所述的医保结算方法，其特征在于，所述获取患者的保险信息的步骤包括：The medical insurance settlement method according to claim 1, wherein the step of acquiring the insurance information of the patient comprises:
    接收来自医院终端的患者的身份信息；Receiving identity information of a patient from a hospital terminal;
    在预存数据中查找所述身份信息；Finding the identity information in the pre-stored data;
    当查找到所述身份信息时，读取所述预存数据中与所述身份信息对应的保险信息；When the identity information is found, the insurance information corresponding to the identity information in the pre-stored data is read;
    当未查找到所述身份信息时，生成未参保信息作为对应的保险信息。When the identity information is not found, the uninsured information is generated as the corresponding insurance information.
  3. 如权利要求1所述的医保结算方法，其特征在于，当所述保险信息满足所述结算条件时，实时接收患者的医疗信息的步骤包括：The medical insurance settlement method according to claim 1, wherein when the insurance information satisfies the settlement condition, the step of receiving the medical information of the patient in real time comprises:
    当所述保险信息满足所述结算条件时，生成授权信号；Generating an authorization signal when the insurance information satisfies the settlement condition;
    发送所述授权信号至医院终端；Sending the authorization signal to the hospital terminal;
    接收所述医院终端根据所述授权信号发送的医疗信息；Receiving medical information sent by the hospital terminal according to the authorization signal;
    其中，所述医疗信息由所述医院终端根据所述授权信号进行标准化处理，以使所述医疗信息的内容和/或格式符合所述保险终端的预设规则。The medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information conforms to a preset rule of the insurance terminal.
  4. 如权利要求3所述的医保结算方法，其特征在于，在接收所述医院终端根据所述授权信号发送的医疗信息的步骤之后，所述当所述保险信息满足所述结算条件时，实时接收患者的医疗信息的步骤还包括：The medical insurance settlement method according to claim 3, wherein, after receiving the medical information transmitted by the hospital terminal according to the authorization signal, the real-time receiving is performed when the insurance information satisfies the settlement condition The steps of the patient's medical information also include:
    验证接收到的所述医疗信息是否完整且正确；Verifying that the received medical information is complete and correct;
    当接收到的所述医疗信息完整且正确时，生成确认信号并发送至所述医院终端；When the received medical information is complete and correct, an acknowledgement signal is generated and sent to the hospital terminal;
    当接收到的所述医疗信息不完整或不正确时，生成重发信号并发送至所述医院终端；Generating a retransmission signal and transmitting to the hospital terminal when the received medical information is incomplete or incorrect;
    接收所述医院终端根据所述重发信号重新发送的所述医疗信息。Receiving the medical information resent by the hospital terminal according to the retransmission signal.
  5. 如权利要求1所述的医保结算方法，其特征在于，所述根据所述保险信息和所述医疗信息结算的步骤包括：The medical insurance settlement method according to claim 1, wherein said step of settlement based on said insurance information and said medical information comprises:
    对在第一预设时段内接收到的所述医疗信息分类；Classifying the medical information received within the first preset time period;
    根据所述医疗信息的类别，设立保险案件；Establish an insurance case based on the type of medical information;
    针对所述保险案件结算。Settle for the insurance case.
  6. 如权利要求5所述的医保结算方法，其特征在于，所述医疗信息的类别包括门诊信息和住院信息；The medical insurance settlement method according to claim 5, wherein the category of the medical information includes outpatient information and hospitalization information;
    根据所述医疗信息的类别，设立保险案件的步骤包括：According to the category of the medical information, the steps of setting up an insurance case include:
    当所述医疗信息为门诊信息时，汇总第二预设时段内同一患者的所述保险信息和所述门诊信息，设立门诊案件；When the medical information is outpatient information, summarizing the insurance information and the outpatient information of the same patient in the second preset time period, and setting up an outpatient case;
    当所述医疗信息为住院信息，且所述住院信息包括住院小结时，汇总第三预设时段内同一患者的所述保险信息和所述住院信息，设立住院案件。When the medical information is hospitalization information, and the hospitalization information includes a hospitalization summary, the insurance information and the hospitalization information of the same patient in a third preset time period are summarized, and an inpatient case is established.
  7. 如权利要求1所述的医保结算方法，其特征在于，在所述根据所述保险信息和所述医疗信息结算的步骤之后，所述医保结算方法还包括以下步骤：The medical insurance settlement method according to claim 1, wherein after the step of settlement based on the insurance information and the medical information, the medical insurance settlement method further comprises the following steps:
    验证结算是否正确；Verify that the settlement is correct;
    当结算正确时，按照结算结果赔付；When the settlement is correct, pay according to the settlement result;
    当结算不正确时，判断是否需要补充患者的医疗信息：When the settlement is not correct, determine whether it is necessary to supplement the patient's medical information:
    若是，生成补充信号并发送所述补充信号至医院终端；If yes, generating a supplemental signal and transmitting the supplemental signal to the hospital terminal;
    接收所述医院终端根据所述补充信号生成的补充医疗信息；Receiving supplementary medical information generated by the hospital terminal according to the supplemental signal;
    根据所述保险信息、所述医疗信息和所述补充医疗信息重新结算；Re-settling according to the insurance information, the medical information, and the supplementary medical information;
    若否，根据所述保险信息和所述医疗信息重新结算。If not, re-settlement based on the insurance information and the medical information.
  8. 一种保险终端，其特征在于，所述保险终端包括存储器、处理器及存储在所述存储器上并可在所述处理器上运行的医保结算程序，所述医保结算程序被所述处理器执行时实现如下步骤：An insurance terminal, comprising: a memory, a processor, and a medical insurance settlement program stored on the memory and operable on the processor, the medical insurance settlement program being executed by the processor The following steps are implemented:
    获取患者的保险信息；Obtain the patient's insurance information;
    比对所述保险信息和预设的结算条件；Comparing the insurance information with preset settlement conditions;
    当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；Receiving medical information of the patient in real time when the insurance information satisfies the settlement condition;
    根据所述保险信息和所述医疗信息结算。The settlement is based on the insurance information and the medical information.
  9. 如权利要求8所述的保险终端，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The insurance terminal according to claim 8, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    接收来自医院终端的患者的身份信息；Receiving identity information of a patient from a hospital terminal;
    在预存数据中查找所述身份信息；Finding the identity information in the pre-stored data;
    当查找到所述身份信息时，读取所述预存数据中与所述身份信息对应的保险信息；When the identity information is found, the insurance information corresponding to the identity information in the pre-stored data is read;
    当未查找到所述身份信息时，生成未参保信息作为对应的保险信息。When the identity information is not found, the uninsured information is generated as the corresponding insurance information.
  10. 如权利要求8所述的保险终端，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The insurance terminal according to claim 8, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    当所述保险信息满足所述结算条件时，生成授权信号；Generating an authorization signal when the insurance information satisfies the settlement condition;
    发送所述授权信号至医院终端；Sending the authorization signal to the hospital terminal;
    接收所述医院终端根据所述授权信号发送的医疗信息；Receiving medical information sent by the hospital terminal according to the authorization signal;
    其中，所述医疗信息由所述医院终端根据所述授权信号进行标准化处理，以使所述医疗信息的内容和/或格式符合所述保险终端的预设规则。The medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information conforms to a preset rule of the insurance terminal.
  11. 如权利要求10所述的保险终端，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The insurance terminal according to claim 10, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    验证接收到的所述医疗信息是否完整且正确；Verifying that the received medical information is complete and correct;
    当接收到的所述医疗信息完整且正确时，生成确认信号并发送至所述医院终端；When the received medical information is complete and correct, an acknowledgement signal is generated and sent to the hospital terminal;
    当接收到的所述医疗信息不完整或不正确时，生成重发信号并发送至所述医院终端；Generating a retransmission signal and transmitting to the hospital terminal when the received medical information is incomplete or incorrect;
    接收所述医院终端根据所述重发信号重新发送的所述医疗信息。Receiving the medical information resent by the hospital terminal according to the retransmission signal.
  12. 如权利要求8所述的保险终端，其特征在于，还实现如下步骤：The insurance terminal according to claim 8, wherein the following steps are further implemented:
    对在第一预设时段内接收到的所述医疗信息分类；Classifying the medical information received within the first preset time period;
    根据所述医疗信息的类别，设立保险案件；Establish an insurance case based on the type of medical information;
    针对所述保险案件结算。Settle for the insurance case.
  13. 如权利要求12所述的保险终端，其特征在于，所述医疗信息的类别包括门诊信息和住院信息；The insurance terminal according to claim 12, wherein the category of the medical information comprises outpatient information and hospitalization information;
    所述医保结算程序被所述处理器执行时，还实现如下步骤：When the medical insurance settlement program is executed by the processor, the following steps are also implemented:
    当所述医疗信息为门诊信息时，汇总第二预设时段内同一患者的所述保险信息和所述门诊信息，设立门诊案件；When the medical information is outpatient information, summarizing the insurance information and the outpatient information of the same patient in the second preset time period, and setting up an outpatient case;
    当所述医疗信息为住院信息，且所述住院信息包括住院小结时，汇总第三预设时段内同一患者的所述保险信息和所述住院信息，设立住院案件。When the medical information is hospitalization information, and the hospitalization information includes a hospitalization summary, the insurance information and the hospitalization information of the same patient in a third preset time period are summarized, and an inpatient case is established.
  14. 如权利要求8所述的保险终端，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The insurance terminal according to claim 8, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    验证结算是否正确；Verify that the settlement is correct;
    当结算正确时，按照结算结果赔付；When the settlement is correct, pay according to the settlement result;
    当结算不正确时，判断是否需要补充患者的医疗信息：When the settlement is not correct, determine whether it is necessary to supplement the patient's medical information:
    若是，生成补充信号并发送所述补充信号至医院终端；If yes, generating a supplemental signal and transmitting the supplemental signal to the hospital terminal;
    接收所述医院终端根据所述补充信号生成的补充医疗信息；Receiving supplementary medical information generated by the hospital terminal according to the supplemental signal;
    根据所述保险信息、所述医疗信息和所述补充医疗信息重新结算；Re-settling according to the insurance information, the medical information, and the supplementary medical information;
    若否，根据所述保险信息和所述医疗信息重新结算。If not, re-settlement based on the insurance information and the medical information.
  15. 一种保险终端，其特征在于，所述保险终端包括：An insurance terminal, characterized in that the insurance terminal comprises:
    获取模块，用于获取患者的保险信息；An acquisition module for obtaining insurance information of a patient;
    比对模块，用于比对所述保险信息和预设的结算条件；a comparison module, configured to compare the insurance information with a preset settlement condition;
    接收模块，用于当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；a receiving module, configured to receive medical information of the patient in real time when the insurance information satisfies the settlement condition;
    结算模块，用于根据所述保险信息和所述医疗信息结算。a settlement module, configured to settle according to the insurance information and the medical information.
  16. 如权利要求15所述的保险终端，其特征在于，所述获取模块包括：The insurance terminal according to claim 15, wherein the obtaining module comprises:
    第一接收单元，用于接收来自医院终端的患者的身份信息；a first receiving unit, configured to receive identity information of a patient from the hospital terminal;
    查找单元，用于在预存数据中查找所述身份信息；a searching unit, configured to search for the identity information in the pre-stored data;
    读取单元，用于当查找到所述身份信息时，读取所述预存数据中与所述身份信息对应的保险信息；a reading unit, configured to: read the insurance information corresponding to the identity information in the pre-stored data when the identity information is found;
    信息生成单元，用于当未查找到所述身份信息时，生成未参保信息作为对应的保险信息。The information generating unit is configured to generate uninsured information as the corresponding insurance information when the identity information is not found.
  17. 如权利要求15所述的保险终端，其特征在于，所述接收模块包括：The insurance terminal according to claim 15, wherein the receiving module comprises:
    信号生成单元，用于当所述保险信息满足所述结算条件时，生成授权信号；a signal generating unit, configured to generate an authorization signal when the insurance information satisfies the settlement condition;
    发送单元，用于发送所述授权信号至医院终端；a sending unit, configured to send the authorization signal to a hospital terminal;
    第二接收单元，用于接收所述医院终端根据所述授权信号发送的医疗信息；a second receiving unit, configured to receive medical information sent by the hospital terminal according to the authorization signal;
    其中，所述医疗信息由所述医院终端根据所述授权信号进行标准化处理，以使所述医疗信息的内容和/或格式符合所述保险终端的预设规则。The medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information conforms to a preset rule of the insurance terminal.
  18. 如权利要求17所述的保险终端，其特征在于，所述接收模块还包括：The insurance terminal according to claim 17, wherein the receiving module further comprises:
    验证单元，用于验证接收到的所述医疗信息是否完整且正确；a verification unit, configured to verify whether the received medical information is complete and correct;
    所述信号生成单元还用于当接收到的所述医疗信息完整且正确时，生成确认信号；The signal generating unit is further configured to generate an acknowledgement signal when the received medical information is complete and correct;
    所述发送单元还用于发送所述确认信号至所述医院终端；The sending unit is further configured to send the confirmation signal to the hospital terminal;
    所述信号生成单元还用于当接收到的所述医疗信息不完整或不正确时，生成重发信号；The signal generating unit is further configured to generate a retransmission signal when the received medical information is incomplete or incorrect;
    所述发送单元还用于发送所述重发信号至所述医院终端；The sending unit is further configured to send the retransmission signal to the hospital terminal;
    所述第二接收单元还用于接收所述医院终端根据所述重发信号重新发送的所述医疗信息。The second receiving unit is further configured to receive the medical information that is resent by the hospital terminal according to the retransmission signal.
  19. 如权利要求15所述的保险终端，其特征在于，所述结算模块包括：The insurance terminal according to claim 15, wherein the settlement module comprises:
    分类单元，用于对在第一预设时段内接收到的所述医疗信息分类；a classification unit, configured to classify the medical information received in the first preset time period;
    立案单元，用于根据所述医疗信息的类别，设立保险案件；a filing unit for setting up an insurance case according to the type of the medical information;
    结算单元，用于针对所述保险案件结算。A settlement unit for settlement of the insurance case.
  20. 如权利要求19所述的保险终端，其特征在于，所述医疗信息的类别包括门诊信息和住院信息；The insurance terminal according to claim 19, wherein said category of medical information comprises outpatient information and hospitalization information;
    所述立案单元包括：The filing unit includes:
    门诊立案单元，用于当所述医疗信息为门诊信息时，汇总第二预设时段内同一患者的所述保险信息和所述门诊信息，设立门诊案件；The outpatient filing unit is configured to: when the medical information is outpatient information, summarize the insurance information and the outpatient information of the same patient in the second preset time period, and establish an outpatient case;
    住院立案单元，用于当所述医疗信息为住院信息，且所述住院信息包括住院小结时，汇总第三预设时段内同一患者的所述保险信息和所述住院信息，设立住院案件。The hospitalization filing unit is configured to: when the medical information is hospitalization information, and the hospitalization information includes a hospitalization summary, summarizing the insurance information and the hospitalization information of the same patient in a third preset time period, and setting up an inpatient case.
  21. 如权利要求15所述的保险终端，其特征在于，所述保险终端还包括：The insurance terminal according to claim 15, wherein the insurance terminal further comprises:
    验证模块，用于验证结算是否正确；a verification module for verifying that the settlement is correct;
    赔付模块，用于当结算正确时，按照结算结果赔付；The payment module is used to pay according to the settlement result when the settlement is correct;
    判断模块，用于当结算不正确时，判断是否需要补充患者的医疗信息：The judging module is configured to determine whether it is necessary to supplement the patient's medical information when the settlement is incorrect:
    补充模块，用于若需要补充患者的医疗信息，生成补充信号并发送所述补充信号至医院终端；a supplemental module, configured to generate a supplemental signal and send the supplemental signal to the hospital terminal if the medical information of the patient needs to be supplemented;
    所述接收模块还用于接收所述医院终端根据所述补充信号生成的补充医疗信息；The receiving module is further configured to receive supplementary medical information generated by the hospital terminal according to the supplemental signal;
    所述结算模块还用于根据所述保险信息、所述医疗信息和所述补充医疗信息重新结算；The settlement module is further configured to re-settlement according to the insurance information, the medical information, and the supplementary medical information;
    所述结算模块还用于若不需要补充患者的医疗信息，根据所述保险信息和所述医疗信息重新结算。The settlement module is further configured to re-setttle according to the insurance information and the medical information if the medical information of the patient is not needed to be supplemented.
  22. 一种医保结算系统，其特征在于，所述医保结算系统包括医院终端、保险终端、设于所述医院终端和所述保险终端之间的信号传输通道、存储器、处理器及存储在所述存储器上并可在所述处理器上运行的医保结算程序，所述医保结算程序被所述处理器执行时实现如下步骤：A medical insurance settlement system, characterized in that the medical insurance settlement system comprises a hospital terminal, an insurance terminal, a signal transmission channel provided between the hospital terminal and the insurance terminal, a memory, a processor, and a memory stored in the memory A medical insurance settlement program operable on the processor, the medical insurance settlement program being executed by the processor to implement the following steps:
    获取患者的保险信息；Obtain the patient's insurance information;
    比对所述保险信息和预设的结算条件；Comparing the insurance information with preset settlement conditions;
    当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；Receiving medical information of the patient in real time when the insurance information satisfies the settlement condition;
    根据所述保险信息和所述医疗信息结算。The settlement is based on the insurance information and the medical information.
  23. 如权利要求22所述的医保结算系统，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The medical insurance settlement system according to claim 22, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    接收来自医院终端的患者的身份信息；Receiving identity information of a patient from a hospital terminal;
    在预存数据中查找所述身份信息；Finding the identity information in the pre-stored data;
    当查找到所述身份信息时，读取所述预存数据中与所述身份信息对应的保险信息；When the identity information is found, the insurance information corresponding to the identity information in the pre-stored data is read;
    当未查找到所述身份信息时，生成未参保信息作为对应的保险信息。When the identity information is not found, the uninsured information is generated as the corresponding insurance information.
  24. 如权利要求22所述的医保结算系统，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The medical insurance settlement system according to claim 22, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    当所述保险信息满足所述结算条件时，生成授权信号；Generating an authorization signal when the insurance information satisfies the settlement condition;
    发送所述授权信号至医院终端；Sending the authorization signal to the hospital terminal;
    接收所述医院终端根据所述授权信号发送的医疗信息；Receiving medical information sent by the hospital terminal according to the authorization signal;
    其中，所述医疗信息由所述医院终端根据所述授权信号进行标准化处理，以使所述医疗信息的内容和/或格式符合所述保险终端的预设规则。The medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information conforms to a preset rule of the insurance terminal.
  25. 如权利要求24所述的医保结算系统，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The medical insurance settlement system according to claim 24, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    验证接收到的所述医疗信息是否完整且正确；Verifying that the received medical information is complete and correct;
    当接收到的所述医疗信息完整且正确时，生成确认信号并发送至所述医院终端；When the received medical information is complete and correct, an acknowledgement signal is generated and sent to the hospital terminal;
    当接收到的所述医疗信息不完整或不正确时，生成重发信号并发送至所述医院终端；Generating a retransmission signal and transmitting to the hospital terminal when the received medical information is incomplete or incorrect;
    接收所述医院终端根据所述重发信号重新发送的所述医疗信息。Receiving the medical information resent by the hospital terminal according to the retransmission signal.
  26. 如权利要求22所述的医保结算系统，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The medical insurance settlement system according to claim 22, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    对在第一预设时段内接收到的所述医疗信息分类；Classifying the medical information received within the first preset time period;
    根据所述医疗信息的类别，设立保险案件；Establish an insurance case based on the type of medical information;
    针对所述保险案件结算。Settle for the insurance case.
  27. 如权利要求26所述的医保结算系统，其特征在于，所述医疗信息的类别包括门诊信息和住院信息；A medical insurance settlement system according to claim 26, wherein said medical information category includes outpatient information and hospitalization information;
    所述医保结算程序被所述处理器执行时，还实现如下步骤：When the medical insurance settlement program is executed by the processor, the following steps are also implemented:
    当所述医疗信息为门诊信息时，汇总第二预设时段内同一患者的所述保险信息和所述门诊信息，设立门诊案件；When the medical information is outpatient information, summarizing the insurance information and the outpatient information of the same patient in the second preset time period, and setting up an outpatient case;
    当所述医疗信息为住院信息，且所述住院信息包括住院小结时，汇总第三预设时段内同一患者的所述保险信息和所述住院信息，设立住院案件。When the medical information is hospitalization information, and the hospitalization information includes a hospitalization summary, the insurance information and the hospitalization information of the same patient in a third preset time period are summarized, and an inpatient case is established.
  28. 如权利要求22所述的医保结算系统，其特征在于，所述医保结算程序被所述处理器执行时，还实现如下步骤：The medical insurance settlement system according to claim 22, wherein when said medical insurance settlement program is executed by said processor, the following steps are further implemented:
    验证结算是否正确；Verify that the settlement is correct;
    当结算正确时，按照结算结果赔付；When the settlement is correct, pay according to the settlement result;
    当结算不正确时，判断是否需要补充患者的医疗信息：When the settlement is not correct, determine whether it is necessary to supplement the patient's medical information:
    若是，生成补充信号并发送所述补充信号至医院终端；If yes, generating a supplemental signal and transmitting the supplemental signal to the hospital terminal;
    接收所述医院终端根据所述补充信号生成的补充医疗信息；Receiving supplementary medical information generated by the hospital terminal according to the supplemental signal;
    根据所述保险信息、所述医疗信息和所述补充医疗信息重新结算；Re-settling according to the insurance information, the medical information, and the supplementary medical information;
    若否，根据所述保险信息和所述医疗信息重新结算。If not, re-settlement based on the insurance information and the medical information.
  29. 一种计算机可读存储介质，其特征在于，所述计算机可读存储介质上存储有医保结算程序，所述医保结算程序被处理器执行时实现如下步骤：A computer readable storage medium, wherein the computer readable storage medium stores a medical insurance settlement program, and when the medical insurance settlement program is executed by the processor, the following steps are implemented:
    获取患者的保险信息；Obtain the patient's insurance information;
    比对所述保险信息和预设的结算条件；Comparing the insurance information with preset settlement conditions;
    当所述保险信息满足所述结算条件时，实时接收患者的医疗信息；Receiving medical information of the patient in real time when the insurance information satisfies the settlement condition;
    根据所述保险信息和所述医疗信息结算。The settlement is based on the insurance information and the medical information.
  30. 如权利要求29所述的计算机可读存储介质，其特征在于，所述医保结算程序被处理器执行时，还实现如下步骤：The computer readable storage medium of claim 29, wherein when the medical insurance settlement program is executed by the processor, the following steps are further implemented:
    接收来自医院终端的患者的身份信息；Receiving identity information of a patient from a hospital terminal;
    在预存数据中查找所述身份信息；Finding the identity information in the pre-stored data;
    当查找到所述身份信息时，读取所述预存数据中与所述身份信息对应的保险信息；When the identity information is found, the insurance information corresponding to the identity information in the pre-stored data is read;
    当未查找到所述身份信息时，生成未参保信息作为对应的保险信息。When the identity information is not found, the uninsured information is generated as the corresponding insurance information.
  31. 如权利要求29所述的计算机可读存储介质，其特征在于，所述医保结算程序被处理器执行时，还实现如下步骤：The computer readable storage medium of claim 29, wherein when the medical insurance settlement program is executed by the processor, the following steps are further implemented:
    当所述保险信息满足所述结算条件时，生成授权信号；Generating an authorization signal when the insurance information satisfies the settlement condition;
    发送所述授权信号至医院终端；Sending the authorization signal to the hospital terminal;
    接收所述医院终端根据所述授权信号发送的医疗信息；Receiving medical information sent by the hospital terminal according to the authorization signal;
    其中，所述医疗信息由所述医院终端根据所述授权信号进行标准化处理，以使所述医疗信息的内容和/或格式符合所述保险终端的预设规则。The medical information is standardized by the hospital terminal according to the authorization signal, so that the content and/or format of the medical information conforms to a preset rule of the insurance terminal.
  32. 如权利要求31所述的计算机可读存储介质，其特征在于，所述医保结算程序被处理器执行时，还实现如下步骤：The computer readable storage medium of claim 31, wherein when the medical insurance settlement program is executed by the processor, the following steps are further implemented:
    验证接收到的所述医疗信息是否完整且正确；Verifying that the received medical information is complete and correct;
    当接收到的所述医疗信息完整且正确时，生成确认信号并发送至所述医院终端；When the received medical information is complete and correct, an acknowledgement signal is generated and sent to the hospital terminal;
    当接收到的所述医疗信息不完整或不正确时，生成重发信号并发送至所述医院终端；Generating a retransmission signal and transmitting to the hospital terminal when the received medical information is incomplete or incorrect;
    接收所述医院终端根据所述重发信号重新发送的所述医疗信息。Receiving the medical information resent by the hospital terminal according to the retransmission signal.
  33. 如权利要求29所述的计算机可读存储介质，其特征在于，所述医保结算程序被处理器执行时，还实现如下步骤：The computer readable storage medium of claim 29, wherein when the medical insurance settlement program is executed by the processor, the following steps are further implemented:
    对在第一预设时段内接收到的所述医疗信息分类；Classifying the medical information received within the first preset time period;
    根据所述医疗信息的类别，设立保险案件；Establish an insurance case based on the type of medical information;
    针对所述保险案件结算。Settle for the insurance case.
  34. 如权利要求33所述的计算机可读存储介质，其特征在于，所述医疗信息的类别包括门诊信息和住院信息；The computer readable storage medium of claim 33, wherein the category of medical information comprises outpatient information and hospitalization information;
    所述医保结算程序被所述处理器执行时，还实现如下步骤：When the medical insurance settlement program is executed by the processor, the following steps are also implemented:
    当所述医疗信息为门诊信息时，汇总第二预设时段内同一患者的所述保险信息和所述门诊信息，设立门诊案件；When the medical information is outpatient information, summarizing the insurance information and the outpatient information of the same patient in the second preset time period, and setting up an outpatient case;
    当所述医疗信息为住院信息，且所述住院信息包括住院小结时，汇总第三预设时段内同一患者的所述保险信息和所述住院信息，设立住院案件。When the medical information is hospitalization information, and the hospitalization information includes a hospitalization summary, the insurance information and the hospitalization information of the same patient in a third preset time period are summarized, and an inpatient case is established.
  35. 如权利要求29所述的计算机可读存储介质，其特征在于，所述医保结算程序被处理器执行时，还实现如下步骤：The computer readable storage medium of claim 29, wherein when the medical insurance settlement program is executed by the processor, the following steps are further implemented:
    验证结算是否正确；Verify that the settlement is correct;
    当结算正确时，按照结算结果赔付；When the settlement is correct, pay according to the settlement result;
    当结算不正确时，判断是否需要补充患者的医疗信息：When the settlement is not correct, determine whether it is necessary to supplement the patient's medical information:
    若是，生成补充信号并发送所述补充信号至医院终端；If yes, generating a supplemental signal and transmitting the supplemental signal to the hospital terminal;
    接收所述医院终端根据所述补充信号生成的补充医疗信息；Receiving supplementary medical information generated by the hospital terminal according to the supplemental signal;
    根据所述保险信息、所述医疗信息和所述补充医疗信息重新结算；Re-settling according to the insurance information, the medical information, and the supplementary medical information;
    若否，根据所述保险信息和所述医疗信息重新结算。 If not, re-settlement based on the insurance information and the medical information.
PCT/CN2018/075165 2017-11-10 2018-02-02 Medical insurance settlement method and system, insurance terminal, and computer-readable storage medium WO2019091001A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201711110994.2A CN107767277A (en) 2017-11-10 2017-11-10 Medical insurance settlement method and system, insurance terminal, computer-readable recording medium
CN201711110994.2 2017-11-10

Publications (1)

Publication Number Publication Date
WO2019091001A1 true WO2019091001A1 (en) 2019-05-16

Family

ID=61273920

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2018/075165 WO2019091001A1 (en) 2017-11-10 2018-02-02 Medical insurance settlement method and system, insurance terminal, and computer-readable storage medium

Country Status (2)

Country Link
CN (1) CN107767277A (en)
WO (1) WO2019091001A1 (en)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN108961075A (en) * 2018-06-22 2018-12-07 泰康保险集团股份有限公司 Medical expense pays for processing method, device, medium and electronic equipment first
CN109215783A (en) * 2018-10-27 2019-01-15 平安医疗健康管理股份有限公司 Cerebral hemorrhage quality certification method, equipment and server based on data processing
HK1256433A2 (en) * 2019-01-21 2019-09-20 Galileo Platforms Ltd System for processing insurance transactions
CN114119259A (en) * 2021-11-22 2022-03-01 湖南和宇数字技术研究院有限公司 Business insurance processing calculation method and device, electronic equipment and storage medium

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4858121A (en) * 1986-12-12 1989-08-15 Medical Payment Systems, Incorporated Medical payment system
WO2002075627A1 (en) * 2001-02-02 2002-09-26 Seo-O Telecom Co., Ltd. System for managing medical insurance using information communication network
CN102332143A (en) * 2011-07-22 2012-01-25 大连亿创天地科技发展有限公司 Method and system for verification and claim of on-line insurance claim settlement
CN106295152A (en) * 2016-08-03 2017-01-04 合肥奇也信息科技有限公司 A kind of medical care insurance Claims Resolution management system
CN106295151A (en) * 2016-08-03 2017-01-04 合肥奇也信息科技有限公司 A kind of medical care insurance is settled a claim system online

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4858121A (en) * 1986-12-12 1989-08-15 Medical Payment Systems, Incorporated Medical payment system
WO2002075627A1 (en) * 2001-02-02 2002-09-26 Seo-O Telecom Co., Ltd. System for managing medical insurance using information communication network
CN102332143A (en) * 2011-07-22 2012-01-25 大连亿创天地科技发展有限公司 Method and system for verification and claim of on-line insurance claim settlement
CN106295152A (en) * 2016-08-03 2017-01-04 合肥奇也信息科技有限公司 A kind of medical care insurance Claims Resolution management system
CN106295151A (en) * 2016-08-03 2017-01-04 合肥奇也信息科技有限公司 A kind of medical care insurance is settled a claim system online

Also Published As

Publication number Publication date
CN107767277A (en) 2018-03-06

Similar Documents

Publication Publication Date Title
WO2019091001A1 (en) Medical insurance settlement method and system, insurance terminal, and computer-readable storage medium
US7260237B2 (en) Method and system for generating data of an application with a picture
US10210343B2 (en) Systems and methods for sharing verified identity documents
EP3284240B1 (en) Systems and methods for electronically sharing private documents using pointers
AU2016214117B2 (en) Systems and methods for generating an auditable digital certificate
US7783072B2 (en) Methods and systems for clinical trial data management
WO2019144738A1 (en) Financial service verification method, apparatus and device, and computer storage medium
US20190019184A1 (en) Systems for Generating an Auditable Digital Certificate
US7415476B2 (en) Digital file management and imaging system and method including secure file marking
WO2013004065A1 (en) Information security method and system based on image acquisition
WO2017096699A1 (en) Fingerprint recognition method and system capable of improving fingerprint recognition rate
WO2021012904A1 (en) Data updating method and related device
US10277402B2 (en) Digitally signing a document
WO2020147384A1 (en) Blockchain-based safe transaction method, device and apparatus, and storage medium
US20140372766A1 (en) Automated document notarization
WO2017012197A1 (en) Network hospital-based examination institution unified matching method and network hospital platform
US10817598B2 (en) Enhanced biometric data and systems for processing events using enhanced biometric data
TWM591672U (en) Transaction Management System
TWI709100B (en) Transaction management system
TW201911191A (en) Image-recognition assisted claim system and method including an image capturing module, a recognition unit, a processing unit, and a storage unit
EP4020486A1 (en) System and method for providing health status with an event ticket
US10826896B2 (en) Enhanced biometric data and systems for processing events using enhanced biometric data
WO2005042269A1 (en) Id card producing system and id card producing method
TW202147169A (en) Image signature system and image signature method

Legal Events

Date Code Title Description
NENP Non-entry into the national phase

Ref country code: DE

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: NOTING OF LOSS OF RIGHTS PURSUANT TO RULE 112(1) EPC (EPO FORM 1205 DATED 22/09/2020)

122 Ep: pct application non-entry in european phase

Ref document number: 18875998

Country of ref document: EP

Kind code of ref document: A1